加勒特亚伯拉罕森

Mr. 加勒特·亚伯拉罕森(加勒特亚伯拉罕森)是一名医疗顾问, 使用以客户为中心的方法交付有影响力的财务可交付成果. PCG医疗保健融资解决方案(HCFS)卓越中心副经理, he has a background in Medicare and 医疗补助计划 成本报告, 供应商费用建模, 医疗审计, 绩效工资考核, 离散的成本分析, 以及制度利率设定.

His work includes leading teams in cost recovery and revenue maximization initiatives for Emergency Medical Services (EMS) providers across the country. Mr. 亚伯拉罕森还领导客户参与双重资格医疗计划, providing Third Party Administration (claims adjudication) services.

Mr. Abrahamson joined PCG in 2009 and holds a Bachelor of Arts in Political Science and a Master of Business Administration in Finance, 都来自克拉克大学.

Mr. Albertoni在州公共卫生规划和医疗补助方面有16年的工作经验. 他曾担任资格、预算和财务、福利和豁免方面的领导职务. 他理解政府领导人在大规模改革中面临的挑战, 复杂的程序, 并致力于帮助客户实现优化当地和区域医疗服务获取的目标. Mr. Albertoni管理着一个专注于医疗保健获取和市场的咨询服务团队, including health plan regulatory 合规 consulting for both 状态 insurance departments and 医疗补助计划 managed care programs.  Mr. Albertoni的团队还帮助各州和县建立行为医疗保健系统的接入和能力. 最后, 他的团队帮助各州积极计划医疗补助的资格标准, 健康保险市场, 以及其他使用联邦豁免授权的州医疗保健计划(1115, 1332, 1915, 等.)和国家计划选项.

Mr. 奥尔德里奇是公共咨询集团(PCG)的经理，在该公司工作了20多年. 在他的任期内, 他在全国各地的卫生和公众服务机构管理了几十个项目.  Mr. Aldridge领导PCG卫生实践领域的付款人服务单位, 主导控制付款人的成本, 包括医疗补助计划和mcco, through placement of tighter controls on member 资格, 供应商的监管, and monitoring and consumer assistance initiatives.  具体地说,先生. Aldridge has led large-scale project teams in North Carolina, 俄亥俄州, 缅因州, 麻萨诸塞州, 密歇根, 西维吉尼亚州, 和路易斯安那州. He also led PCG’s Medicare Part D State-to-Plan claims reconciliation project with the Federal Center for Medicare and 医疗补助计划 Services (CMS).  通过这些努力, PCG’s project teams strive to improve efficiency and precision in the administration of various public sector health programs. 作为一个结果, PCG has generated hundreds of millions of dollars in revenue and cost savings direct to the program and measurable efficiencies through technological and administrative improvements. Mr. Aldridge’s educational background includes an undergraduate degree in Economics from Clemson University and a Master of 健康 Care Administration degree from the University of North Carolina at Chapel Hill.

希瑟·考德威尔 is an associate manager in 健康 at PCG. 在这个角色, she works with the cost allocation team to help government health agencies claim reimbursement from the federal government for administrative activities. 希瑟为客户管理随机时间研究和成本分配处理. 她还提供咨询服务. 希瑟和她的团队在跨机构和联邦项目的项目中工作, 包括医疗补助, the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), 和标题四.

在加入PCG之前, 希瑟曾担任多个职位，专注于业务开发和项目管理. With two decades of experience working with government programs, 她对帮助缺乏服务的人群过上更好的生活充满热情.

希瑟毕业于牛津迈阿密大学国际研究专业，获得文学学士学位, OH. She also completed a Master of Business Administration (MBA) degree with a concentration in Management Information Systems (MIS) from the State University of New York at Albany.

除了, Heather volunteers with End 68 Hours of Hunger, a non-profit program 设计ed to provide meals to children for the approximate 68 hours of hunger that some school children experience between the free lunch they receive in school on Fridays and the free breakfast they receive in school on Mondays.

Mr. Carlson在医疗保健技术领域拥有超过20年的经验. 他曾监督许多电子健康记录的开发和实施, 收益周期管理, 商业智能, 以及全美的卫生信息交换(HIX)系统. 对你们的健康, he oversees the 健康 Software Development team, which develops and deploys a wide scope of SaaS applications. Mr. Carlson拥有Northeastern University的计算机科学学士学位.

