ATTAC Consulting Group’s Leadership and Consulting Team

Sharon is a member of ACG’s clinical pharmacy team supporting Medicare Part D, Medicaid, and pharmacy benefit management groups. Sharon has extensive experience in integrated clinical practice, formulary management, operational process reengineering and PBM oversight. She has designed and implemented utilization management programs for long-term care provider groups (Medicare Part A/ managed care) and has organized and participated on corporate JCAHO certification teams, for both skilled nursing facilities and pharmacies. Her experience as both a clinical pharmacist and national manager provides unique qualifications and insights into the internal workings of a broad scope of healthcare environments, including acute care, chronic care, long term care (LTC), and Medicare/Managed care arenas. She has over 20 years of healthcare industry experience and has worked for RX Answers and Phamerica, as well as serving on the Board of Directors for the American Society of Consultant Pharmacists.

Laurie is part of ACG’s clinical pharmacy practice group serving all program segments. She has extensive experience in clinical and operational management of pharmaceutical services in a complete scope of healthcare environments, including Medicare health programs, acute care and LTC arenas. Her multi-industry expertise has included integrated clinical and operational strategic planning, pharmacy network oversight, PBM oversight, pharmaceutical contract evaluation and negotiation, and process reengineering to enhance margin and compliance. She is a co-author of CMS Star Rating analysis and performance improvement tool-kit. Laurie is a member of the American Society for Consultant Pharmacists (ASCP) and the Academy of Managed Care Pharmacy (AMCP).

Angela has over 15 years of experience and leadership in commercial and Medicare pharmaceutical program management with management expertise in Medicare Part D operations and regulatory compliance, medication therapy management, chronic disease management as well as in development of prescriber and patient educational programs designed to support formulary adherence and patient drug therapy adherence.  She has previously worked for organizations such as Constellation Health, LLC, BeneCard, Total Therapeutic Management and Kaiser Permanente.

Margaret is a member of ACG’s Clinical Management and Government Programs groups. She provides ACG clients with over 35 years of healthcare administration experience with expertise in Utilization, Quality and Case Management program design, and implementation with focus on effective use of data for population targeting and management. Margaret’s broad experience includes developing and implementing Model of Care (MOC) for Medicare Special Needs Plans. Prior to joining ATTAC Consulting Group, Margaret held senior roles at CareMore Health Plan, Healthcare Partners, Matria Healthcare, Blue Shield of California and CarePath.

Helene is a member of ACG’s Clinical Management and  Government Programs Groups.   Helene brings to clients expertise in practical implementation of clinical and quality operations in the areas of commercial health plans, managed Medicaid, Medicare Advantage and Dual programs, Special Needs Plan (SNP) Model of Care, Medicare STARs, CAHPS, HOS and other Quality Programs and NCQA Accreditation.  She has extensive experience in management of delegated provider groups and California DMHC requirements.  Her past roles have included serving as Director Regulatory Compliance and Director of Quality for Blue Shield of California, VP of Quality Improvement at Arcadian Health Plans and VP of Quality Programs at Bravo Health (now part of Cigna).

Sheila is a member of ACG’s Clinical Management and Government Programs groups, specializing in the areas of managed Medicaid, Medicare and Dual programs, Special Needs Plans (SNP), federal and state regulations, risk management, and clinical operations. She has worked with the California Department of Managed Care (DMHC), NCQA, and URAC. Her past roles include Executive Director of Clinical Services and Long Term Care Operations at Presbyterian Health Plan in Albuquerque, Director of UM, QM and Credentialing for CareMore Health Plan in CA, and Director of Accreditation and Credentialing at Blue Shield of California.

Angela is a member of ACG’s Clinical Management and Government Programs groups, specializing in the areas of Special Needs Plans (SNP), federal and state regulations, risk management, and clinical operations.  Angela is also an NCQA SNP-MOC Reviewer.

Darlene is a member of ACG’s Government Programs Practice Group. She brings broad expertise in organizational development and compliance management in the Medicare and Medicaid arenas. For over a dozen years, she has held senior legal and compliance roles within the insurance and managed care industries, where she has led activities as diverse as health plan start-up, management of JCAHO and NCQA accreditation, state and CMS regulatory oversight audits, managed line responsibility for grievances and appeals, sales agent oversight and market conduct along with business processes and policy for corporate record retention. She has previously worked for Centene Corporation, AmeriGroup and United Healthcare.

Rick is a member of ACG’s Government Programs and Health Plan Operations groups, consulting on compliance management and oversight as well as fraud, waste and abuse program development and implementation. Rick consults on Medicare Advantage and Medicare Part D program implementation and compliance monitoring, including grievance and appeals, claims payment, COB processes, Part D transition management and PDE management business processes. Over his almost 20 years in the industry, Rick has held senior compliance and FWA auditing roles with organizations such as United Health Care, National States Insurance and American National Insurance.

Cindy is a member of ACG’s Government Programs group. She leads clients in health plan operations and compliance monitoring activities, specializing in licensure and regulatory interface, enrollment, customer service, grievance, appeal, CTM complaint management, marketing, sales oversight, HIPAA, internal and downstream delegate oversight and training program development across all operational arenas. Cindy also specializes in Accountable Care Organization (ACO) compliance programs. Her operational and compliance experience crosses Medicare, Medicaid and Commercial lines of business. She previously held senior compliance and oversight roles at WellCare Health Plans, Windsor Health (serving as CCO), and the Tennessee Department of Commerce and Insurance, with responsibility for oversight of various TennCare program plans.

Erin Miskell is a member of ACG’s Compliance Solutions and Operations Groups.   She is an accomplished project manager who has led enterprise-wide initiatives to restructure compliance oversight of delegated provider entities, off-shored operations, sales and marketing agents and other delegates including creation of pre-delegation review programs, audit tools, design of required data feeds and monitoring programs.   In addition she has been responsible for state regulatory interface for a multi-state organization for commercial, Medicare and Medicaid programs.   She has been a key participant in the implementation process for multiple state Medicaid MCO programs.    Erin also specializes in management of appeals, grievances and for Medicare programs Complaint Tracking Module (CTM) processes and work-flows.    She holds her J.D. from the University of South Carolina School of Law.

Medicare, Medicaid, Exchange subject matter expert with 25+ years’ experience in Government Sponsored healthcare. C-Suite level expertise in  managing all aspects of Health Plan Operations to include: P&L, policy, strategy, plan management, network development, regulatory and compliance, while maximizing efficiency and effectiveness.

Tina is a key leader guiding ACG clients on Provider Network Management and Payer Innovation / Population Health initiatives. ACG’s network development team is one of the nation’s largest, bringing clients broad coverage along with, strong experience in assessing and developing high performance provider networks. ACG specializes in provider network development and management, regulatory compliance, program development, business process engineering and auditing, along with medical and pharmacy management.

Prior to joining ATTAC Consulting Group, Ms. Gallagher held State Plan President positions for United Health Group (TX); Molina Healthcare of MO; served as Executive Director (MO and Southern Illinois) with responsibility for regional and statewide health plan performance; and various leadership positions within Coventry (MO).
Building and managing effective provider networks is the foundation for managing cost and member/provider satisfaction. ACG’s strong experienced team offers a flexible approach to our clients and expertise spread across the United States.
ACG’s network development team is one of the nation’s largest, bringing clients broad coverage along with, strong experience in assessing and developing high performance provider networks

Ashleigh is the Practice Leader for ACG’s Provider Network Operations Team. Ms. Majdeski dedicates herself to develop, manage and drive uniformity, efficiencies and consistencies within Operations including provider relations, process improvement, network analysis and credentialing. She also provides a wealth of contracting background from the physician and health plan perspective. Ashleigh also leads clients through merger/acquisition integration including providing “On Demand” interim placement. Ashleigh previously held leadership roles at Universal American, AmeriHealth Caritas and served as the Provider Network Contracting Manager and Credentialing Manager of a national firm before joining the ACG team.

Amy brings over 20 years’ experience working on behalf of health plans and providers on initiatives across Commercial, Medicare Advantage and Medicaid lines of business. She has specialized expertise in network analysis and performance, contract negotiations and strategy development. Amy works with clients to assess performance over various network indicators, conduct contract analysis and optimization across reimbursement and language provisions, review payor mix and compensation against benchmarks, perform audits to prepare for regulatory and compliance reviews, and identify plans for remediation. Amy also develops strategy and responses for Medicaid RFPs, and creates written materials such as provider manuals, policies and procedures, and network development plans. Prior to consulting Amy worked in health care management roles for UnitedHealthcare, CIGNA of Arizona, and PacifiCare of Arizona. She holds a master’s Degree in Business Administration from the State University of New York at Buffalo.

Dory Hicks’ has previously served as CIO for numerous health plans, including Central California Alliance for Health, LA Care, Santa Clara Health Plan and New West Health Services.   She brings health plan clients over 30 years of experience and expertise in management of information technology resources, applications and platforms, including a broad range of current core transaction systems, ancillary systems (UM/Case Management, A & G, customer service, CRM, etc.,) data warehouses and data marts.   She has guided system selection and implementation for Medicare Advantage, Medicaid and commercial insurers.

Kevin is a senior Project Manager with over 30 years of experience serving in lead project management roles for large scale IT systems implementations, re-installations, configuration engagements along with business development and organizational build engagements.  Kevin guides ACG client engagements from establishing governance through task and resource management and overall project execution against milestones to assure timely and complete execution of mission critical engagements.   Prior to joining ATTAC Consulting Group, Kevin held senior project management and IT implementation roles at Deloitte Consulting, McKesson, Avidyn Health, Capgemini – Ernst & Young and Perot Systems.

Alan is a senior Project Manager with over 26 years of experience serving in lead project management roles for large scale systems and operations implementations, engagements with specialization in Medicaid MMIS system implementation and operations, along with 9 years of experience in Medicare health plan, start-up and operations.  Alan advises and guides ACG client engagements in IT, operations and business development engagements managing project teams, project management, task identification to assure execution of the clients objectives.  He also consults on health plan operations build and re-engineering.   Prior to joining ATTAC Consulting Group, Alan served as Chief Operating Officer at Ally Align a multi-state MA plans as well as  Senior Vice President and CIO for Government Healthcare Solutions at Xerox / ACS.

Jeff bring clients over 25 years of experience with implementation and operations of information technology platforms, including evaluation, selection, implementation and operation of core transaction systems, including enrollment and claims platforms with expertise in most major transaction systems in operation today.   Jeff is also deeply experienced in data management including data migration between platforms along with design and implementation of system interfaces and data exchange processes.   Jeff previously worked for Perot Systems and The Pace Group

Mae is a member of ACG’s Health Plan Operations and Government Programs groups. Mae brings ACG’s clients over 20 years of experience in health plan operations, including claims management system configuration, business process design, workflow development, process interfaces and quality and process control implementation. Mae has extensive experience in assessing and developing operational processes within complex, delegated and/or matrixed environments. She brings broad experience in commercial, Medicare Advantage, and various state Medicaid programs to bear on client engagements. She has had broad expertise in the major information systems used within the health insurance industry.

Linda is a member of ACG’s Information Technology, Health Plan Operations and Government Programs Practice Groups. She brings over 20 years of private and public sector systems, architecture, application, data management business process engineering, quality management and project management expertise to clients serving the health insurance and managed care industries. Her emphasis is on HIPAA compliance in data management along with state Medicaid MMIS claims payment and EQRO systems and management of encounter data at the health plan level. She has previously worked with United Health Care, Mercer Consulting, Health Services Advisory Group and Affiliated Computer Services Corporation (ACS).

Jill is a member of ACG’s Medicaid Programs group, providing clients support in Medicaid RFP response, operational development to support specific state requirements, systems configuration and implementation, systems testing, business process design, process controls and reporting to state agencies.   Jill specializes in system management, enrollment and other transactional operations and data interfaces with state agencies related to Medicaid programs.   Prior to joining ACG, Jill held positions with organization such as Mercer Consulting and Arizona Health Care Cost Containment System (AHCCCS).

Cathy McClain Gordon brings ACG clients more than 20 years of experience with Commercial programs, including HIX, and Government-sponsored programs (Medicare Advantage, Medicaid and TRICARE) as well as a passion for transforming health plan operations, establishing process controls to meet regulatory compliance requirements, quality management, provider network contracting and maintenance, technology implementations, and business development.

Over the years, Cathy has leveraged her expertise to aid clients in launching new lines of business, managing financial risk arrangements by developing and deploying successful risk adjustment strategies, preparing for delegation oversight and monitoring, developing care coordination models, executing provider network incentive models, and employing quality improvement strategies to meet CMS 5-Star, HEDIS, State and health plan quality measures.

Prior to joining ACG, Cathy worked for another nationally recognized consulting firm, various MAOs, Management Service Organizations (MSO) and commercial insurers leading healthcare reform implementation and process improvement initiatives, implementing delegation oversight and monitoring, executing internal corrective action plans, developing program controls, provider network contracting, driving population health management strategies and executing risk adjustment strategies. She also led various technology assessments and implementations.

Megan supports ACG operations, IT and data management engagements, bringing clients 13 years of experience as a business analyst, configuration support analyst, and work team lead in documentation of business requirements, process and data work flows to support configuration of various systems.  She also brings strong data analytic skills along with work plan development and project management experience to engagement teams.   Prior to joining ATTAC Consulting Group, Megan held roles at LA Care Health Plan, FlexTech, Inc., SynerMed, Inc. and Arcadian Management Services Inc.

Kevin bring clients over 15 years of extensive experience in health plan operations and compliance management in the operational domains of UM authorizations (organization determinations,) member appeals, and grievances (complaints).   Kevin expertise include systems configuration, business process design and re-engineering, development of process controls and monitoring for compliance, monitoring reporting design, training and auditing.   Kevin also has experience in enrollment and other operational aspects of health plan operations.   He previously held management roles with United Healthcare and XL Health.

As a member of ACG’s Health Plan Management, M & A, and Government Programs groups, Al provides clients expertise in finance and accounting issues in all product sectors of the insurance and managed care industries, including finance and reconciliation for Medicare Advantage and Part D programs. Al has consulted and held interim CFO roles through numerous plan reorganizations and restructurings during M & A transactions and receiverships. He has also led forensic accounting initiatives on distressed and acquired companies. Over his 25-year industry career, Al has held CFO roles for Sutter Connect, Wisconsin Health Organization and senior finance roles with numerous Blue Cross and Blue Shield plans, as well as serving on the consulting team at The Pace Group.

Nalini is a member of ACG’s Data Audit and Compliance Solutions teams.  She brings clients over 8 years of experience in project management and leadership in managing internal audit activities in data focused arenas such as claims and process focused arenas such as HIPAA compliance.   She has also worked extensively in analysis of data to conduct risk assessments of various elements of operations.    Prior to joining ACG, Nalini held various management and audit roles within Cigna, Inc., Elder Plan of New York and Horizon BCBS.

Stephanie brings ACG Clients over 15 years of experience working on Revenue Cycle Management, Risk Adjustment operations, provider education and contracting expertise.   Stephanie is a lead audit manager supporting ACA HHS-RADV Risk Adjustment Audits and MA-RADV Audits along with guiding clients through other data audits and RA related program development.  Stephanie is certified in coding by the American Academy of Professional Coders (AAPC).

Prior to joining ACG, Stephanie served as Senior Engagement Manager – Medicare Risk Adjustment with SCIOInspire, Corp, Revenue Cycle Trainer with Allegheny Health Network, Medicare Risk Adjustment Educator with Humana, Inc. and Provider Relations Specialist with United Health Care.

Elizabeth serves as a audit quality specialist in ACG’s Data Audit Group and supports clients on consulting engagements related to Medicare Advantage and Part D enrollment, reconciliation and premium billing operations, where she provides guidance on business process design and process controls and oversight and monitoring.

Prior to joining ACG, Elizabeth held roles such as Manager Enrollment and Premium Billing with AvMed Health Plans, Manager of A/R with CompBenefits and Finance Administrator with PNR Developers