Modernized strategies. Optimized technologies. Smarter operations.

Rebellis Group

Jennifer Beckett has over twenty years of experience as a HEDIS®, Stars, and Quality Improvement professional, working with Medicare Advantage, Special Needs Plans (SNPs), Commercial, Medicaid, Medicare, and Exchange/Marketplace populations. 

Jennifer is a proven collaborative leader with a technical and analytical background.  In addition to her many years of HEDIS and Star Ratings experience, she has expertise in developing and implementing quality-related healthcare initiatives and programs for member engagement, provider outreach, care management, and disease management.  Jennifer also has expertise with healthcare systems evaluation, vendor/software selection processes, software implementation, vendor management and oversight, healthcare data analysis, and data warehouse implementation.

Her professional background includes a large national health insurance organization, a national Medicaid health plan, two regional health plans, and a prominent healthcare consulting firm.

Jennifer Beckett

Jill brings more than a decade of technical and consulting expertise in the Medicare Advantage and Part D managed care industry.  She has worked with numerous health plans to implement and support compliance software products and has also assisted with marketing material review, mock Centers for Medicare & Medicaid Services (CMS) audits, delegation oversight programs, and the overall streamlining of compliance processes for Medicare organizations.

Jill is a skilled technical advisor for software design and development.  She has expertise in managing and developing SaaS products, including software design, programming, developing production documentation, BETA testing, and release support.  She has overseen multiple concurrent software implementations and bee the primary contact for clients for ongoing training, support, and troubleshooting.
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Prior to joining [Rebellis Group](/org/rebellis-group), Jill served as Senior Product Manager at Gorman Health Group, where she managed several compliance software products, including a technical overall of one of these products.  Jill also worked on an enrollment reconciliation team, resolving thousands of retroactive cases and providing support for beneficiary enrollment processing, as well as performing many compliance and operational consulting engagements.



Jill Stillman

Victoria’s Medicare Advantage expertise includes network development and marketing materials review.  Prior to her healthcare consulting experience, Victoria worked in the banking, real estate, and custom home building industry with over 20 years of project management, customer service, finance, and accounting experience.  Victoria’s acute attention to detail and ability to manage complex requirements makes her a valued member of our team.
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Victoria (Tori) is pursuing a degree in Accounting and has served as a Board Member of Our Family Service, an organization whose mission is to eliminate homelessness and strengthen the community.

Victoria Davern

Martha Goodlin is an experienced healthcare professional with over 20 years of comprehensive work in the industry, with a strong focus on HCC Risk Adjustment and HEDIS operations.  She has worked with both large healthcare systems and third-party vendors, where she was responsible for the planning, directing, and strategic oversight of retrospective and prospective risk adjustment programs.  Her experience includes the development and implementation of quality audit programs and design of coding education curriculum and guidelines, as well as the oversight of OIG and CMS RADV audits.  She also has extensive expertise in driving improvement in HEDIS outcomes and STAR ratings. 

Martha is proficient in facilitating process improvement and change management, as well as building strong relationships among operations, quality, and educational teams.  She has led teams of coders, nurses, auditors, and business analysts to drive success and efficiency. 

Martha has served as both Director of Risk Adjustment and Quality and Senior Manager of Quality Audits, Risk Adjustment Coding, and Clinical Review for leading healthcare organizations.  She holds a Bachelor of Science degree in Healthcare Administration from Robert Morris University and is licensed as a registered nurse in the state of Pennsylvania.  She is also a member of the AAPC and a Certified Risk Adjustment Coder.

Martha Goodlin

Jennifer’s background includes over 30 years of experience with Medicare and health insurance. Her expertise includes compliance program review and implementation, appeal and grievance processing, review of marketing material and provider contracts, CMS audit preparation and mock audits, application filing, and Part D operations compliance.  Most recently, she assisted plans with process improvements for Star Ratings in appeal and grievances.

Prior to consulting, Jennifer was a CMS Account Manager at the Seattle Regional Office for nearly 10 years. There she was responsible for Medicare Advantage (MA) application review, audit, and oversight of MA plans, and was part of CMS national teams who developed audit protocols and application requirements for Private Fee-for-Service contractors. She was a Compliance Officer at a start-up MA plan and was part of the contractor audit teams conducting compliance program audits for MA plans. She began her career in provider office billing and then moved into the insurance industry.

Jennifer is certified in Health Care Compliance from the Health Care Compliance.

Jennifer Rogalla

Annette brings more than twenty-four years of expertise in Medicare Advantage enrollment, appeals and grievances, provider disputes, and Medicare operations. Annette’s expertise includes developing and implementing Medicare training programs, process improvements, and providing managerial and operational experience to health plan Appeal & Grievance and Enrollment departments, as well as streamlining the Provider Dispute Reconsideration Resolution (PDRR) process.