Mr. Cheesman directs PCG’s Member Eligibility Management group. 在这种能力, Peter 设计s and deploys creative technical solutions connecting government agencies with third-party verification data and predictive analytics 设计ed to automate and expedite manual case processing activities and identify public assistance in资格 和欺诈. As a leading subject matter expert in this area, Peter also regularly assists the world’s largest data providers in 设计ing and deploying complex data management and predictive analytics solutions aimed at the human services (HHS) market.

Mr. Cheesman brings more than 15 years of identity, 资格, and data management experience across more than 100 federal and 状态 agencies focused on public sector information technology (IT), 包括数据分析, 管理咨询, 系统集成, and the 设计 of 资格 quality control systems and services. 他监督盈科市场领先的会员资格管理小组的发展和成长, including the 设计 of proprietary PCG software; PCG Instant Eligibility Verification System & API网关，PCG预测分析系统，PCG资格审核 & 系统精度保证引擎, 盈科资产核查系统, PCG威胁监控服务, and the PCG Managed Care Population Monitoring Service.

在加入PCG之前，Mr. Cheesman worked for multiple public sector consulting firms supporting biometrics-based identity and access management initiatives, 包括边境安全, 监测, 身份管理市场. Mr. 他持有Clark University的工商管理硕士学位, 东北大学工商管理学士学位.

Mr. Curatola, 具有PCG和PMP认证的经理, has more than 29 years of experience in the Information Systems industry with over 22 years in project management and 18 years in 医疗补助计划.  他在公共和私营部门(包括州政府)拥有丰富的项目管理经验, 财产及意外保险, 医疗保险, 和银行.  Mr. Curatola是一位公认的领导者，具有出色的沟通和人际交往能力, and has extensive experience in resolving conflicts within teams, 以及跨职能领域.  他成功地领导和实施了许多大中型系统和项目.

Mr. Dachos, a Manager in our 健康care Financing Solutions division, has 13 years of 医疗补助计划 and 健康care experience with PCG. He leads PCG’s Emergency Medical Services (EMS) division, 他在哪里监督成本回收和收入最大化计划. 在这个职位上，Mr. Dachos is directly responsible for the 发展, 设计, 实现, and ongoing administration of EMS reimbursement programs. He manages these programs for over 200 providers in Texas, 佛罗里达, 华盛顿, 和俄勒冈州, 以及科罗拉多州的州级项目. Mr. 达克斯还担任6个州级学校卫生服务医疗补助计划的项目经理, 支持1个以上,全国的000个学区. 通过这些约会，Mr. Dachos负责监督收入最大化和合规的规划领域. He possesses a deep understanding of the modeling requirements and analysis necessary to 设计 and implement supplemental reimbursement programs. He has vast experience working with Centers for Medicare and 医疗补助计划 Services (CMS) throughout the program approval process, including composing legislation and State Plan Amendments, developing 合规-driven reimbursement strategies, 并协商联邦批准. Mr. Dachos graduated from Bates College with a Bachelor of Science, 并获得克拉克大学工商管理硕士学位.

Mr. 德怀尔, a Manager located in our Boston office since 1993, has over thirty years of experience in financial and operations management in corporate and healthcare provider and payer environments.  对于供应商,先生. 德怀尔 has been actively involved in improving revenue and management operations to optimize program revenues and to bring healthcare facilities into 合规 with federal, 状态, 以及其他第三方需求.  这项工作涵盖了包括医院在内的各种提供者设置和程序, 社区精神卫生中心, 有联邦资格的健康中心, 公共卫生诊所, 部分医院, 医药(医疗保险D部分)服务.  为纳税人, he has directed third-party administration and related services for 状态 agencies and private insurance companies who chose to outsource those functions.  Mr. 德怀尔 has also directed numerous planning and evaluating projects involving mental health hospital and community-based programs. 在这些活动中, expanded use of automated systems and system 实现 and change management services were provided to achieve optimal results.  Mr. 德怀尔在位于马萨诸塞州韦尔斯利的巴布森学院获得了工商管理硕士和工商管理硕士学位.

