»Managed Care Plans
Managed Care Plans 2018-03-05T01:21:53+00:00

Opportunities in Medicaid Managed Care

Sellers Dorsey offers managed care expertise to national and community-affiliated managed care plans, state Medicaid programs, Medicaid providers, and Medicaid support vendors. Leverage our experience and capability and allow us to serve you in these and other areas:

States

  • Designing and managing an effective Medicaid managed care program, including program and waiver creation, procurement, readiness review, implementation, health plan contract monitoring, and quality and value-based purchasing (VBP) initiatives
  • Meaningful engagement with stakeholders including technical assistance on stakeholder engagement strategy and facilitation services
  • Understanding and implementing state and federal regulations and health care innovations

Managed Care Organizations

  • Preparing for and winning new Medicaid business through successful responses to requests for information and requests for proposals, as well as readiness review
  • Educating stakeholders and improving relationships with members, providers, advocates, and public officials through stakeholder engagement strategy and stakeholder facilitation services
  • Applying the latest in health care trends, best practices, and regulations to your business, including VBP initiatives

Providers

  • Succeeding in the Medicaid managed care environment through strategic business development, MCO contracting and relationship support, VBP models, etc.
  • Incorporating the latest in health care trends and regulations into your business processes

Support Vendors

  • Business and relationship strategies to help technology companies and others providing support for or within a managed care system to succeed in the Medicaid managed care environment
  • Preparing for and winning new Medicaid business by writing, reviewing, and providing technical assistance for responses to requests for information and requests for proposals
  • Identifying the latest in health care trends and regulations and applying them to your business

Experts Who Get Things Done

Get to know our experts and how you can benefit from their experience. Sellers Dorsey includes former Medicaid Directors and health plan executives, clinicians, and former state officials responsible for the development, financing, administration and operation of managed care and long-term services and supports programs for states and health plans.

Gary JesseeManaging Director
Gary Jessee serves as the Managing Director leading the firm’s work in managed care and long-term services and supports. With over 20 years of experience working in health and human services both at the state and national level, Gary assists states, managed care organizations, service providers and support vendors working within the Medicaid space with relationship support and strategic advice and assistance with the design, implementation and expansion of their business. During his tenure in Texas state government, Gary held several key leadership positions including Deputy Executive Commissioner for Medical and Social Services, State Medicaid Director, Chief Deputy Medicaid Director and Assistant Commissioner for Access and Intake Services. Gary also served as President of the Association of States United for Aging and Disability Services.
Read full bio and contact Gary
Pam Coleman, MBASenior Consultant
Pam Coleman’s expertise is in Medicaid integrated managed care including the implementation of programs for complex populations with the need for home and community-based services. Pam served as the Deputy Medicaid Director for the Texas Health and Human Services Commission from 2006 until 2010 administering the Managed Care Operations Department. As a consultant, she has worked with a number of states and health plans to develop and implement Medicaid managed care and MLTSS programs.
Read full bio and contact Pam
Pat Brady, MBAManaging Director
A former Pennsylvania state government official, Pat. Brady offers more than 20 years of experience in federal and state health policy matters. She is an authority on Medicaid financing and provides public and private sector clients with strategic, policy and technical assistance in the design and implementation of revenue maximization initiatives and long-term care programs, in particular Medicaid managed care programs. Pat is providing extensive technical assistance to the Commonwealth of Pennsylvania regarding its Medicaid MLTSS program Community HealthChoices. The ongoing engagement has involved educational work, stakeholder engagement, and supporting the procurement and implementation process.
Read full bio and contact Pat
Tania ColonSenior Consultant
With over 18 years of experience in health care management and design, Tania has a diverse understanding and experience with state and federal regulations. She is part of the firm’s team of subject matter experts in the area of Medicaid managed care, having years of experience working directly with plans and state Medicaid programs. At Sellers Dorsey, Tania is a key intellectual anchor in our work with public programs and MCOs who wish to optimize operations through value based payments. Tania has also assisted a number of national managed care plans with RFP development for MLTSS, Acute Care Medicaid and Dental services.
Read full bio and contact Tania
Billy Millwee Senior Strategic Advisor
As an expert in strategic planning for Medicaid and market positioning, Billy has been able to successfully lead his clients in designing, implementing, and evaluating Medicaid programs. Until August 2012, Billy served as Texas Health and Human Services Commission Deputy Executive Commissioner and Texas Medicaid Director. In recent years he has consulted with at least six states on Medicaid managed care, 1115 waiver development, and value based purchasing strategies, including Texas, Florida, Illinois, and Louisiana, among others.
Read full bio and contact Billy
Nancy KohlerSenior Consultant
A resident expert on Value-Based Purchasing (VBP), Nancy provides assistance in federal and state health policy issues and financial analysis and works with various clients on issues related to VBP in Medicaid managed care and Medicaid financing. Prior to joining Sellers Dorsey, Nancy played a key role in the Statewide Quality Care Assessment for the Pennsylvania Department of Human Services. She has a comprehensive portfolio of experience that includes both large and small scale public health program operations, policy development, implementation, fiscal analysis and strategic positioning. Her years of experience allow her to collaborate effectively with key stakeholders, leverage performance management, organizational effectiveness and process improvement to boost efficiency, drive innovation and most importantly deliver results.
Read full bio and contact Nancy
Emily ZalkovskySenior Consultant
Emily Zalkovsky is a Senior Consultant with strong expertise in Medicaid managed care, health care policy development, and design and implementation of new Medicaid programs. She provides market advisory services, research, and strategic technical assistance to help clients better understand Medicaid so they can make effective business decisions. A recent former Deputy Medicaid Director in Texas, Emily directed a large unit responsible for managed care programs, acute and long-term services and supports policy development, medical benefit design, legislative analysis, and waiver and state plan negotiations. Emily was instrumental in the implementation and ongoing management of several Medicaid managed care programs, including those for adults and children with disabilities, individuals in nursing facilities, dual eligible beneficiaries, and children in foster care.

