The grief is still fresh for UnitedHealth employees and colleagues who were close to Brian Thompson, the former CEO who was gunned down in New York City in December. (Photographer: Tiffany Hagler-Geard/Bloomberg)

Tim Noel knows his new job as UnitedHealthcare CEO isn’t going to be much like his predecessor’s role.

Noel was promoted to the position previously held by Brian Thompson, who was killed in an early morning shooting in December on his way to a UnitedHealth investor conference in Manhattan. Thompson’s death prompted a social media outcry about health insurers denying care, causing Noel to look inward about his job and industry.

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“I think everyone did some level of soul-searching over that period of time, I certainly did,” he said in his first media interview since taking on the new role, from the company’s headquarters outside Minneapolis.

Noel, who previously helmed the company’s Medicare health plan business, said he had known Thompson for 15 years, worked for him for 10, and considered him a “good friend.”

“What definitely does change is, we have to be more out there and more visible about conversations around the role that we play in the health care system and the role health insurers play.”

He wants to dispel some of the misunderstandings around how insurers manage health care, saying United’s claim approval rates are 98% for valid claims. He also said that many of the curbs put on health care spending are actually decided by the employers who are paying for the health plan, rather than by the insurance company.

Even so, the threat of violence remains. The company now has security checking cars on the way in.

“We certainly have to be much more conscious of the security elements,” he said. “It’s certainly a new way that we’re operating. The answer is not to get really insular.”

The shooting and manhunt that followed Thompson’s killing set off a furious reaction to the US insurance industry, with public anger focused on the perception that health insurance companies put profits over patients.

The grief is still fresh for UnitedHealth employees and colleagues who were close to Thompson. The shock of his death was compounded by the often callous reaction on social media, where some fetishized the man charged in the killing.

Since the tragedy, UnitedHealth reported financial results that disappointed Wall Street, and continues to grapple with the ongoing fallout from a catastrophic data breach plus fresh scrutiny from regulators and lawmakers. One of the world’s most prominent investors has picked a fight with the company on social media.

Noel steps into the top job at the UnitedHealthcare insurance division under circumstances no one would wish to precede their promotion. He now faces the challenge of rallying the stricken company — and trying to repair its perception with a deeply skeptical, sometimes hostile public.

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