Tom Doran
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, Underwriting and Network contracting. Tom brings the voice of the customer and member to our organization, driving new and innovative products and improved clinical outcomes.
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.
Current Board of Director affiliations include:
- Autism Speaks – Western PA
- Children's Institute of Pittsburgh.
- Light of Life, Pittsburgh
Thought Leadership Topics:
Remote Workforce
- Optimizing remote workforce in sales and underwriting capacity
Predictive Modeling
- Predictive modeling application for underwriting and actuarial
Strategy Development
- Enterprise strategy development and implementation
Advancing Technologies
- Healthcare technology and digital transformation
Interviews/Articles:
- Article in Pittsburgh Post-Gazette, August 8, 2019: Highmark Health lays out its plan now that the UMPC deal has been struck
- Article published in the Self Insurer Magazine, August 2011: Stop Loss and Network Discount Validation
