Denise Olivares, Vice President of Product Development at Prognos in New York City, knows the value of data.

Working in the health industry for 25 years, Olivares said she often purchased data for different purposes.

“Now, I’m a purveyor of data and analytics,” Olivares said. “Man or woman, a business person needs to be clear in communicating with IT partners and open to involving IT in the early stages of innovation and design.” 

Olivares, who lives in Atlanta, started her career with the insurance company AIG. She said that technology is such a part of business today that both sectors in a company need to work closely together. 

“Some will say that being a woman in the business of insurance and data gives us an edge because we have the ability to see how various pieces of a puzzle might fit together,” she said.

At Prognos, she finds ways to bring the company’s vast amount of lab results data to insurance companies in a form that helps them identify risk in a member population.

Olivares works with payers throughout the life cycle of a plan, from underwriting, policy issues and claims review. 

“We see many priorities across the entire lifecycle of a payer’s business. The idea is to bring data and analytics to improve risk management. The data is so prevalent,” Olivares said. “We are looking at how data can help a payer with risk management overall for a block of business in various stages of the lifecycle.”

The company applies predictive analytic methodologies to clinical diagnostic data. Using artificial intelligence capabilities, the Prognos registry has allowed clinicians and data scientists to develop over 500 proprietary patient profiles. 

More frequently, and especially through value-based care trends,  health insurers are focused on being patient-centric, making sure  members are adhering to prescribed medications, following up with appointments, getting vaccinated and aware of wellness programs.

Having the history of an individual allows insurers to close care gaps, leading to decreased costs, improved outcomes and an increase in HEDIS – Healthcare Effectiveness Data and Information Set – scores and star ratings. 

“These insights are invaluable for doing a better job,” Olivares said. “Women tend to think about a lot of parts at once and like the challenge of fitting it all together in the complex environment that we operate.” 

Twitter: @SusanJMorse
Email the writer: [email protected]

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