Ms. 加拉格尔在PCG工作10年了. Ms. Gallagher helps lead the Cost Allocation Center of Excellence, 专注于成本分摊, 时间研究, 医疗补助和第IV-E法案, 业务流程审查, 目标病例管理(TCM)和医疗补助行政索赔(MAC), and training initiatives for PCG with experience in health agencies, 快乐8官网机构, 还有几十个州的部落组织. 她工作, 或工作, on large scale efforts in 状态s including Texas, 科罗拉多州, 印第安纳州, 阿肯色州, 麻萨诸塞州, 罗德岛州, 和亚利桑那州. 这些努力包括随机时刻时间研究的回顾和重新设计, 组织评审, 以及增收工作. Ms. Gallagher has conducted several nationwide training sessions, 许多代表国家人力服务财务官员协会(HSFo), 在儿童福利筹资领域, 医疗补助计划, 和成本分配. Ms. Gallagher earned a Master of Business Administration degree from Clark University and holds a Bachelor of Science Degree in Business Administration from Boston University.

安德鲁·希尼, PCG的副经理, 在卫生信息技术(HIT)方面有丰富的经验, 卫生信息交流, 健康保险交易所(HIX), 电子健康纪录(EHR), 各州医疗补助计划, 财务管理, 综合资格系统, 业务流程设计, 以及卫生和公共服务项目规划. 公司健康创新部门的认证项目管理专家(PMP), 政策和信息技术团队, Mr. Heaney曾在州和县一级担任多个客户项目的项目经理, 包括领导PCG规划, 采购, and 实现 projects for the State of Wisconsin’s enterprise EHR system and the Commonwealth of 麻萨诸塞州’ 健康 Safety Net (HSN) program, 最近. 在这些约会之前，Mr. 希尼提供咨询服务和监督全州范围内的HIE在怀俄明州的实施. Through extensive project management and consulting experience in various 状态s across multiple 医疗补助计划 and 健康 Insurance programs, Mr. Heaney has honed a comprehensive understanding of the major goals, 挑战, and initiatives involved in managing large and complex HIT projects. Mr. Heaney holds a Bachelor’s degree in Economics from Colby College and a Master of Business Administration (MBA) from Clark University.

Mr. Holman has been working in health policy for the past decade, starting in the 美国 Senate working on Medicare, 参议员Debbie Stabenow(密歇根州民主党)和财政委员会的芯片和健康IT领域. Mr. 霍尔曼还曾在华盛顿担任说客，专注于医疗IT融资和标准开发, 主要是在隐私方面, 安全与保密, 作为立法的起草者，最终创建了“有意义使用”项目. Mr. Holman’s private sector experiences have focused primarily on operations improvements and the 发展 of growth strategies for commercial hospital and insurance companies. 他的许多客户代表了美国最大的医疗保健公司, 包括HCA, 美国健康, 信诺, 和合作伙伴医疗. Since the passage of the Affordable Care Act, Mr. Holman has worked with various Partnership and State-based Marketplaces in assisting with the certification of their Qualified 健康 Plans, as well as on various 医疗补助计划 waiver programs. Mr. Holman currently oversees PCG’s work on Delivery System Reform Incentive Payment (DSRIP) waiver programs across various 状态s such as New York, 新泽西和马萨诸塞州. Mr. 他拥有密歇根大学的文学学士学位和哈佛大学的理学硕士学位.

Mr. 休斯(MBA, CHFP), 公共咨询集团的经理, 是否有经验丰富的健康管理顾问，专注于财务管理, 战略规划, 政策分析, 信息技术评估, and management reporting for 医疗补助计划 agencies. 他目前担任PCG健康创新的卓越中心(COE)负责人, 政策, 和信息技术(HIPIT)部门. HIPIT部门领导该公司在全国范围内的医疗服务体系转型工作, 卫生政策, 健康信息技术咨询. These projects include delivery system reform efforts, 支付方式改革, patient centered medical home and health home program 设计, 健康数据分析, 行为健康系统设计, 合资格双重人口管理, 健康交流发展, MES是评估, PMO, 与制度创新咨询. Mr. Huse received his Bachelor of Arts in Economics and Neuroscience & Behavior from Wesleyan University and completed a Master’s Degree in Business Administration (MBA) with a concentration in health care administration from Clark University. He is also a Certified 健康care Financial Professional (CHFP) with the 健康care Financial Management Association (HFMA).

An Associate Manager within the firm’s 健康 Innovation, 政策, 和信息技术(HIPIT)团队, Tom在卫生信息技术(HIT)方面有丰富的经验。, particularly in the areas of 医疗补助计划 资格, 医疗补助企业系统(MES), and 健康 Insurance Exchange (HIX) 实现s. 他拥有超过15年与政府合作的国际经验, 以及公共和私人组织. Supporting projects at both the 状态 and Federal levels, Tom’s most recent work includes modular MES transformations and other business and technology modernization initiatives. His team specializes in supporting HIT projects and providing related professional services for program and project management, 业务分析, 质量保证, 和技术咨询. 他的投资组合包括由医疗改革推动的项目，以及为PCG客户提供规划支持, 采购, 资金的请求, project management office (PMO) setup and operations, 实施支持, 和第三方用户验收测试(UAT).

Tom’s professional interests include introducing new technologies into the public sector; he is a blockchain enthusiast and a certified Project Management Professional (PMP).

Mr. McCourt，副经理，自2011年以来一直是PCG团队的成员. Dale brings over 25 years of experience spanning many industries where he has served in a variety of roles including Chief Operating Officer, 项目经理, 财务经理 & 管理和老. 保险精算的分析师. Dale’s innate curiosity and eagerness to solve problems using process improvement techniques and technology solutions has manifested itself in the 发展 of new product lines aimed at proactively guarding against 医疗补助计划 provider fraud, 浪费和滥用, 以及通过高接触教育提供者遵守医疗补助计划, technology-driven 供应商的监管 techniques. 戴尔•麦考特 holds a Bachelor of Science degree in Mathematics and Computer Science and is a certified Project Management Professional (PMP). 戴尔住在阿什维尔, 与妻子的NC, 威利, 他们是狂热的铁人三项运动员, 享受游泳, 骑自行车和跑步.

Ms. 莫里斯, 该公司医疗保健融资解决方案团队的副经理, 有经验的项目经理主要关注健康和医疗补助计划吗. A certified Project Management Professional (PMP), Ms. 莫里斯 currently oversees several rate setting, 价值取向的采购, 以及成本报告项目也为各种附加项目提供项目管理支持. Ms. 莫里斯领导了该州的一些项目, 县, 和提供者的水平, 包括最近担任威斯康星州医疗补助成本报告(WIMCR)项目的项目经理, 纽约消防局紧急医疗服务补助补充支付项目, and the District of Columbia Behavioral 健康 Rate Study, 举几个例子. She has more than a decade of project management, 政策发展, and 实现 experience; during her tenure at PCG, Ms. 莫里斯 has played a project management role to support all stages of 医疗补助计划 reimbursement and 支付方式改革 programs. Ms. 莫里斯 holds a Bachelor’s degree in Business Administration and Accounting from Emory University and a Master’s degree in Public Administration from the University at Albany.

该公司医疗保健融资解决方案团队的副经理, Alissa Narode在该州有广泛的经验监督医疗补助费率设置和费率研究项目, 县, 和提供者的水平. 她于2015年加入盈科. Narode曾担任多个关键客户项目的项目经理，包括, New York State’s School Supportive 健康 Services Program (SSHSP), 佛罗里达’s Public Emergency Medical Transportation (PEMT) program, and Ground Emergency Medical Transportation (GEMT) programs for the States of Iowa and Illinois – 举几个例子. 对于这些项目和其他项目，邓文迪说. Narode与州和地方政府机构的利益相关者密切合作, 提供紧急医疗服务的机构, 以及县医疗服务提供者监督年度医疗补助费用报告的完成情况. Her role spans all aspects of the 成本报告 process, from staff training and preparation to data analysis, 审查, 审计的支持, 和更多的. Ms. Narode joined PCG with broad policy and healthcare experience including over four years with the New York State Assembly and Ways and Means Committee where she served as the Principal 健康 Budget Analyst. She holds a Bachelors degree from the State University of New York (SUNY) at Cortland and a Masters degree in Public Administration from SUNY at Binghamton.

