Jawad Bajjou — Healthcare Economics & Analytics Executive

About

Where healthcare economics meets execution

I'm a Healthcare Economics and Analytics executive who translates complex data into decisions leaders can act on. My work spans CMS risk adjustment (HCC/RAF), HEDIS/STARS quality, population health, and clinical affordability — the full economic engine of Medicare Advantage.

At UnitedHealth Group and CVS Health, I've led multi-year, enterprise-scale analytics transformations: standing up governance frameworks, building BI platforms, integrating acquired medical groups, and directing AI into production analytics workflows — cutting manual operations by more than 40% across 5M members while improving accuracy.

Beyond the dashboards, I build teams. I've grown and led geographically distributed organizations of 30–45 analysts, actuaries, and data scientists — and lifted retention 25% along the way.

My current focus is the next chapter of that story: transforming analytic workflows into AI employees — agentic systems that don't just report on the work, but do the work: monitoring populations, surfacing risk, drafting analyses, and escalating judgment calls to humans.

Enterprise ScaleAnalytics powering $100B+ in annual Medicare Advantage revenue

AI-Driven OperationsAutomated risk suspecting & quality gap identification for 5M members

M&A AdvisoryDue diligence and analytics integration across enterprise acquisitions

Team Builder30–45 member teams; +25% employee retention

Thought LeadershipRecognized enterprise voice on healthcare economics & VBC

Engineer's RigorBS Electrical Engineering + MBA Quantitative Methods, Purdue

Selected Impact

Results, not reports

A career measured in outcomes — a few representative engagements.

40%+Manual ops reduced

AI-Powered Risk & Quality Automation

Directed AI integration into enterprise BI workflows, automating risk-adjustment suspecting and quality gap identification across 5M Medicare Advantage members — reducing manual operations 40%+ while improving accuracy.

AI/MLHCC/RAFSTARS

$100BPortfolio transformed

Enterprise Analytics Transformation

Spearheaded a 3-year, enterprise-scale analytics transformation — governance frameworks, KPI dashboards, and data validation protocols that maximized operational efficiency across the full Medicare Advantage portfolio.

GovernanceTableau / Power BIKPI Strategy

M&AEnterprise diligence

Acquisition Diligence & Integration

Key analytic consultant for M&A and risk-transfer initiatives — evaluating business performance and revenue opportunity in diligence, then rapidly integrating acquired medical groups' data into national standards.

Due DiligenceRisk TransferData Integration

80MMembers analyzed

Research That Shaped Policy

Authored a state-by-state pharmacy outcomes report on 80M members cited in state-legislature policy debates, and led landmark cigarette-cessation research using interrupted time-series modeling — a major public-health and brand win.

Public HealthEconometricsPolicy Influence

Career Journey

Two decades across the healthcare value chain

2017 — Present

Senior Director, Healthcare Economics

UnitedHealth Group (Optum Health) · Remote

Lead enterprise BI and analytics delivering insights across the full spectrum of healthcare economics — risk adjustment, clinical quality, population health, and affordability — for 5M+ Medicare Advantage lives and $100B+ in annual revenue.

$100B+ Revenue Insights45-Member TeamAI IntegrationM&A Consulting

2012 — 2017

Senior Manager, Enterprise Innovation Analytics

CVS Health · Northbrook, IL

Led analytics and reporting for the enterprise's fastest-growing business units (Provider Relations, Med-D). Built the Specialty Pharmacy P&L analytics team for 340B initiatives and served as the analytic closer in PBM finalist meetings — driving client retention and new business wins.

340B AnalyticsClient RetentionPBM Consulting9-Member Team

2011 — 2012

Senior Analytic Consultant, Enterprise Innovation Analytics

CVS Health · Northbrook, IL

Published the state-by-state pharmacy outcomes report analyzing 80M members and led the enterprise prior-authorization analytics initiative recognized by executive leadership as one of the most successful analytic efforts of the year.

80M MembersPolicy InfluenceExecutive Recognition

2007 — 2011

Validation Analyst / Design Project Coordinator

Abbott Laboratories (Diagnostics) · Abbott Park, IL

Coordinated design projects and validated systems in the diagnostics division, ensuring FDA regulatory compliance and quality standards.

FDA ComplianceSystem Validation

MBA, Quantitative Methods

Purdue University · 2009

BS, Electrical Engineering

Purdue University · 2006

The Lab

Where analytic workflows become AI employees

I don't just lead analytics — I still build. These working prototypes, engineered end-to-end, explore my core thesis: the analytic workflows teams run today become the AI employees of tomorrow.

Independent personal R&D, built exclusively on public and synthetic data (CMS public use files, CDC, Synthea). Not affiliated with, or representative of, any employer.

Live prototype

ACO Benchmark Explorer

Interactive benchmarking of MSSP ACO performance — savings rates, quality scores, and risk-model dynamics — built from CMS public results files with an AI analyst layer for plain-English interpretation.

CMS MSSP PUFs · Python · Streamlit · LLM analyst

Live prototype

Avoidable Utilization Atlas

Geographic atlas of avoidable ED visits and admissions — surfacing where utilization patterns diverge from clinical expectation and what that means for total cost of care.

CMS & CDC public data · Geo analytics · Streamlit

Agentic AI

Care Manager Co-Pilot

An AI copilot for care management workflows — prioritizing outreach, drafting member summaries, and flagging care gaps — demonstrated on fully synthetic patient data.

Synthea synthetic data · Anthropic API · Persona UX

Insights

What I think about, out loud

Themes I write and speak on — where healthcare economics is moving and what leaders should do about it.

Risk Adjustment, Reframed

As CMS keeps tightening the model, risk adjustment is no longer a coding exercise — it's a clinical-data discipline. The organizations that win treat accuracy as an engineering problem, not a chart-chase.

The Rise of the AI Employee

Most healthcare AI dies in the deck. The real shift is analytic workflows becoming AI employees — agents that run suspecting, gap closure, and quality review end-to-end while humans move up to judgment.

Affordability Is an Analytics Problem

Total cost of care doesn't bend with dashboards alone. It bends when utilization signals, risk data, and provider incentives are engineered into one decision system.

Follow along on LinkedIn — where I share perspectives on healthcare economics, value-based care, and building AI-driven analytics organizations.

Follow on LinkedIn

Advisory

How organizations work with me

I selectively engage on problems at the intersection of healthcare economics, analytics strategy, and AI.

Executive & Board Advisory

Strategic counsel for leaders navigating Medicare Advantage economics and value-based care.

Risk adjustment & STARS strategy
Affordability & total cost of care
Analytics org design & talent

Workflows → AI Employees

Hands-on guidance transforming analytic workflows into agentic AI teammates — with humans on judgment.

Agentic AI roadmaps & pilots
Workflow redesign for AI operations
Governance, guardrails & data quality

M&A Analytics Diligence

Analytic due diligence for healthcare transactions — from thesis to integration.

Performance & revenue evaluation
Risk-transfer analytics
Post-close data integration

Expertise

Depth across the full stack

Healthcare Analytics

Population HealthClinical AffordabilityCMS Risk AdjustmentHCC/RAF ModelsHEDIS/STARSMedicare AdvantageClaims AnalyticsValue-Based Care

Business Intelligence

TableauPower BIMicroStrategySASData VisualizationKPI DevelopmentDashboard Design

Data & AI

SQLOracle / DB2 / TeradataData WarehousingETLData GovernanceLLM WorkflowsAI Automation

Leadership

Team BuildingAgile/ScrumM&A ConsultingExecutive AdvisoryStakeholder ManagementStrategic PlanningChange Management

Turning healthcare data into decisions — and analytic workflows into AI employees.