With a strong managerial background, as a consultant she has assisted several Medicare Advantage organizations, ranging in size from small to national, in interim Director positions to train and provide guidance to department management and staff to ensure that they meet CMS requirements.

Annette Ayala-Martinez

Jennifer is an experienced healthcare executive with a demonstrated history of working within the government programs industry. She has nearly 25 years’ experience in Medicare Advantage with a unique perspective from both provider and payer organizations and is particularly skilled in operations, compliance, and MA organizational strategic planning. 

Jennifer’s experience includes large-scale management of new plan implementations, operations contracting and in-sourcing, reconciliation and revenue enhancement and solutions, system and process reviews, new system implementations, operations, and interim management.  She has led health plans and teams through the challenging projects from enterprise system and business process implementations to organizational assessments to identify areas of non-compliance and opportunities for efficiency. Her comprehensive and deep knowledge of CMS across the entire Medicare program allows her to help health plans focus compliance and improvement efforts. Jennifer ability to work with teams at the line level as well as to guide executive decision making and Board level communication makes her a value part of the Rebellis team. 

Prior to joining the ranks of the consulting industry, Jennifer served in executive level positions for national and local health plans.  Jennifer has held positions throughout her career for Fortune 500 companies and national established organizations, as well as several start-ups.  She has an MBA in Healthcare Management from the [University of Phoenix](/org/university-of-phoenix-inc) and a BA in Organizational Psychology from [Kent State University](/org/kent-state-university). 

Jennifer Young

Michael Shaw

Tameisha brings over 20 years of experience in the healthcare field.  Her expertise includes health insurance claims processing, underwriting, full cycle billing and reimbursement, and medical coding and auditing. Tameisha led a team of 15 coders on various multi-specialty projects for nearly 6 years. She was also an adjunct instructor for a medical billing and coding program which prepared students for the coding certification exam.

Tameisha began training with the American Academy of Professional Coders in 2008.  Upon completion, she obtained the CPC (Certified Professional Coder) certification.  Tameisha went on to receive credentials in both Inpatient and Risk Adjustment coding along with a Bachelor of Science in Health Administration.  Her memberships include AHIMA, American Academy of Professional Coders, and American Trauma Society.  

Tameisha Brunson

Heidi is an expert in Medicare Part D benefit administration, including Part D readiness assessment, payment validation, formulary development, and CMS Formulary Administration (FA) and Coverage Determinations, Appeals, and Grievances (CDAG) audit readiness.  She brings more than 35 years of pharmacy, operational, and benefits administration experience, focusing specifically on Medicare Part D for the last 15 years.  Heidi’s business skillsets include problem solving, data mining and analysis, communication, quality assurance, and relationship building.

Heidi’s previous experience includes consulting to CMS’ Division of Payment Validation (DPV) as part of the team who develops the annual Part D payment error for Office of Management and Budget (OMB) and Congress.  She also performed FA and CDAG audits and participated in a two-year review of federal agency pharmacy benefit formularies for CMS.  Heidi was a benefit administration pharmacist for a large managed care organization before consulting to CMS.  Additionally, she was part of the organization’s electronic health records implementation, from test scenario development through staff training and onsite support during roll-out.

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Heidi received her MHA from the University of Maryland University College and her BS from the University of Connecticut School of Pharmacy.  She is a member of Upsilon Phi Delta Honor Society for academic achievement in healthcare administration and Phi Kappa Phi Honor Society for academic excellence.

Heidi Harmon

Anita provides expertise to health plans regarding quality improvement, the CMS Quality Bonus Program, Special Needs Plans (SNP) Model of Care (MOC), HEDIS, and Star Ratings improvement.  She brings clients more than 30 years of experience in the healthcare industry.  Her areas of experience include medical necessity compliance, quality management and improvement, preventive programs, and clinical practice.

Anita has designed programs and initiatives to support preventive health and disease management business goals. She has a proven track record in developing various quality assurance programs, a public health online web-base, and written educational tools.  Her diverse leadership expertise extends to managing people and leveraging team-building skills and situational leadership. She utilizes and values cross-functional relationships both internally and externally.

Anita has guided plans in readiness for CMS review of Models of Care, NCQA Accreditation Preparation, and Chronic Care Improvement Programs (CCIPs).  She has also developed project management tools, readiness assessments, and corrective action plans.

Anita served as Director of Quality Assurance for a leading organization in a new industry of second-level review for appropriate hospitalization. Anita has held numerous positions as Director of Quality for multiple markets in the managed care industry for multiple lines of business (Medicare, Medicaid, Commercial, Exchange).

Anita Mccreavy

With over 40 years of experience in healthcare delivery, Rebecca is a seasoned leader with a track record encompassing health system and managed care strategies, achieving sustainable demonstration of both high reliability and performance improvement.  She provides consultative assistance to various healthcare organizations in the areas of quality and medical management for commercial, Medicare, and Medicaid populations. 