Mr. Peck在PCG工作了13年以上, 专门研究医疗补助计划的完整性, 质量改进, 和受益人的正当程序. He has successfully led the 实现 of large-scale projects, 比如俄亥俄州的“提供者监督”项目, 以及更集中的努力，如PCG在北卡罗来纳州的“事先授权和正当程序监督”. Mr. Peck has developed a team of Program Integrity (PI) professionals, 包括临床评论者, 数据分析师, 和医疗专家, 帮助了许多州改善和优化他们的PI操作. 这个团队的成就运行了程序完整性操作的范围, 从数据分析和预测建模, 医疗记录审查和审计, 到组织运营咨询. 通过了解医疗补助计划的现状和各州预算的现实情况，奥巴马说. 派克的团队帮助他们的客户识别了数百万美元，不仅是在恢复过程中, 但在成本规避方面也是如此, 从而帮助修改提供者的行为, 提高合规, and maximize the impact of limited 医疗补助计划 dollars. 除了医疗补助计划(医疗补助计划)，奥巴马还表示. Peck has experience in 合规 审查s under the Social Security Act and auditing similar claims as part of a quality control initiative. 他还协助多个州完成了ACF联邦Title IV-E审计. Mr. 派克毕业于雪城大学(Syracuse University)，获得法学学士学位 & 他在克拉克大学获得工商管理硕士学位.

Mr. Sorrentino, 快乐8网站医疗保健融资解决方案部门的经理兼卓越中心(COE)负责人, 是拥有15年以上医疗补助和医疗保健经验的管理顾问吗. Mr. 索伦蒂诺专门从事这个设计, 实现, and evaluation of healthcare operations and payment systems. 具体到医疗保健业务. 索伦蒂诺负责监督PCG的索赔处理服务和解决方案, 数据中介服务, 以及收益周期管理服务. 他曾协助医疗补助机构, 私人费用, and providers in implementing efficient and cost effective outsourcing solutions to process claims and supporting functions, streamlined the collection of important healthcare data to empower policymakers to make informed decisions on healthcare programs and resources, 优化了供应商的资金来源, 特别关注对医疗安全网至关重要的公共提供者. In terms of payment and reimbursement systems, Mr. 索伦蒂诺领导了利率设定, 供应商评估, 以及为机构和社区服务的公共支付者开展的其他重要财务管理工作. He has helped 医疗补助计划 agencies and other publicly-funded programs move from cost-based reimbursement programs to acuity-based reimbursement methodologies, and now to value-based reimbursement strategies. 此外,先生. Sorrentino has advocated for safety net public providers that provide a disproportionate share of healthcare services to the 医疗补助计划 and uninsured patient populations. 他帮助公立医院确保了新的医疗补助计划的重要资金来源, 以社区为基础的供应商, 在第一时间作出回应, 以及学区通过开拓创新的补充支付策略和项目. Mr. Sorrentino has navigated 医疗补助计划 agencies and other healthcare programs through all facets of these strategies from program 设计, to facilitating stakeholder engagement and feedback, 就联邦批准进行谈判, 最后是项目的实施.

Mr. Staubley是盈科健康部门的实践区域总监，也是盈科股东. 在这个角色, he provides executive leadership to over 400 staff who manage a portfolio of over 200 projects that span across more than 35 状态s. Mr. Staubley is an experienced health and human services leader, 与州和地方卫生和快乐8官网机构合作超过20年. 他提供了各种报销转换的行政领导, 包括监督向基于资源的支付方法的转换, 绩效工资的实现, 以及供应商索赔方法的业务流程重组，以适应支付改革工作. 先生于一九九四年加入盈科. Staubley has also been deeply involved in the determination and reporting of provider costs as part of cost-based and/or cost settlement reimbursement mechanisms for federal health and human service programs.  他支持快乐8网站客户进行各种正在进行的报销操作, 包括年度利率设定工作, 成本结算功能, 审核和评估供应商提交的成本和利用率数据. Mr. Staubley’s work has covered a broad and diverse set of programs, 例如家庭和社区服务, 以学校为基础的服务, 运输项目, traditional 状态 plan community-based services, 机构服务, 而最近, 配送系统改革方案.  除了担任PAD的角色外，Mr. Staubley担任人力资源解决方案组织(SSO)总裁.

Mr. Waldinger, 盈科经理, is an experienced 医疗补助计划 policy and reimbursement professional who focuses on healthcare operations and reimbursement transformation, as well as mental health and substance abuse policy and integration.

Mr. Waldinger’s current role at PCG includes oversight of PCG’s 第三方管理(TPA)业务线，包括登记、理赔处理、客户服务和个案管理. 服务非牟利及公众客户, 调整快乐8网站贸易促进权业务，以满足公共部门客户的独特需求.

Mr. 瓦尔丁格的背景是医疗补助计划的报销计算, 政策发展, 和转换. His experience speaks to multiple behavioral health engagements, 从供应商战略规划, to 状态wide behavioral health services assessments, 发展奖励整合社区服务的补偿方法. Mr. Waldinger’s in-depth understanding of provider costs, 成本报告, 成本建模, 有成本结算经验, provides clients with a unique understanding of the behavioral health system and potential impacts of policy changes.

作为马萨诸塞州医疗补助计划的前首席财务官和预算主任, Mass健康, and CFO for the 麻萨诸塞州 Behavioral 健康 Partnership (MBHP), Mr. 瓦尔丁格负责理解所有规划和政策变化对财政的影响, 包括建筑, 更新, and tracking of all provider reimbursement calculations, 政策, 和影响.  在Mass健康,先生. Waldinger led all financial efforts related to multiple successful State Plan Amendments (SPAs) and 1115 Waiver submissions, 包括马萨诸塞州2005- 2006年里程碑式的医疗改革豁免.

与先生联系. 瓦尔丁格在社交媒体上:

在推特上 @WaldingerPCG

在LinkedIn www.linkedin.com/in/jameswaldingerpcg

Mr. 韦伯，PMP，在PCG工作了13年. Mr. Weber helps lead the 健康 Care Financing Solutions (HCFS) Center of Excellence with over twelve years of public sector consulting focusing on publicly funded healthcare programs 包括医疗补助, 芯片, 和医疗保险, 重点是在机构和社区项目中的医疗补助报销. 他领导PCG在全州范围内的努力，为社区开发和实施cms批准的报销方法, EMS, 以及纽约的基于学校的服务项目, 新泽西, 麻萨诸塞州, 宾西法尼亚, 西维吉尼亚州, 乔治亚州, 和威斯康辛州. Mr. 韦伯在机构成本报告和利率设定方面也有丰富的经验, 包括为州立精神科准备医疗保险和医疗补助的成本报告, 急症护理, 以及长期护理设施. 除了 to his health care financing expertise, Mr. Weber has also led 状态wide programmatic and financial assessments of publicly funded behavioral health services in Texas and 西维吉尼亚州. Mr. Weber’s experience also includes leading PCG’s efforts supporting the New York State Department of 健康 in the 实现 and operation of the 状态’s Delivery System Reform Incentive Payment (DSRIP) Program. Mr. Weber graduated with a Bachelor of Arts in Economics from the College of the Holy Cross in 2005 and a Masters of Business Administration from Clark University in 2009.

Angelene Willetts-Carvi是公共咨询集团医疗支付服务部门的副解决方案经理. 拥有超过20年的家庭和社区服务经验, 她负责评估, 发展, and delivery of HCBS Quality Oversight Support Services. Ms. Willetts-Carvi oversees Quality Oversight operations in Illinois, 马里兰, 密歇根, 和俄亥俄州, conducting critical incident and health and welfare investigations, 供应商合规审查, 现场访问, 用例记录审查, 供应商登记, 和供应商培训. She is a subject matter expert on HCBS waiver services, 国家计划服务, 事件调查, 合规, 民族自决, 豁免遵守, 计费, 和欺诈. Ms. Willetts-Carvi has received her bachelor’s degree from Capital University in Psychology and is obtaining her MBA with a focus on healthcare administration from Clark University.