Kate Karam - Director, Data Science, CVS Health

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Work Background

CVS HealthDirector of Data Science

Jun. 2021Chicago, Illinois, United StatesManage and lead a team of data scientists and decision scientists, providing technical leadership to ensure successful analytics products for our key business partners. Continue to deliver a portfolio of initiatives to improve medical cost for Commercial, Medicare, and Medicaid members, which has resulted in over $82M medical cost savings for the past three years with around 30 medical cost savings initiatives. Provide data driven solutions to Service Operations through their Itemized Bill Review process, focusing on excluding low save hospitals and using a predictive model to prioritize claims for post-pay itemized bill review. Partner with Utilization Management leadership, translating their business needs into analytics projects through randomized control studies for UM programs, tool development for provider selection and consulting work for vendor agreements. Leveraging AI technology to help leadership meet aggressive admin targets while expanding into medical cost savings ideas. Collaborate with business partners across the enterprise to identify business opportunities and create a strategy that can be addressed using data science techniques.

CVS HealthLead Analytics Consultant

Jun. 2019 - Jun. 2021Chicago, IllinoisConsult with internal clients to identify opportunities that implement data science solutions with business problems at an advanced level. Act as an analytics product owner translating business needs into analytics projects and actions. Understand and recommend modeling techniques to data scientists while presenting recommendations to senior staff and internal clients. Mentor more junior team members and data scientists. Collaborate with business partners to understand their problems and goals, develop predictive modeling, statistical analysis, data reports and performance metrics. Consult on the creation of analytics solutions that effectively weigh business and technical tradeoffs using an advanced understanding of business strategy as well as relevant big data environment topics.

CVS HealthSenior Informatics Consultant / Lead

Nov. 2015 - Jun. 2019ChicagoResponsible for the successful delivery of analyses and analytic solutions for Value Based Contracts, interacting directly with internal and external clients and colleagues. Acts as the analytic team lead for complex projects involving multiple resources and tasks, providing individual mentoring in support of company objectives. Perform applied statistical research and custom analysis of integrated healthcare data, interpret results, and make recommendations based on analytic findings.

UnitedHealth GroupMarket Health Analytics Consultant

Mar. 2013 - Nov. 2015ChicagoAnalyze and interpret various forms of utilization and healthcare data to identify potential areas for medical cost improvements via products, services and other market trends. Create a clear, compelling assessment of root causes and actionable/non-actionable contributing factors. Participate in customer meetings as subject matter expert to present findings and recommendations to customers. Quantify value generated by historically implemented solutions. Serve as a trusted advisor to internal & external customers on healthcare cost & quality topics

AetnaMedical Economics Senior Analyst

Jun. 2011 - Mar. 2013ChicagoWork as a member of the Medical Cost Team on managing medical cost projections and financial analysis of medical cost experience. Present the medical cost variances each month for the Kansas City, St. Louis, and Oklahoma markets. Identify medical trends and cost saving opportunities through the analysis of medical claim experience. Participate in Ad Hoc medical cost analysis. Continue to use advanced Microsoft Excel spreadsheets & Microsoft Access databases, SQL language & IBM DB2 application in order to extract and explain the medical claims detail behind medical cost trends.

AetnaMedical Economics Analyst

Nov. 2009 - Jun. 2011ChicagoWorked as a member of the Experience Analysis Team, reporting on medical costs for the Kansas City and St. Louis markets. Supported the RFP process for the region by responding to each customer specific request in a timely manner with the most complete and accurate information. Assisted the P-Model Team in Projection Model audits/loads, updating the Medical Cost projections for various hospital systems based on the actual re-negogiated contracts & network projections. Worked on Ad-Hoc medical cost analyses, including an in-depth drill down into the Ambulatory Facility and Emergency Room medical cost categories. Assisted with monthly results reporting and report downloads.

AetnaMedical Economics Intern

May. 2009 - Nov. 2009ChicagoSupported the Contract Analysis Team by analyzing physician and facility contracts, while consulting contract negotiators on financial impact of current versus proposed contracts. Supported the Experience Analysis Team on monthly market reviews with analysis on medical cost drivers for key segments and medical cost categories.

DePaul University Department of FinanceTeacher's Assistant

Jan. 2009 - Jun. 2009ChicagoAssisted finance professor with four different classes, including Financial Management, Investments and Securities, International Finance, and graduate level Financial Management. Responsible for reading weekly discussion posts made by students on-line and grading them according to certain guidelines provided by the professor and own professional judgement.

Celtic InsuranceMarketing/Market Research Intern

Jun. 2007 - May. 2009ChicagoConducted both primary and secondary research on major medical and short term products and services. Assisted with price index research for each product and state, comparing relative competitor's prices in order to analyze Celtic's position in the health insurance industry. Worked with the Vice President of Product Development each quarter on the analysis of every state's productivity, comparing to the past fifteen months of data.