Reza Mohasesi, FCA, ASA, MAAA
Mr. Mohasesi has founded Key HealthCare Concepts to provide solutions to the problems faced by the health insurance and healthcare-related organizations.
has more than 22 years experience in the health insurance industry in various capacities, including as a consultant and an executive.
He is an actuary with executive experience with insurance, reinsurance, third party administrators, provider groups, employee benefits and managed care entities.
Risk Management - Provider network evaluation, financial analysis and forecasting, reserve assessment, pricing and underwriting guidelines.
Commercial Sector - Product management and development for HMO, PPO, self funding, dental, vision, prescription drug and group life.
Public Sector - Pricing
, product development and financial analysis for Medicare (med Supp and MA-PD) , Medicaid (acute and long term care) lines of business.
Business Development - Opportunity identification and assessment, merger & acquisition, turn around strategy.
Actuarial Reports and Certifications - IBNR, GASB (16, 43, 45), FASB 106, small employer group certification, etc.
Prior to founding KHC, Mr. Mohasesi served as Vice President of Pricing and Underwriting for Health Net of Arizona.
In this role, he
was responsible for developing underwriting guidelines for both group and individual products, pricing and development of rating factors, experience analysis and forecasting of the healthcare cost.
participated in different task forces and processes such as reserve analysis/development, financial forecasting, development of an experience refund product, a self-funded and consumer driven health coverage.
As a key member of the executive team, he
participated in development and implementation of a strategy for Health Net
, resulting in a financial turn around in Arizona.
Mr. Mohasesi was the Director of Underwriting for PacifiCare (Desert Region covering Arizona and Nevada) prior to joining Health Net.
was responsible for underwriting operations and working with other regions of PacifiCare
to develop uniform underwriting guidelines.
participated in the development and launch of PPO and ASO plans while keeping the financial stability of the HMO and POS book of business secure.
Through implementation of these initiatives, the company became the most profitable health insurance plan in Arizona while increasing its market share.
Mr. Mohasesi's professional experience also includes serving as the Vice President and Actuary for Transamerica Reinsurance.
In this role, he
oversaw the actuarial functions related to reinsurance pricing and reserving for group life, health , AD&D, HMO excess, portfolio excess, specific and aggregate employer stop loss, catastrophic coverage, clash coverage and disability products.
In addition, he
was involved in contract negotiation with the retro carriers.
also represented some clients in provider reimbursement negotiation and partnership with different vendors to enhance premium collection and claim payment.
Beyond his professional experience, Mr. Mohasesi graduated from IndianaUniversity in Mathematics and received his credentials from Council of Consulting Actuaries and Society of Actuaries as well as the AmericanAcademy of Actuaries.