Rajendra Kadam, SVP, Health Plan Operations & CIO at Liberty Dental, joins CIO Leadership Live from Foundry’s CIO100 event

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Welcome to CIO Leadership Live. I'm Lee Renick, executive director of CIO communities for CIO, and I'm really thrilled to
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be here today at the CIO 100 and Symposium with Raj Kadam, SVP, Health Plan Operations and CIO, Liberty Dental Plan. Welcome to the show. Thanks so much for joining us today. Could you please introduce yourself and tell us a little bit about your current role?
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Absolutely. Thank you. Thank you for having me here. so Liberty dental plan. As a dental insurance company, we insure about 7 million people, in the United States. We are, we are, our owners are, a couple of one is private equity company. And other is anthem or they call Elevance Health right now. Okay.
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And, so our job is to take care of all our members, right? 7 million members. So my job there, as in the role of senior VP, health plan operations and CIO is obviously take care of technology, cybersecurity. Right. That's the primary thing. And then over over a period of time I have been given more responsibility on the operations side.
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So claims processing, utilization management are like the key to any health insurance company or any insurance company, if you will. Yeah. And so those operations also fall under my belt. Right. So it's it's it's a good balance between technology and applying that technology on my operational areas as well. Yeah. Right. Yeah. Which really must be a great opportunity to learn just to learn like understand the whole business.
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Right. Yeah. It really sounds like that would be. Yes. A big part of your remit, understanding the end customer, the operations and how you interact with them and then all the technology aspects of it too. So congratulations on that and congratulations very much on winning the CIO 100 award. So could you tell me a little bit about the project?
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Yeah. So for any health insurance company what has to be done is preventive care management is key. Yeah. To keep the cost low. Right. So the goal is amount of claims has has to be low. So how much preventive care can you take care of your members. So any health insurance company or a higher bunch of, say, nurses, call them care managers or case managers, and they do case management for all these people.
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So what in Liberty used to happen and this was all a manual process. based on a bunch of Excel files, even Microsoft Access and emails. Right. So first and foremost automated all this. Then what care managers use to do is they use to create a care plan in detail, which used to take anywhere between an hour to 90 minutes to create a care plan for one member.
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Right. So it's it's about setting goals. identifying barriers, doing interventions. And what are the patient actions that need to happen. So what we did is we aggregated all this data, put all that together, or did some machine learning algorithms on top of it and then fed it into LMX and using now generative AI. Generative AI gives us an output of these care plans.
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Wow. So whatever was done in 90 minutes is available right there. Wow, with way higher accuracy than what a human could do. Right. Because they had to go through all these pages and pages of doctor notes. Right. Right. Which is humanly impossible. Right. To capture like there could be a small world about some socioeconomic barrier that might be there that someone can miss, right.
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But generative AI doesn't miss that. Wow. Right. So that's the award winning. Wow. Which has increased our accuracy first and foremost. And helped these care managers big time. Yeah. Because they get assigned like thousands of members. Yeah. And they are doing a good job now. Yeah. Yeah. So it really improves the output of the people in terms of care managers.
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Yes. So I'm going to ask a question within the next question because we've been talking a lot over the last few days about data. Yeah. Seems to be and generative AI one one sentence. Right. So that must have been a major like I would love to learn how long it kind of took you to build that project out, to create that productivity and efficiency, and then maybe how you, you know, managed like the data aspect.
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Because a lot of CIO's i’m speaking to, you know, around Covid, they put their data up in the cloud, a lot of it. Then it was very costly. They were looking even at the use of like, edge computing to get their most valuable data to the edge. And then they were a lot of now saying, well, they're thinking now, doing a combo back on prem.
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So you had a lot of data in this project. How did you first of all, like manage that process? Any tips for anybody out there? And yeah, just how long did it take to to do this project? It sounds phenomenal. Yeah. So I joined this company about two and a half years ago, and the very first big opportunity I saw was data, which was all over the place.
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And there was a kind of a small data warehouse on prem. Right. And so that was my first project. So like anyone else in that period of time, what we did was we moved it to the cloud, but in a way that only what is needed. Right, right. So we created our data model in a way that it satisfies kind of the requirements of what we had a vision of.
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And that played like a big role. So even before this whole Chat GPT, generative AI, became a big thing…maybe like three months before that, we went live completely in the cloud on Azure. Oh, wow. And that that was like the foundation. But to answer your question, the biggest point is the data governance. Yeah. Right. So you can host data anywhere on prem or cloud or whatever.
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If your data quality is not good, it serves no purpose. Yeah, right. Yeah. Yeah. So data governance was the biggest piece. Yeah. that we took care of. And so that was the foundation to all of this. And then came GenAI, and it was like, wow. And that's why we could we could go live with that, like within six months after this whole generative AI thing.
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And we already have a big ROI on this. Congratulations. And that really segues well into the next question. So we've been talking a lot about the state of the CIO report. We surveyed 1,100 CIOs globally, and 79% said they have an educational partnership with the board and the CEO of the organization in the C-suite.
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So it sounds like that even that data governance piece of it was really something probably you had to educate and partner with, with your C-suite on. Yes, yes. So that was a big part to educate everyone, not just on and including the board, not just on data, but overall, okay, what we are planning to do all right ahead of time and how this will benefit.
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Yeah, right. So even if I go with the project and ask for, say, CapEx dollars, yeah, it was hard for them to envision that they we could capture right, that level of ROI. Right? Right. So educating them on how things work, how things look, walking people through okay, this is how ChatGPT looks. Now design your prompts and all that and go through it.
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And they were like, wow. Oh right. Right. Yeah. Because it takes a bit of education to do that. And but along with that, of course, it's very highly important that we as technologists have all the business knowledge. Yeah. Right. And that is key. So to any anyone in IT, I tell them okay, you know SAM machine learning or Python or whatever the case might be.
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You're still a commodity, right? Until a point that you learn business and you learn all the domain aspects, then you become valuable, right? Right. So that's always have been our kind of focus and which has helped us, big time. That's fantastic. Thank you for sharing that. Well, we've been talking a lot too about like, how GenAI built productivity for business has for yours and for yours, not only internally but externally.
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Right. For your client, your end users and clients, which is, you know, I don't hear as much of that. But in this sector, you know, because you have that end user customer, you can really apply a lot of it. So that's amazing. So I'd love to tap into like some future predictions. So, you know, what do you foresee sort of heading into 2025 around generative AI in business.
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And maybe do you see any new potential use cases or the way people might, you know, develop it further? Yeah, I would think there'll be more and more adoption of generative AI because you're seeing even in this conference, people are talking about various use cases like mine. Yeah. how everyone is leveraging within their business domain generative AI.
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Right. So that is giving everyone an idea. Yeah, maybe they should look for it. Right. And that is where that whole business domain knowledge, is important so that the technologist can apply those tools and say, hey, here is the use case. Here's an opportunity where I can use generative AI. Yeah. All right. And so it's it's a matter of identifying the proper use case.
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Yeah. That gives you the ROI. Yeah. In our case ROI was like 400% or something like it was very quick. Right. Yeah. Because of all the work you'd done previous. Exactly. And everything exactly. Well that is phenomenal. Thank you so much, Raj, for joining me today. And congratulations again on the award. Thank you project I appreciate it so much.
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Thank you. Thank you for having me. Thanks.