Considerations and Lessons Learned for Medicare First Tier, Downstream and Related Entities (FDRs)
Please join us as Doris Stein and Kristina Park, Managing Directors from Alvarez and Marsal’s Healthcare Industry Group, discuss their experiences with Medicare FDRs in understanding risks, considerations, and lessons learned to maintain Medicare compliance with CMS and Medicare Advantage Organizations (MAOs). As CMS continues to enhance its oversight of MAO contracts, this has put pressure on FDRs to maintain compliance. Creating transparency and efficiency is essential for FDRs to maintain CMS compliance and MAO satisfaction.
Topic areas discussed will include: quality assurance, roles and responsibilities with delegation, and CMS current and future trends and mandates related to models of care and value-based contracting.
Managing Director, Alvarez and Marsal
Doris Stein is a Managing Director in Alvarez & Marsal’s Healthcare Industry Group based in Washington, D.C. Ms. Stein has more than 25 years of consulting and healthcare industry experience. She is an industry leader in delivery system innovation and has led strategic market expansion planning and execution. Ms. Stein has extensive experience in all aspects of healthcare engagement, including consumer engagement, performance improvement, technology enablement, provider operations, and government programs. Her relevant experience includes:
- Led Medicare compliance assessments for multiple clients including a national dental organization and a national behavioral health organization. This included assessing the people, processes, and technology for compliance, identifying gaps, and developing recommendations to minimize risk as well as an implementation roadmap.
- Led the strategy development for a large national integrated health plan moving from Medicare cost to Medicare Advantage (MA). Reviewed end to end processes and systems including care management, billing, enrollment, appeals and grievances, and customer service.
Prior to joining A&M, Ms. Stein was a Partner at global consulting firm where she headed up the Healthcare practice. Prior to that, she served as a Director at WellPoint/Lumenos where she led the consumer engagement strategy, and also worked in consulting at Ernst & Young and Navigant Consulting. Ms. Stein earned a BS in Industrial Engineering from Virginia Polytechnic Institute and State University, and is a board member of the national advocacy organization Families Fighting Flu. She also received her PMP, and lean six sigma certification.
Managing Director, Alvarez and Marsal
Managed Care organizations, and providers / health systems across the US and internationally.
Ms. Park has led numerous Medicare organizations in building and expanding into new markets and specialized populations. Ms. Park has assisted clients with large transformational consulting engagements; high growth, new market expansion; provider contract reimbursement analysis and assessment; and operationalizing critical programs to support special needs populations and programs, e.g., long term services and support (LTSS), managed long term care (MLTC), dual eligibles, etc.
Prior to joining A&M, Ms. Park was a founding Partner of a global management consulting firm working across three continents. She ran the organization’s West Region business unit and was a senior member of the healthcare industry practice, leading numerous strategic accounts for the firm. Ms. Park also led the development of the firm’s market-facing solution in data analytics. Prior to that, Ms. Park was a Director in Navigant’s Healthcare Strategy and Operations practice. Ms. Park also worked in consulting at Accenture, Ernst & Young, and McKinsey & Company. Ms. Park earned her BA in Economics from William Smith College and her MBA from Cornell’s Johnson School of Management. Kristina is a member of Women Business Leaders in US Healthcare (WBL) and a board member of the Washington, DC Chapter of Girl's On the Run (GOTR).
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