President, Highmark Health Plan
Tom Doran is the President of Highmark Health Plan. In this role, Tom is responsible for Commercial and Government segments, enrollment, revenue and profit/loss. He's also responsible for Financial Planning & Analysis, Actuarial, Product, Underwriting, the Market and Provider team and Network contracting. Tom brings the voice of the customer and member to our organization, driving new and innovative products and improved clinical outcomes.
Under Tom's leadership, total Health Plan membership has grown to approximately 7 million while Highmark Inc. has expanded its presence in Western and Northeastern New York as well as Southeastern Pennsylvania.
He has also prioritized and optimized cross-selling for Highmark, capitalizing on opportunities for our customers to achieve better clinical outcomes and lower costs by pairing health insurance with our diversified business offerings including stop-loss insurance (HM Insurance Group), dental (United Concordia Dental) and pharmacy.
Tom joined Highmark in 2017 as the President of HM Insurance Group (HMIG) and continues to serve on the board for HMIG. In 2019, he took on the additional responsibility of CFO for Highmark Health Plan, and eventually transitioned to a COO role for the Health Plan. His areas of expertise include Stop Loss market dynamics and strategy, reinsurance, actuarial services, network contracting, pricing and reserving.
With more than 20 years of experience in the insurance industry, Tom came to Highmark from Medical Risk Managers (MRM), the largest Stop Loss MGU in the country, where he served as the company's president. Prior to that, Tom held the role of executive vice president at MRM, and he has actuarial experience at Aetna, Hartford Life and Aon Hewitt.
Tom earned a Bachelor of Science degree in Mechanical and Aerospace Engineering from Princeton University and worked as an Aerospace Engineer for Grumman Aerospace upon graduation. He is a fellow of the Society of Actuaries and a member of the American Academy of Actuaries. Tom has served on the AHIP Advisory Board, was a featured speaker at the 2023 Tomorrow Health Leadership Council Conference, and earned a 2024 C-Suite Award from The Pittsburgh Business Times for his community-focused leadership.
Current Board of Director affiliations include:
Thought Leadership Topics:
Remote Workforce
Predictive Modeling
Strategy Development
Advancing Technologies
Interviews/Articles:
