Matt Mize is a Healthcare Consultant and Actuary who helps healthcare industry stakeholders optimize their strategy, business model, and earnings.

In his 23 years at health plans before starting as a consultant, Matt worked as a Chief Actuary, CFO, VP of Analytics, and VP of Risk Adjustment. After a successful career helping health insurance companies achieve double digit membership growth and exceed earnings targets, Matt now advises health insurance stakeholders on how to improve their value within the healthcare system.

Matt’s latest role was as SVP and Chief Actuary at EmblemHealth (primarily NY and CT) where he had responsibility for Actuarial, Underwriting, Risk Adjustment, and Healthcare Economics. In his time there, he reorganized the department to further clarify roles, established foundational data sets and tools, developed financial discipline and reporting, enhanced risk adjustment operational focus (ACA, Medicaid, and Medicare Advantage), and improved pricing and valuation work products. 

Prior to his role at EmblemHealth, Matt held several leadership roles in his 20 years at HCSC (Blue Cross plans in IL, TX, NM, OK, and MT), the largest not for profit health insurance company in the country with over $50 billion in operating revenues. His roles included CFO of Individual, VP of Government Pricing, VP of Risk Adjustment Operations, and VP of Medical, Provider, and Sales Analytics. Known as a builder, innovator, and turnaround specialist, Matt was asked to move to each of these roles when a new department or a financial improvement was needed.

As a result of all these roles, Matt not only has extensive experience with pricing all lines of business, valuation, forecasting, healthcare value story development, provider contracting, risk adjustment optimization, underwriting guidelines and processes, data infrastructure and visualization tools, etc. but also a depth of knowledge on the interactions of all these functions.

In all of Matt’s roles, he has created a culture of continuous improvement toward excellence with the ultimate goal of improving the physical and financial health of our country through efficient healthcare delivery.

Matt holds a BS in Mathematics from the University of Texas at Arlington, is a Fellow of the Society of Actuaries, and is a Member of the American Academy of Actuaries. He is also an avid reader of business books and has attended several leadership classes at SMU and the University of Chicago.