Rob Lotze Email & Phone Number

Tampa, Florida

Lead a team of analysts in regional analytics that sizes enterprise-wide HBR (Health Benefit Ratio) saving opportunities.• Create the initial sizing analysis of new initiatives to determine the annual cost savings to the organization.• Partner with each department and the Health Benefit Ratio office to refine and revise the opportunity as it moves through steps L1 and L2 of the L gate process.• Set Health Plan and Line of Business specific goals for each HBR including re-forecasting as appropriate.• Once savings are approved work with the Clinical Program reporting team for build-out of dashboards for ongoing oversight and monitoring.

Tampa, Florida, United States

Managed the Utilization Management, Care Management, Health Benefit Ratio Cost savings, Long Term Support Services, and Audit and Regulatory reporting teams. • Hired to lead the Utilization Management reporting team which quickly lead to the addition of the Care Management and Long Term Support Services reporting teams of 45 associates. In addition moved the Cost Savings (HBR) reporting in house that was being developed through a contract with Accenture. • Took a new direction working directly with internal customers to provide personalized deportment reporting that provided the needed reporting to achieve and enhance our savings. • Developed a department standard of reporting that created confidence within the organization of the team’s value to each department. • Implemented an intake system that created consistency, accuracy, and timeliness in building out the reports based on having all requirements and needed metrics from the initial intake. • Implemented Tableau as the reporting platform. • Managed the audit and regulatory reporting including ODAG, NCQA, Quality, and Appeals reporting. Lead the development of new internal weekly reports that provided the business the opportunity to see the direction of performance leading to the improvement of audit scores.• Led team that created the PHS KPI report that has evolved into the “Integrated 2021 KPI Executive Dashboard” for Population Health, Medical Affairs, and CABH.

St. Petersburg, Florida

Leader and designer of an interdisciplinary reporting and analytics department. Hired and trained a department that eventually comprised over 25 analysts, consultants and managers.• Oversaw multiple reporting and analysis teams including Humana at Home, Humana Chronic Care, Special Needs Plans (SNP), Long term support services (LTSS), STARs, and Medicaid Demo’s, with impact over the entire Humana enterprise. • Managed accuracy and ongoing development and maintenance of Humana’s claims-based algorithm for member risk stratification.• Led a team of associates that received over 50 of Humana’s top employee recognition awards.• Created membership projections (cost analysis) with over 95% accuracy for six consecutive years.• Identified and implemented cost savings for 10 pilot programs, fully implementing six programs.• Successfully oversaw the development, maintenance and expansion of Humana at Home’s reporting portfolio to over 400 production reports and over 1300 ad-hoc requests, impacting over 600,000 managed members, 150,000 SNP Medicare Advantage members and 15,000 Medicaid Dual Demonstration members. • Increased Humana’s revenue via analytics targeting Star Score efforts and generated additional $300M annual savings over target.• Worked almost daily with IT to design and develop the data structure to provide the best reporting and analysis for savings and member satisfaction.

Louisville Kentucky

Lead strategist for the development of bid pricing assumptions and pricing during four Medicare Part D bid seasons.• Guided regions to meet pricing goals, validation of formularies and utilization trends as well as monitoring CMS regulations relevant to the Prescription Drug Expense Analysis and Pricing Team. • Collaborated with Milliman Group to develop Medicare Advantage Competitive Value-Added Tool.

Louisville, Kentucky Area

Lead evaluator of daily, weekly, and monthly pharmacy Medicare trend metrics. • Developed a Pharmacy model that would forecast the next year’s trend, based on utilization assumptions.• Served as Representative for Humana’s Medicare Pharmacy trend to relevant internal leaders. • Responded to regulatory audits, surveys and inquiries. Lead contributor to presentations at senior leadership trend meetings.

Louisville, Kentucky Area

Louisville, Kentucky Area

Louisville, Kentucky Area