William T. O'Brien, F.S.A., M.A.A.A.
Principal
Reden & Anders, Atlanta, GA
Bill O’Brien has worked with numerous HMO plans, provider organizations, health systems, and other managed care organizations across the country. His areas of expertise include claim reserving, experience analysis, pricing, underwriting, provider reimbursement and financial reporting/modeling.
Recent engagements include:
- Developing “Net Economic Value” of an owned health plan to a health system: incorporating transfer pricing, provider contracting leverage (including the “defensive value” of the plan), and alternative options into a revised health plan income statement.
- Developing full actuarial modeling software for a health plan client, including group premium rate development, individual underwriting, IBNR reserve, premium deficiency reserve, and LOB financial projection models.
- Assisting numerous employer clients in projecting health expenditures, evaluating benefit plan and vendor changes, determining employee contribution strategy and rates, determining claims reserve needs, and retiree health valuations.
- Implementing a detailed claims reporting and profitability system, including an actuarial data warehouse, automated capitated provider contract reviews, claims anomaly and duplicate claims identification, high cost claimant early ID system, capitated claims submission monitoring, and automated recasted financial statements.
O’Brien’s prior experience includes two years with a national carrier, two years with a Blue Cross Blue Shield plan, four years as CFO and chief actuary of a provider-owned health plan in Florida, and five years in consulting with Tillinghast/Towers Perrin and Harmony Consulting. He received a Bachelor of Science cum laude in mathematics from Stetson University and is a fellow of the Society of Actuaries and member of the American Academy of Actuaries.
Contact:
email: bill.obrien@reden-anders.com
|
.gif){kind=small}