Joel Hoffman is a Senior Vice President with OptumInsight, and is responsible for the firm’s Business Advisory and Actuarial Services practice. This practice comprises more than 200 analytical professionals that have direct experience in all financial analytical aspects of health care. Joel has over 20 years of consulting experience in health insurance and managed care, and has been involved in health care actuarial and consulting engagements. His responsibilities have focused on product development and plan design; pricing and capitation; rating and underwriting; care management and clinical resource allocation; and provider network management, including reimbursement and incentive mechanism development, risk assessment and mitigation, experience analysis, and financial projections.

Mr. Hoffman’s recent advisory service efforts have focused on performance improvement for health and managed care organizations, and as a result he works extensively with health care payers and risk-bearing provider entities seeking to understand and enhance their current financial, clinical and operational performance levels. In these efforts, Mr. Hoffman leads a team of OptumInsight health care advisors, representing experience in operational areas of a risk-bearing health care organization. This team’s composition includes professional service consultants with actuarial, claims, clinical, contracting, financial, rating and underwriting expertise. Together, this team quickly helps a health or managed care organization assess and diagnose performance issues, implement necessary corrective action measures honed from both the team’s own experiences and knowledge of the industry’s leading practices, and put in place the requisite infrastructure and tools to maintain desired performance levels. These efforts lead to successful turn-arounds, growth, sales, partnerships and acquisitions for his health care clients.

Mr. Hoffman is experienced at leading and directing our advisory initiatives that comprises improvement agendas, addressing all these operational areas of an organization. Together, his team is able to quickly understand the forces driving any aberrant experience. He is also able to suggest necessary corrective actions by leveraging both the specific diagnostic tools he has developed and the industry leading practices obtained from his years of experience advising health care payer and provider organizations.

Mr. Hoffman consults with HMOs and other managed care organizations, health care providers and provider organizations, “single-service” plans (e.g., mental health/chemical dependency carriers or prescription benefit management firms), BlueCross BlueShield organizations, insurance companies and other risk bearing entities. He has extensive experience with the delivery and finance of health care services under both private and public sector products covering the commercial, Medicare and Medicaid populations. Mr. Hoffman is a speaker at industry events covering health care and managed care topics, including performance improvement, and is a member in the Conference of Consulting Actuaries, the Society of Actuaries, and the American Academy of Actuaries.