Managed Care

Working with states, providers, managed care organizations, and administrative support organizations across the nation, our consultants provide strategic advice, technical assistance and relationship management to help achieve goals where business and policy intersect in managed care service delivery systems.

CLIENTS AND SERVICES
Managed Care Expertise Tailored for Clients

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

Take a look at our capabilities with the various clients we serve:

  • 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
  • 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
  • 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
  • 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
  • Provide advice on Part C and D Medicare operations and compliance
  • Training or interim staffing to fill gaps in case processing, subject matter expertise, and management
  • Prepare Medicare plans for CMS Program Audits by conducting mock audits using CMS protocols and coaching staff for desktop reviews and interviews
  • Build monitoring and auditing programs to ensure their operations are compliant with CMS requirements
  • Provide program management for Medicare bid process, readiness audits, data validation audit submissions, and timeliness monitoring projects

OUR TEAM
Managed Care Experts Who Get Things Done

Get to know our experts and how you can benefit from their experience. Sellers Dorsey includes former Medicaid Directors, 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 Jessee
Managing Director
Pat Brady
Managing Director
Nancy Kohler
Director
Janice Fagen
Senior Strategic Advisor
Karen Brach
Director
Sharen Ludher
Director
Brian Dees
Senior Consultant
Michael Luckovich
Associate Director

Gary Jessee assists states, managed care organizations, service providers, and support vendors working within Medicaid. For 20+ years, he’s worked in health and human services at state and national levels, and his successful tenure in Texas state government comprises several leadership roles, including State Medicaid Director.

Read Full Bio view entire team

Offering 20+ years’ experience with federal and state health policy, Pat is an authority on Medicaid financing. She provides public and private sector clients with strategic, policy, and technical assistance throughout revenue maximization initiatives and long-term care programs, particularly Medicaid managed care programs.

Read Full Bio view entire team

A resident Value-Based Purchasing (VBP) expert, Nancy works with clients on VBP in Medicaid managed care and Medicaid financing. Prior to Sellers Dorsey, she was integral to PA’s Statewide Quality Care Assessment, and her comprehensive experience includes public health program operations, policy development, implementation, fiscal analysis, and strategic positioning.

Read Full Bio view entire team

Janice is a seasoned expert and leader in the health care industry. She is the former Vice President of Medicaid Operations at Blue Cross and Blue Shield of Texas. Janice’s areas of expertise include Medicaid managed care, RFP and state procurements, managed care contract development, solicitation support, value-based care strategy, business development, health care operations, and enrollment.

Read Full Bio view entire team

Karen is a former managed care executive with more than 20 years of leadership experience in the health care industry. She uses her areas of expertise including managed care, Medicaid policy, RFP and state procurements, and mergers and acquisitions to support Sellers Dorsey clients. Before joining Sellers Dorsey, Karen was the President and CEO of Meridian Health Plan for four years.

Read Full Bio view entire team

Sharen Ludher serves as Director of Consulting Operations 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 helps clients through strategic business 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.

Read Full Bio view entire team

A seasoned health policy expert, Brian Dees, Senior Consultant, provides strategic and business planning assistance to Sellers Dorsey clients using his in-depth knowledge of managed care and Medicaid policy.

Read Full Bio view entire team

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 to help the Commonwealth of Pennsylvania, combining his operational experience in long-term services and supports with his managed care experience. 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 view entire team

CLIENT STORIES
Client Success in Managed Care

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

EVENTS AND CONFERENCES
Continual Growth in Knowledge and Relationships

Through our ongoing work and our relationships with key decision makers and thought leaders in the private sector and in state and federal governments, Sellers Dorsey remains well informed of the latest rules and guidance from CMS and trends and innovations emerging from the private sector. Our staff regularly communicates with leaders and staff of organizations and affiliations in the industry, and they attend events with these influencers and decision makers 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 info@sellersdorsey.com.

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.

