Sun Life

Director, Advanced Sales Analytics| Stop-Loss & Health

Lincoln Financial Group

•	Lead team responsible for providing predictive analytics solutions for more effective and efficient handling of claims from group disability products. 
•	Developed and operationalized fraud detection for misrepresented disability claims; deployed SMOTE method and GBM dealing with low response rates of misrepresentation for disability claims; explored text mining as ways to extract misrepresented outcome from claim notes.
•	Created customized triage solution model for Walmart, Target, Apple and Charter Communications to improve handling of intake Short Term Disability (STD) claims from Third Party Administrator.
•	Built triage solution utilizing survival termination model with a group of permanently disabled claims resulting in 200+ closures of claims (return to work) and more than $20 million in reserve release. 
•	Optimized tracking mechanism as models were implemented to allow active monitoring of outcome and evidence of ROI.
•	Ran social media trial on Long Term Disability (LTD) claims utilizing outside vendor for surveillance recommendations.
•	Expanded low touch modeling solutions for STD claims at claim intake to >3 diagnostic chapters and introduced a new segment in addition to standard and complex; collaborated with IT to build a dashboard for actively monitoring key metrics for low touch model implementation.
•	Improved implementation process for 12-week triage solution at STD phases by refining threshold of impactful area along lift curve and added protocol to ensure accurate tracking; delivered annualized savings of $1-2 million from preventing claims going into LTD.

Director, Business Analytics & Data Science

Liberty Mutual Insurance

Director II, Data Science

Global Reinsurance Strategy Group 

•	Collaborated with Enterprise Technology Services and Resolute Claims Operation to provide and prioritize technical support for Web App Claim Prioritization Tool bug fixes and improvements.
•	Produced $1.5 million in annual savings by introducing a Claims Prioritization tool using propensity score methods to match claims being actively managed vs. claims not managed.

Director Of Special Projects

Liberty Mutual

Complex Emerging Risks Analytics

•	Directed external consultants in model development (EDA, univariate and multivariate analysis) targeting better management of total outcome form litigated Commercial General Liability claims from historic asbestos exposure.
•	Winner of Innovation Award and earned patent pending application for the development of 3 models using logit to model probability of settlement and GLM Gamma to model defense litigation expenses and settlement outcome.

Commercial Claim Analytics

•	Optimized and coordinated efforts among 2-3 analysts in modeling development for litigation management model focused on general lines and automobile liabilities lines.
•	Assessed and selected a variety of modeling methods (logit, decision trees) in modeling binary outcomes; presented results and demonstrated savings to executive managers and colleagues.

Liberty Mutual Group

Commercial Claim Analytics

•	Winner of Platinum Bravo Award for development and implementation of Workers’ Compensation early alert model; this tool models claims at 5 evaluation points critical to claims and uses GLM and assumed Gamma for developed losses.
•	Developed and piloted a litigation management model focused on General Liability and Auto liabilities lines. 

Product Management Personal Auto

•	Predictive modeler and main contributor to personal auto rating plan; built master research database for modeling purposes by using internal loss data and external vehicle and census data.
•	Award winner for modeling company loss experience by coverage; developed rating factors using GLM frequency, severity and pure premium modeling using EMBLEM.

Lead research analyst

Product Management - Personal Auto 

•	Predictive modeler and main contributor to personal auto rating plan; built master research database for modeling purposes by using internal loss data and external vehicle and census data.
•	Award winner for modeling company loss experience by coverage; developed rating factors using GLM frequency, severity and pure premium modeling using EMBLEM.

Lead Research Analyst

Highly motivated senior level data scientist with 13 years of experience and a comprehensive background in predictive modeling/statistical techniques coupled with a broad understanding of multiple business and product line statistical techniques. Defines and prioritizes predictive analytics and decisions; manages and directs staff, utilizes key drivers to react to problem resolution; researches and recommends changes to policy, procedures and processes – re-engineering them, as necessary, to maximize company effectiveness and efficiency.

Taplio

Jie Gao's Linkedin Analytics

Jie Gao

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