James Y Takamatsu
Actuary
Torrance,CA
Summary
Close to achieving the Fellow of the Society of Actuaries designation, possessing a strong foundation in quantitative, technical, statistical, and analytical skills. Expert level proficiency in Excel, successfully generating valuable insights and developing comprehensive dashboards for diverse stakeholders. Exceptional written and verbal communication abilities consistently facilitating effective collaboration and knowledge sharing. Over two decades of experience in actuarial pricing, analysis, and modeling, honing expertise in managing and coaching a team of 12 analysts through complex projects.
Overview
22
22
years of professional experience
4002
4002
years of post-secondary education
Work History
Vice President and Actuary
Keenan & Associates
11.2022 - 9 2024
- Company Overview: a Subsidiary of AssuredPartners
- Led all actuarial functions including IBNR projections, loss development, creditable coverage determinations, actuarial value determinations, stop-loss evaluations, actuarial modeling/analytics, and financial projections
- Led underwriting review activities for self-funded and fully insured clients’ medical, dental, and vision renewals
- Led underwriting analysis support for client RFPs
- Created meaningful analytical insights for clients that led to actionable responses
- Analyzed risk factors in annual renewals in conformance with established underwriting policies, practices, and standards
- Reviewed carriers rate computations and underwriting results to ensure prices are fair and accurate
- Provided accurate analysis of financial exhibits to sales and account management
- Represented Underwriting in partnership with internal and external stakeholders to develop client employee benefit strategies (e.g Case strategy, funding strategy, benefits strategy)
Actuarial Director, UHC Actuarial Pricing - Level2
UnitedHealthcare
09.2022 - 11.2022
- Led pricing and analytics in support of innovative product to address unique needs of patients with Type2 Diabetes
- Created pricing models, reporting packages, and data extracts to support Level2 product
- Created and maintained SAS programs to extract complex data from differing sources
- Proactively identified potential risks and implemented mitigation strategies to minimize negative impacts on projects or business operations.
Director, Healthcare Economics – Network Analytics & Pricing
OPTUM
03.2011 - 09.2022
- Led team of 12 direct reports to complete complex network pricing analyses, including contract valuation and unit cost trend mitigation
- Cultivated a positive work environment that fostered employee engagement, increased retention rates, and boosted overall team morale.
- Implemented innovative solutions to solve complex problems, resulting in increased productivity and streamlined operations. the creation of innovative analytical insights for network providers using Tableau and Excel
- Analyzed the monetary impact of network related corporate initiatives (e.g., policy changes, healthcare affordability) or external regulations (e.g., healthcare reform)
- Managed unit cost budgets, affordability initiatives, target setting, provider performance reporting, and associated financial models
- Managed the ideation, implementation, analysis, and reporting of VBC (Value-based Contracts)
- Provided guidance and information to applicable stakeholders regarding Network Pricing matters
- Engaged with external providers to explain financial analysis, reconcile model, and/or participate in negotiation with Network Management
- Oversaw the analysis of claims data to evaluate provider utilization and unit price trends
- Designed and oversaw ad hoc provider health cost analyses
- Priced outpatient fee schedules and facility rate contracts when necessary
- Knowledgeable regarding all provider payment methodologies (e.g., DRGs, per diems, case rates)
- Developed methodologies to Narrow and Tier networks in response to the Affordable Care Act and quantify savings due to its cost containment capabilities
- Led initiative to transition high-cost providers to a bundled payment methodology (e.g., case rates, capitation) and setting the price for these alternative reimbursement strategies
Senior Actuarial Analyst
OPTUM
09.2009 - 02.2011
- Collected and analyzed claim data to set medical benefit and IBNR reserves using sound actuarial principles for monthly close
- Developed and prepared forecasting models in support of finance to help budget medical expense
- Trained and mentored junior staff on actuarial concepts and analyses
- Mentored junior analysts, enhancing their technical proficiency and fostering a collaborative work environment.
- Enhanced actuarial model accuracy by conducting thorough data analysis and validation.
- Assisted in the maintenance of reserving systems, such as RPS and FSDB, and reconciled medical benefit expense and various other liabilities to the general ledger
- Analyzed claims triangles and developed completion factors in support of underwriting and in direct response to provider requests
- Collaborated with underwriting team, providing insights on risk assessment and policy pricing adjustments.
- Assisted in the forecasting, trend analysis, experience reporting, and preparation of ad hoc requests from various departments
Senior Pricing Analyst
OPTUM
02.2007 - 09.2009
- Analyzed trends, costs, access, utilization, and financial experience of external/direct health plans and employer groups
- Optimized pricing strategies by analyzing market trends, competitor pricing, and customer behavior.
- Improved forecast accuracy by identifying trends, risks, and opportunities through comprehensive data analysis.
- Calculated reserve estimates to be used in pricing models and developed product pricing for renewal and new business
- Identified potential areas for medical cost improvements and alternative pricing strategies
- Built predictive pricing models for new products in support of Underwriting and received a monetary spot bonus for their creation
- Produced periodic standard and ad hoc analytic insights to evaluate client activity and performance
- Effectively communicated with sales, account management, and clients directly to negotiate rates, as necessary
- Supported strategic decision-making by providing timely and relevant insights on pricing trends and competitive landscape.
- Contributed to long-term planning efforts by evaluating potential pricing-related initiatives based on their financial impact and strategic alignment with business goals.
Senior Actuarial Analyst
Farmers Insurance Group
02.2001 - 01.2007
- Responsible for the actuarial pricing and management of personal line automobile and homeowner insurance products
- Integral part in implementing progressive homeowners rating plan using regression modeling
- Enhanced actuarial model accuracy by conducting thorough data analysis and validation.
- Performed profitability and forecasting analyses of various business segments
- Measured and monitored financial performance on a state-wide basis
- Prepared and analyzed supporting statistical data and actuarial information used in connection with formal rate reviews for filing with state regulatory authorities; prepared written correspondence relative to such analyses
- Analyzed premium and loss trends, loss development, reserve allocation as well as modeled and analyzed various aberrant phenomena in claims data
- Prepared financial statements and made projections for the following year’s financial goals
- Mentored junior analysts, enhancing their technical proficiency and fostering a collaborative work environment.
Education
Bachelor of Science - Chemistry
University of California, Irvine
Irvine, CAMaster of Science - Statistics
San Diego State University
San Diego, CASkills
Microsoft Excel
Microsoft Access
Tableau
Unix
SAS
SQL
R
Rstudio
VBA
Problem-solving
Team leadership
Coaching and mentoring
Decision-making
FSA Exams
- SOA FSA Module: Health Systems Overview, 10/01/08
- SOA FSA Module: Pricing, Reserving, and Forecasting, 11/01/08
- SOA FSA Module: Financial & Health Economics, 11/01/14
- SOA CSP Exam, 11/01/12
Professional Designations
- Associate, Society of Actuaries, 09/01/08
- Member, American Academy of Actuaries, 11/01/08
Timeline
Vice President and Actuary
Keenan & Associates
11.2022 - 9 2024
Actuarial Director, UHC Actuarial Pricing - Level2
UnitedHealthcare
09.2022 - 11.2022
Director, Healthcare Economics – Network Analytics & Pricing
OPTUM
03.2011 - 09.2022
Senior Actuarial Analyst
OPTUM
09.2009 - 02.2011
Senior Pricing Analyst
OPTUM
02.2007 - 09.2009
Senior Actuarial Analyst
Farmers Insurance Group
02.2001 - 01.2007
Bachelor of Science - Chemistry
University of California, Irvine
Master of Science - Statistics
San Diego State University
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