We Bring Centuries of Combined Experience

Our team is made up of senior-level managed care professionals and
former CMS regulators who have each worked at health plans,
CMS and pharmacy benefit managers.

Julie Mason

Principal

MCS co-founder Julie Mason began her Medicare career more than twenty-five years ago when she joined the Centers for Medicare and Medicaid Services (then HCFA, the health Care Financing Administration) in the, more

Shelley Segal

Principal

MCS co-founder Shelley Segal is a Medicare Advantage industry veteran whose experience in Medicare program leadership and day-to-day operations provides our clients with an expert resource for strategic planning, more

Liza Arias

Vice President

Geni Bennetts, MD

Medical Consultant

Ryan C. Dodson

Director Of Risk Management

Michelle Ford

Vice President

Marilyn Hendricks

Vice President

Annette Ayala-Martinez

Vice President

Sheila Muller

Vice President

Laura Paschold

Vice President

Karen Rennie

Vice President

Vicky Sobschack

Vice President

Mary Kaye Thibert

Senior Vice President

Jennifer Barros

Vice President

Julia Cohen

Vice President

Talia Eisen

Consultant

Johnni Hansen

Vice President

Brent A. Hiley

Vice President

Ron McGinnis

Consultant

Mike Opich

Senior Vice President

Mae Regalado

Vice President

Harry Alan Segal

Chief Financial Officer

Jen Sousa

Vice President

Yvonne Tso

Vice President

Cindy Pierce Allen

Vice President

Nirali Patel

Vice President

Delana Mosley

Consultant

Vibhuti Singhal

Vice President

ENDORSEMENTS

“I have known Shelley and Julie in various capacities over the past 25+ years, including working with Julie as my health plan’s CMS regulator and with Shelley as part of my operations and executive team.  Their knowledge and expertise is second to none, and by bringing both the regulatory and health plan perspectives to their clients, they provide effective, thoughtful solutions to some of the most complex compliance issues facing Medicare Advantage plans.  I have engaged MCS on consulting projects and my staff greatly appreciated their insights, observations and recommendations.  I  look forward to working with them into the future!”

Mike Myers

President, President, Health Industry Collaboration (ICE)

“Engaging MCS last year to conduct a compliance program effectiveness (CPE) audit was a great decision. Shelley and Julie helped us design an audit that was very meaningful and also reasonable. Their extensive expertise and experience were apparent throughout the audit and, while they were evaluating our compliance program against the strict CMS requirements, they were highly professional, collaborative and supportive.

The CPE audit confirmed specific opportunities, strengths and best practices of our unique compliance program. We received a high quality final report that included recommendations and benchmarking information to help us continue our journey.

Most importantly, our CPE audit experience with MCS was far superior to our past audit experience with a large consulting firm and provided much more value. We look forward to working with Shelley, Julie and the MCS team in the future.”

Terry Somerville

Director, Compliance Officer, Priority Health

“Medicare Compliance Solutions helped support SCAN Health Plan through a recent CMS Program Audit, as well as a new system implementation, by backfilling leadership duties for our Grievance & Appeals Department. Shelley and her Team provided superb knowledge and skill sets through a risky time period SCAN encountered.”

Patrick Maloney

Vice President of Operations, SCAN Health Plan

“As a Medicare Advantage industry executive overseeing multiple areas requiring quality, accuracy, services and compliance, I have had the pleasure of utilizing Medicare Compliance Solutions on many occasions. Due to the complexities surrounding Medicare’s regulatory and operational challenges, Medicare Compliance Solutions has aided our organization with Stars, Audits, PBM assessments and management support. The combined leadership efforts of Shelley and Julie’s expertise have assisted our company to surpass several obstacles.”

Dawn Maroney

Executive, Alignment Healthcare

“MCS assisted us in preparing for our CMS Program audit including finalizing our pre-audit issues summary, and testing universes prior to submission to CMS, and conducting mock audit sessions. Once the audit was underway, their presence was valuable in supporting us throughout the webinar sessions and providing input where necessary.  The MCS team was professional and collaborative during the audit  and their partnership provided the expert resources needed to provide all information required by CMS during the audit, which often required long arduous hours.”

John Tanner

VP, Compliance, Medicare Compliance Officer, Molina Healthcare

We offer proven expertise in the following areas:

Appeals and Grievances
Audits and Monitoring
Benefit Design/Strategy
Claims
CMS Audit Validations
CMS Program Audits
Compliance
Contracting

Enrollment/Disenrollment
Health IT and systems
Implementations
Interim Management
MA and Part D Applications
Medical Management and Quality
Medicare Star Ratings/HEDIS
Member Service Support

Network Development
Operational Gap Analysis
Oversight
Part D Operations
Pharmacy Oversight
Risk Adjustment/Chart Review
Sales, Marketing and Strategy
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