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Mr. Herman is a 22 year managed care veteran. He is a co-founder
and principal of Pine Grove Advisors, a company that advises
managed care related organizations on actuarial, product
development and financial matters. He is also a co-founder of Pine Grove Management. He has founded and held
senior positions at a number of managed care related businesses,
including:
- Chairman and CEO of Patient Choice Healthcare, Inc, a
company that develops and manages tiered provider networks
(2000 – Present) - Senior Vice President of Ingenix / UnitedHealth Group,
responsible for strategic business development and
acquisitions (1998 – 2000) - Founder and Managing Principal of Reden & Anders
(actuarial firm) and Founder and CEO of Certitude (a Reden &
Anders affiliated healthcare data and technology firm) both
sold to Ingenix / UnitedHealth Group (1990 – 2000) - Founder and Chairman of EvergreenRe, a managed care
reinsurance brokerage covering over 1,000,000 lives (1994 –
Present) - Senior Manager, Deloitte & Touche. (1982 – 1990)
- Staff Actuary, American Express Life Insurance Company
(formerly IDS Life) (1979 – 1982)
Mr. Herman has provided actuarial support for over 75 HMO
start-ups and numerous managed care acquisitions. He has worked
with employers and employer coalitions advising them on a
variety of managed care and consumer-driven healthcare issues.
He has had extensive experience performing claims-based analyses
and disease state modeling using risk-based approaches including
DxCGs, ACGs, ETGs as well as proprietary methodologies. He has
provided compliance support for numerous health plans and
insurers relating to their Medicare, Medicaid, CHAMPUS and
commercial lines of business. He has provided expert support for
regulatory, civil litigation and arbitration actions.
Mr. Herman is the author of several articles and monographs
relating to managed care issues. He is a Fellow of the Society
of Actuaries and a Member American Academy of Actuaries. He has
Bachelor of Science degrees in Mathematics and Economics from
the University of Minnesota, Duluth, where he graduated with
honors.