Humana
Company: Humana Inc.
Company Description: Humana Inc., headquartered in Louisville, KY., is one of the nation's largest publicly traded health services companies with approximately 6.8 million members located primarily in 18 states and Puerto Rico. The company, founded in 1961, is traded on the New York Stock Exchange (NYSE: HUM) and has been the recipient of numerous awards for technology leadership.
Nomination Category: Individual Awards Categories
Nomination Sub Category: Best Product Development or Engineering Executive
Nomination Title: Bruce J. Goodman, SVP and Chief Service and Information Officer, Humana
Tell the story about what this nominee achieved in 2003 (up to 500 words). Focus on specific accomplishments, and relate these accomplishments to past performance or industry norms. Be sure to mention obstacles overcome, innovations or discoveries made, and outcomes:
Bruce Goodman has won numerous technology awards for Humana and holds a
patent on a PC data capture technique. But technical expertise alone is not what
he would credit for the results he and his team accomplished in 2003. He’d say
three things were essential: understanding business process, knowing where the
leverage points are to improve top and bottom line performance, and developing
strategic partnerships. By applying these principles, Goodman and his team have
helped Humana become the technology leader in the health benefits industry and
put much needed information into the hands of consumers.By July 2003, Humana had announced the significant results employers were
getting with Humana’s Smart products in curing the health benefits cost crisis. It
had introduced a new model of prescription drug coverage, RxAllowance, and a
combined ID and benefit card that were both industry firsts. The backbone for
these innovations and more are technology initiatives implemented by Goodman
and his team.To choose individualized Smart plans and drug coverage options, consumers use
online wizards — custom enrollment applications only available with Humana.
These tools display information graphically to help consumers visualize where their
health dollar has gone, amounts used and remaining in flexible spending or other
accounts and to compare plans or options for out of pocket expense, payroll
deductions, copays and more. In a post enrollment survey, 78 percent of
respondents strongly agreed or agreed that the wizard helped them make benefit
decisions.But giving consumers choices—and pricing those choices optimally—requires
sophisticated predictive and analytical tools. Humana’s enterprise data warehouse
(EDW) currently has about 3.2 billion rows of data and uses 3.5 terabytes of
storage. Humana applies predictive models (that it hopes to patent) to EDW data
to design and price benefit plans, identify market opportunities and at risk
members (to offer Personal Nurse assistance).In 2003, Humana redesigned backend processes to improve service and shorten
claims processing time for physicians, hospitals and consumers with eHub, an
enterprise application integration (EAI) initiative. Through vendor partnering,
Goodman estimates Humana saved more than 2,000 person-hours in development
time, and as a result was the first large payer to accept transactions that met
federally imposed data and format requirements a year ahead of the deadline. With
eHub, Humana now has a single EDI gateway that provides end-to-end processing
from submission, validation, exception handling, routing, transformation, and
processing through outbound response.By year end 2003, Humana had also consolidated its service center operations
from six locations down to three and achieved significant cost savings while
reducing call handle time for customers. To enable this significant organizational
streamlining, Goodman and his team implemented a custom, enterprise-wide
customer relationship management solution integrated with a knowledgebase and
advanced telephony platform with skills-based routing, workforce management
tools and enhanced systems for measuring customer satisfaction. A single point
of entry capability and redesigned physician contract loading processes were
implemented resulting in an expected operating cost improvement (from this
initiative alone) of over $2 million.Through the contributions of Goodman and his team, Humana demonstrates an
enterprise-wide level of technological and procedural integration and innovation that
is benefiting all its stakeholders.
List hyperlinks to any online news stories, press releases, or other documents that support the claims made in the section above. IMPORTANT: List each link on a separate line, begin each link with http://, and enclose each link in square brackets; for example, [http://www.website.com]:
Humana Executive Honored as 2004 Premier 100 IT Leader by IDG’s
Computerworld http://www.humana.com/corporatecomm/newsroom/releases/PR-News-20040121-081423-NR.htmlHumana Named To Prestigious CIO 100
http://www.humana.com/corporatecomm/newsroom/releases/PR-News-20030827-122410-NR.html“Refocusing the Future: Humana is developing advanced analytical models to help
control costs, improve service and identify business opportunities”;
ComputerWorld
http://www.computerworld.com/databasetopics/businessintelligence/story/0,10801,
90833,00.html"E-volutionizing Health Insurance"; Best's Review (9MB)
http://www.humana.com/visitors/pdf/BestReviewarticleJan2004.pdfHumana’s e-Health Strategy Success Recognized with Industry Award
http://www.humana.com/corporatecomm/newsroom/releases/PR-News-20030225-145909-NR.htmlHumana Customers Cut Cost Increases by 60 Percent with Next-
Generation “Smart” Plans That Create Greater Consumer Incentives and Choice
http://www.humana.com/corporatecomm/newsroom/releases/PR-News-20030807-101734-NR.html“HIPAA Moves Humana to Revamp Process”, Insurance & Technology
http://www.insurancetech.com/it2/story/IST20030211S0001Humana Goes Live with Vitria for HIPAA Compliant Claims Processing and
Process Cost Reduction
http://www.vitria.com/news/press_releases/pr_2003-01-06.htmlHumana and Evolution Benefits Introduce the First-of-its-Kind Combined ID and
Prepaid MasterCard® Card for Health Plan Members
http://www.humana.com/corporatecomm/newsroom/releases/PR-News-20030529-132202-NR.htmlHumana launches revolutionary prescription drug coverage in ongoing effort to
expand choice and control costs
http://www.humana.com/corporatecomm/newsroom/releases/PR-News-20030702-104117-NR.html
Provide a brief (up to 100 words) biography about this nominee:
Bruce Goodman currently serves as Humana’s senior vice president and chief
service and information officer. In this role, he is responsible for Humana’s national
service center operation, billing and enrollment, provider affairs and quality
management as well as all information systems, distributed and centralized data
processing operations, and communications facilities for Humana. With over 30
years experience leading large-scale service and technology organizations, he
directs these diverse functions across many geographic areas.Before joining Humana, Goodman served as a senior executive in leading
insurance firms such as Metropolitan Life and Prudential, as well as establishing a
technology consulting firm and serving as its CEO.