Read full bio and contact Emily

Sharen LudherSenior Consultant
Sharen Ludher serves as a Senior Consultant for the firm’s work in Medicaid managed care and long-term services and supports. With experience in both the public and private sectors, Sharen assists clients to realize increased success through strategic business advice and intelligence and relationship support. In her previous role as Senior Advisor to the Deputy Executive Commissioner for Medical and Social Services at the Texas Health and Human Services Commission, Sharen provided critical thought, analysis, and recommendations on a wide range of topics including Medicaid managed care and long-term services and supports. Previously, Sharen served as the Director of Policy and Government Programs for Texas Association of Health Plans.
Read full bio and contact Sharen

Brian DeesSenior Consultant
Brian Dees is a Senior Consultant with significant expertise in health care policy, Medicaid managed care program implementations, home and community-based services, managed long term services and supports, and stakeholder relations. Drawing on years of experience in state government, Brian provides strategic advisory and research services for managed care organizations, Medicaid support vendors, providers, and governmental entities. Previously, Brian served as a senior advisor at the Texas Health and Human Services Commission, where he provided policy, program, and legislative analysis for the Medicaid program, and led the design and implementation of a managed care program for children and youth with disabilities.

Read full bio and contact Brian

Kinsey JoliffSenior Consultant
Kinsey provides management and support to a wide spectrum of firm clients in the areas of health policy, Medicaid finance and program operations. Kinsey’s expertise includes health policy development and implementation, program analysis and evaluation, Medicaid program operations, political and community organizing, strategic positioning as well as Federal and state health policy issues. Previously, Kinsey worked as a Project Manager for Buckeye Health Plan where he was responsible for the committee responsible for budget initiatives valued at $60M. Kinsey also worked for the Ohio Department of Medicaid as a policy development manager.
Read full bio and contact Kinsey
Clare Seagraves Consultant
Clare Seagraves is a Consultant with many years’ experience in Texas health and human services, including leading the initial development of the Texas Dual Eligible Demonstration, an integrated managed care program for individuals dually eligible for Medicare and Medicaid. In addition, Clare was involved in the administration of the Texas Medicaid Managed Care program for children in foster care. Clare also served as a lead in developing communications and providing guidance to the Texas Medicaid health plans on implementation of a new Medicaid benefit. At Sellers Dorsey, Clare has been involved in developing relationships between Medicaid MCOs and support vendors and supporting health plans with their pursuit of state Medicaid contracts.

Read full bio and contact Clare

Michael LuckovichConsultant
Michael is an expert in managed care and government programs, providing strategic guidance, operational expertise, and project support. A key area of focus for Michael is the firms’ engagement with the Commonwealth of Pennsylvania to implement its statewide mandatory managed care program. He is combining his operational experience in long-term services and supports with his managed care experience to assist the Commonwealth in this effort. In the past Michael worked for Geisinger Health Plan where he managed operations for multiple products, and he spent over 10 years working for the Pennsylvania Department of Human Services (DHS) and the Department of Aging.
Read full bio and contact Michael

Recent Managed Care Engagements:

Sellers Dorsey has a strong track record of helping clients succeed in Medicaid managed care. Our staff have experience both as former state officials and as consultants serving various clients with diverse goals.

Read some of our client success stories in Medicaid managed care.

Investing in Relationships and Knowledge

Sellers Dorsey stays abreast of the latest rules and guidance from CMS and is connected to policymakers, payers, and providers, maintaining knowledge and relationships that enable us to help clients to be successful. Our staff regularly communicate with leaders and staff of organizations and affiliations in the industry, and they attend events with members of the Medicaid managed care community.

We attend industry and issue-focused events year-round. Please let us know if you would like to meet a member of our team at an upcoming event. If you are an event organizer and are interested in hearing one of our thought leaders speak to your audience please contact us at [email protected]

See our events list here

Contact Sellers Dorsey

If you would like additional information or wish to speak to any of our experts about issues facing your managed care organization, please get in touch and we will have a conversation at a time that’s best for you.