The regular advancements in technology have opened an array of new opportunities to apply creative analytical thinking to solve problems and improve people’s lives. This is an exciting time to be alive for women in technology. Women are still severely underrepresented in the technology industry, but that is changing. “New technologies tend to get the most traction when we begin with a deep understanding of the specific problems to be solved. Women must be involved in seeking the solutions for these problems and provide their perspectives,” says Heather H. Wilson, CEO of CLARA Analytics.
Heather has over a decade of executive experience in data, analytics, and AI. Throughout her career, she has held senior roles like Global Head of Innovation and Advanced Technology at Kaiser Permanente and Chief Data Officer of AIG. While at AIG she was named the Insurance Woman of the Year by the Insurance Technology Association for her data innovation work. Currently, she sits on Equifax’s board of directors.
Heather believes that the technology industry is recognizing the value of gender diversity. She has been a steady supporter of diversity and she launched the Kaiser Permanente Women in Technology group, focused on mentorship and retention for women in math, technology, and science, and at AIG, she launched Global Women in Technology and served as Executive Sponsor of Girls Who Code.
Using the Power of AI
It is important to have a diverse executive team and workforce. Heather empathizes that a diverse workforce delivers better outcomes at all levels of the company and CLARA looks to hire the brightest for every job regardless of race, ethnicity, gender, or sexual orientation.
“I am not the founder, but I am very proud to be the CEO of CLARA Analytics to carry on the mission of using the power of AI to provide intelligence on insurance claims,” asserts Heather. As the new CEO, she and her team are striving to take CLARA Analytics to another level with new products, culture, and leadership. She highlighted that AI has the potential to dramatically improve people’s lives, not just by enhancing the bottom line but also by creating more value for the customer.
Leading AI-powered Products
CLARA Analytics aims to have a positive impact on everyone in its customer’s value chain. This includes the insurers who buy the product, the policyholders who rely on them, and injured employees. CLARA minimizes the time required to resolve claims. It matches the patients with the providers most likely to produce positive outcomes, getting them back to work and their normal lives faster. “We make the claims process vastly more efficient. There’s an enormous amount of benefit there,” explains Heather.
Distinguishing itself from the others, CLARA has the advantage of having one of the largest repositories of insurance claims with over $70 billion in claims. CLARA possesses the industry-leading AI-powered analytics using this historical data and the products drive returns for its customers many over 500%. The varied set of products specifically targets the market gaps and addresses the challenges to deliver maximum value for the customers.
- CLARA Treatment: It enlists AI to score doctors based on actual outcomes and comparisons to thousands of relevant closed claims. The factors that influence the score give adjusters the confidence to optimize care selection. Adjusters, nurse case managers, and network optimization teams can now recommend the right doctor for a specific injury, know when injured workers see low-scoring doctors, and ensure care networks are set up to provide the best care for any given claim.
- CLARA Litigation: It uses AI to predict attorney likelihood and litigation likelihood for Workers Comp and Commercial Auto claims. CLARA inspects the nature of the claim, claimant rapport, and settlement expectations to compute these likelihoods. In addition, CLARA Litigation uses AI to score attorneys and prompt users that it might be time to settle or switch attorneys. Adjusters can now keep their current counsel focused on a claim or search a list of high-scoring attorneys nearby to bring on. The result is more favorable legal outcomes and lower claim costs across the board.
- CLARA Triage: CLARA employs AI to help adjusters detect and proactively manage active claims. Triage predicts claim severity based on years of prior claims, identifying tightly defined claim cohorts that yield insights about the future direction of a claim. CLARA’s AI technology monitors millions of data points, looking for clues that might indicate the claim is about to escalate in severity and cost. Triage then alerts adjusters to take prompt action to reduce complexity, lower cost, and enable workers to return to work faster.
- CLARA MSP Compliance module: It streamlines future medical cost projection report production from weeks to minutes, dramatically reducing the work and cost involved. It scans medical records for future medical recommendations, analyzes current medical treatment from payment data, and generates future medical cost projections, automatically compiling them into reports that meet CMS guidelines. Multiple versions of a report can be generated to assess current liability and can be edited on-demand to ensure claims teams are submitting the optimal report.
- CLARA Optics: This is one of the latest products. CLARA’s AI engine can scan bills, images and read the text to summarize medical records and provide insights. It takes a matter of seconds to sort years of medical bills, records, and other insurance claim documents into a chronological medical record. The customers gain new insights and find opportunities to help direct claimants to better health outcomes.
Amongst the myriad range of exceptional products, CLARA Treatment has generated the most immediate ROI. Customers can see the positive returns within six months. Also, CLARA Litigation. CLARA’s AI engine predicts the likelihood of attorney involvement and alerts a claim adjuster on actions to take to avoid litigation costs.
Tips for AI Adoption
Capgemini recently published a study that found only 18% of insurance companies have the culture and skillset to master their data to drive competitive advantages. CLARA helps insurers bridge that skill gap with the adoption of AI.
Heather has outlined a few tips on AI adoption which can be applied broadly to any industry:
- List the challenges and seek solutions: Start with a list of your biggest challenges, then identify a path to solving them, one step at a time. Engage with stakeholders throughout your organization to identify specific problems and operationalize AI to achieve tangible benefits in the near term.
- Innovate and experiment: Assess the opportunity for solving those challenges by reengineering (not necessarily replacing) existing business processes to incorporate AI. Map various AI technologies against those challenges.
- Augment Human Intelligence- don’t replace it: Assess your organization’s capacity to adapt and integrate AI, including fundamental competencies in AI technology, data access, data quality, change management, and willingness among the target users to adopt proposed solutions. AI is strategic, and the C-suite needs to be informed and involved.
Aiming for Growth
CLARA Analytics has marked a great year of revenue and profits last year and aims to continue the trajectory by doubling the revenue in 2022. The team is currently working on introducing three brand-new products. CLARA has launched CLARA Analytics 2.0 with a new leadership team, new products, and a new drive to win. “2022 will be a year of tremendous growth,” proudly asserts Heather.
With new innovative products under production and a new team to manage it is evident that Heather has her hands full. As a leader with tremendous responsibilities, the life between work and life blurs, but Heather has figured out a way to maintain the balance. Being a mother she has to work 24/7 to nurture and take care of the children. But with CLARA being divided into two time zones, half on the West Coast and the other half on the East, it becomes challenging.
“I work on a ‘Mom time-zone’. Fortunately, my twins are in elementary school. This allows me to work across multiple time zones and work around my kids’ schedules. It is a lot, but it is very rewarding,” explains Heather.
Heather is as exceptional as a mother as she is as a leader, making her one of the top women leaders of the year. Her contribution towards increasing the participation of women in math, technology, and science, will be an inspiration for this generation.
First published in Global Business Magazine