Presentation during the MISTI Superstrategies Conference in Las Vegas, November 2018

1. IMPLEMENTING TECHNOLOGICAL
AUDIT PRACTICES
Manuel Coello
Senior Director Data Analytics
AETNA

2. INNOVATION REQUIRES COURAGE AND
INTELLIGENCE, BUT NOT PERMISSION
– BETH COMSTOCK

3. OUR
JOURNEY

4. ANALYTICS PLAYBOOK
1. EXPONENTIAL GROWTH - by creating an ecosystem of
collaborative analytics and partnering with machines
2. INCREASED EFFECTIVENESS - by using descriptive
analytics on every audit and leveraging risk and predictive
models
3. UNPRECEDENTED VALUE - by deploying a suite of
analytic capabilities on every audit

5. EXPONENTIAL GROWTH

6. TOOLS USED

7. CREATING A
CULTURE OF
“EVERYONE”
IS A CODER

8. PRESIDENT OBAMA

9. ANALYTICS REPRODUCTION MODEL

10. SELF-SERVICE ANALYTICS PLATFORM

11. ROBOTIC
PROCESS
AUTOMATION

12. ANALYTICS METHODOLOGY

13. ANALYTICS
GAMIFICATION
ANALYTICS GAMIFICATION

14. VISUALIZATIONS

15. VISUALIZATIONS

16. VISUALIZATIONS

17. NEXTGEN AUDIT REPORTING PLATFORM
Audit Summary
What were the results of the
audit?
Audit Report
What are the issues?
Reporting
What open issues are nearly
due?
Remediation
What is the status of the
issues?
Audit Plan
What is the status of all the
audits?

18. EARLY WARNING SYSTEM

19. CONTINUOUS AUDITING

20. INCREASED
EFFECTIVENESS

21. USE OF DESCRIPTIVE ANALYTICS

22. DESCRIPTIVE ANALYTICS

23. RISK SCORING

24. RISK SCORING FORMULA
Z-score
Amount Avg Amount Std Deviation Amount Weightage
1,000 800 720 0.28
450 500 452 (0.11)
58 250 240 (0.80)
37 40 50 (0.06)
200 150 50 1.00
Quantitative Calculation
Quantitative Risk Weightage
Employee Pass/Fail Test Weight (1-10) Pass/Fail Test Weight (1-10) Pass/Fail Test Weight (1-10) Score
1 Yes 9 Yes 3 Yes 6 18
2 No 0 Yes 3 Yes 6 9
3 Yes 9 No 0 Yes 6 15
4 Yes 9 Yes 3 No 0 12
5 No 0 No 0 Yes 6 6
Test 1 Test 3 Test 3
Qualitative Calculation
Org Level Score Category Name Score Business Activity Score Qualitative Risk Weightage
GOV Leadership 6 Dinner 9 Agency/Broker Activity 8 23
NA National Accts Ops 7 Entertainment 9 Sales/Prospect 8 24
TER Territories Admin 4 Projects 7 External Meeting 7 18
SPC Specialty Businesses 8 Lunch 7 Internal Meeting 5 20
FIN Internal Audit 5 Travel Transaction Fee 5 Travel-Training/Education 5 15
FORMULA:
Risk Score % = ((Quantitative Risk Weightage * ((Amount – Avg Category Amt) / Std dev Category Amt) + Qualitative Risk Weighted) / Max Score
RiskScore Calculation
Employee
Quantitative Risk
Weightage
Amount
Weightage
Qualitative Risk
Weightage Risk Max RiskScore Final Risk
1 18 0.28 23 28 250 11%
2 9 (0.11) 24 23 250 9%
3 15 (0.80) 18 6 250 2%
4 12 (0.06) 20 19 250 8%
5 6 1.00 15 21 250 8%

25. RISK MONITORING

26. PREDICTION SCORING

27. PREDICTION SCORING
Case
Management
Audit
Exceptions
Predictive
Variables
Results
(Risk Score)
Logistic
Regression
Historical
Exceptions
Accuracy Check
Model

28. UNSUPERVISED ANALYTICS

29. ANOMALY DETECTION – AUTO ENCODER

30. UNPRECEDENTED
VALUE

31. UNLIMITED ANALYTICS CAPABILITES

32. STRUCTIRING DATA

33. TEXT ANALYTICS

34. DISTANCE CALCULATIONS

35. SPATIAL ANALYTICS

36. UNDERSTANDING THE CUSTOMERS
Income range Household Size
Owners vs Renters Household Composition

37. NETWORK ANALYSIS

38. CORRELATION ANALYSIS

39. CLOSING COMMENTS
1. Plan your journey in 3-year increments
2. Be an Analytics & Technologist advocate
3. Become a marketing master
4. Keep tabs on the wins
5. Lead the disruption movement!

40. THANK YOU