US Health Insurance Plans

Brief

 

We were approached by a finance intelligence firm to recruit and conduct analyst interviews from the top 100 Health Plans companies and Third-Party Administrators (TPA). Our client was interested in acquiring specialized insights in health insurance coverage for business employees, as well as understanding the intricacies of its administration and claims processing. The main players of interest were companies, such as BCBS, UHG, Humana, Aetna, as well as Trustmark, Meritain Health and Centene Corporation. Our goal was to approach key decision makers in finance and payables at those companies, and interview them about their experiences, both as service providers and as its users.

Solution

 

As a result, RightAngle conducted a thorough analysis of the health plans market, and identified a suitable pool of experts qualified to address the client’s research needs. We then interviewed a number of senior finance profiles in health insurance management, such as:

  • Claim Benefits Specialists and Consultants, responsible for medical regulation and guidelines compliance in employee benefits programs, coverage, eligibility verification, cost containment measures and claim adjudication process.
  • Financial Accounting Analysts and Directors, responsible for financial reports, balance sheet accounting, reconciliation adjustments, reclasses, write-offs, and other financial and employee benefits management operations.
  • C-suite Health Insurance Executives, specialized in healthcare growth operations, such as corporate development of the company, strategic investing and business development activities related to the health insurance sector, as well as providing advisory services to leading healthcare venture capital, private equity and portfolio companies.

Impact

 

Ultimately, the client was able to address their research questions centered around employee benefits programs within the health insurance market. They were able gather financial, administrative and clerical experiences from top health plan provider representatives, and get a deeper understanding of expenses control, payment regulations, processing, verifying and reconciling payouts to employees’ claims. Following these interviews, the client was able to evaluate best approaches in health plan finance intelligence, having obtained first-hand knowledge about the industry’s inner operations, financial risk mitigation and benefits management strategies.

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