     
     
     
     
    Sellers Dorsey is tracking and assessing the large volume of information coming from the Biden Administration, Congress, CMS, and state governments regarding Medicaid. Sellers Dorsey publishes these updates in a weekly newsletter called the Sellers Dorsey Digest.
    Sellers Dorsey Digest.
    • Alex Abbott
    • Vinu Abraham
    • Susan Ackerman
    • Nomair Alam
    • Leesa Allen
    • Scott Allocco
    • Alexa Altman
    • Josh Anderson
    • Chris Bailey
    • Christina Bascomb
    • Andy Baskin
    • Pamela Bentancor
    • John Benz
    • Ryan Bishop
    • Tanya Boone
    • Karen Brach
    • Pat Brady
    • Mindy Braithwaite
    • Wendy Braunstein
    • Sarah Brooks
    • Olivia Brown
    • Virginia Brown
    • Nancy Brucker
    • Matthew Bucknell
    • Jordan Bullock
    • Cherie Buser
    • Jessica Candito
    • Julie Cannariato
    • Mari Cantwell
    • Kevin Carvalho
    • Christopher Chang
    • Elisabeth Clauss
    • Stephen Coady
    • Mark Colantonio
    • Corie Colby
    • Jana Covington
    • Pilarica Crocker
    • Jay Davenport
    • Brian Dees
    • Randie DeHerrera
    • Rachel Delavan
    • Tyler DeRubio
    • Jose Diaz
    • Rosalinda DiTommaso
    • Donna Dorris
    • Brian J. Dorsey
    • Alexia Duany
    • Robert Ducay
    • Jennifer Duffy
    • Leslie Duran
    • Janice Fagen
    • Tressa Feher
    • Rachel Feldman
    • Paul Frank
    • Lauren Fujioka
    • Josh Gall
    • Darin Gordon
    • Fran Grabowski
    • Jason Green
    • Kathy Grogan
    • Meagan Guidry
    • Sierra Hamilton
    • Leah Hartlander
    • Michael Heifetz
    • Matthew Hertzog
    • Jason Ivey
    • Sofia Javed
    • Gary Jessee
    • Alexandra Kanemaru
    • Nina Kavarthapu
    • Heather Kennedy
    • Amaan Khan
    • Tiffany Ko
    • Nancy Kohler
    • Deborah Kozick
    • Drew Kyler
    • Christopher Labonte
    • Elizabeth LaMair
    • Elaine B. Lamarre
    • Mason B. Lane, Esq.
    • Tasha Laney
    • Michael Larmond
    • Stella Lee
    • Shawna Leeds
    • Vas Litkewycz
    • Felicia Lockhart
    • John Louiselle
    • Michael Luckovich
    • Sharen Ludher
    • Marisa Luera
    • Cassandra Ly
    • Joe Madsen
    • Matthew Maughan
    • John McCarthy
    • Brian McGuckin
    • Cathleen McNelis
    • Jessica Mead
    • Kerstin Meeks
    • Allison Montano
    • Mike Moss
    • Amanda Mozes
    • Megan Mueller
    • Janel Myers
    • Seun Onafowora
    • Matt Onstott
    • Mario Ortiz
    • Clayton Palmer
    • Sarah Rabot
    • Lauren Rava
    • Scott Reasonover
    • Stephen Reightler
    • Karla Richardson
    • Gabe Roberts
    • Edwin Roby
    • Justin Rodriguez
    • Kurt Runco
    • Riyaz Sachak
    • Rossana Sandoe
    • Justin Sauerwine
    • Carla Scarpone
    • John Seaver
    • Arianne Sellers
    • Martin D. Sellers
    • Nancy Smith-Leslie
    • Mark Smith
    • Ann Spishock
    • Dave Spishock
    • Justin St. Andre
    • Bradford Stansbury
    • Lydia Storey
    • Jennifer Stratton
    • Jen Swails
    • Regine Tilghman
    • Jeremy Tipton
    • Tom Traylor
    • Tara Turse
    • David Ulsh
    • Carol Villecco
    • Michelle Welby
    • Billy Werner
    • Zach Williams
    • Tessa Wimmer
    • Lauren Wolf
    • Meredith Wurden
    • Mia Young