Rebecca’s areas of expertise include quality program and structure optimization, CMS Model of Care compliance, NCQA® and The Joint Commission® accreditation preparation, HEDIS® and STAR rating improvement, health analytics platform vendor transition, and medical management system/process redesign.  Rebecca has experience in projects with an emphasis on health system cross-continuum care, invoking quality principles to shepherd organizational determination of actionable clinical priorities, given the vast array of potential opportunities.

Rebecca holds an MBA in Quality Leadership from Saint Joseph’s College of Maine, a BS in Nursing, graduating Magna Cum Laude from Otterbein College, and an AS in Applied Science from [West Virginia University](/org/west-virginia-university).  She has been recognized as a Certified Professional in Healthcare Quality (CPHQ) since 1999.  Prior to joining [Rebellis Group](/org/rebellis-group), she served as the Senior Vice President of Clinical Programs for Avalon Health Care Solutions and the Vice President of Field quality Operations for WellCare Health Plans.

Rebecca Lynn Spicer

Jane brings over 35 years of experience in healthcare as one of the industry leaders on Special Needs Plans (SNPs), development and implementation of Models of Care (MOCs), as well as the Star Ratings Quality Bonus Payment Program. Her experience expands to the areas of quality improvement (QI), utilization and medical management, claims operations, and provider/associate education.  She has extensive knowledge of federal regulations and health plan compliance as well as experience with new Medicare Advantage plans and Accountable Care Organizations in the development of CMS applications and plan implementation processes.

In her role as Executive Advisor, Jane provides expert guidance and advice to the [Rebellis Group](/org/rebellis-group) Executive Leadership team.

Jane Scott

Beth Matel is an established compliance professional with over 30 years of comprehensive healthcare regulatory and operational experience which includes Medicare Advantage compliance, enrollment and disenrollment operations, and client relationship development and management. 

Beth has assisted health plans in developing compliance processes and corrective actions for Centers for Medicare & Medicaid Services (CMS) in response to audit conditions and findings, directed onsite and virtual focused audits, assessed new and existing plan readiness and compliance program effectiveness, produced Part C and Part D delegation oversight programs, assisted with large-scale member and marketing material review, directed application filings, and created and conducted focused trainings. 

Beth is certified as a Healthcare Compliance Professional (HCP) by [America’s Health Insurance Plans](/org/americas-health-insurance-plans) (AHIP) Trade Association. 

Beth Matel

Patty provides clinical expertise to medical management and health services with a focus on CMS regulatory guidance, quality improvement and NCQA.  She brings over 35 years of experience in the healthcare and health insurance industry. Her areas of experience include management and administration of services, utilization management, case and disease management, discharge planning, prior authorizations, appeals and grievances, and quality across Medicare, Medicaid, Exchange, and commercial lines of business.

Patty has assisted in the development, implementation, auditing, and monitoring of programs surrounding Special Needs Plan Models of Care (SNP MOC) and managed care, utilization management, case management, and discharge planning to ensure compliance with regulatory guidance. She has experience in developing and implementing quality programs and processes to support regulatory guidance and STAR measures, including creation and implementation of policies and procedures and training to ensure consistency and accuracy of processes.

Patty has served as a Manager and Director of Utilization Review and Care Management for several leading healthcare organizations. Patty holds a bachelor’s degree in Nursing and is a certified case manager and life care planner. ​

Patricia Kelly

Sheila’s background includes 40 years of nursing and healthcare management experience in strategic planning, compliance, operations, standards of practice, accreditation, privacy, quality, clinical risk management, contracting, credentialing, utilization management, case and care management, pay-for-performance and quality incentive (QI) programs, disease management, life planning (hospice and palliative care), infection control, health information management services, grievances and appeals in varied settings including acute and long-term care hospitals, community-based organizations, private equity groups, managed care plans, provider organizations, clinics, PACE centers, and behavioral health/chemical rehabilitation care centers, including many senior leadership positions, as well as clinical nursing focused on Emergency Department and Trauma control nurse in a level II trauma unit.

Sheila serves as a clinical leader conducting due diligence reviews for mergers, acquisitions, bankruptcies, and consolidations and prepares organizations for CMS audits, TJC (Joint Commission), NCQA Accreditation and other voluntary accrediting organizations such as AAHC, [URAC](/org/urac), and [CHAPS](/org/chaps).  Additionally, Sheila works with organizations to drive improvement with HEDIS outcomes and Star Ratings and has provided review, investigation and/or expert testimony in over 40 matters for medical management, credentialing and compliance matters and multiple case investigations for fraud, waste, and abuse.

Sheila is a recognized speaker on compliance and credentialing, including publications with the American Health Lawyers Association and healthcare operations.  She is licensed as a Registered Nurse in the state of California and is a current California state auditor and a contractor with the [Centers for Medicare and Medicaid Services](/org/centers-for-medicare-and-medicaid-services) (CMS) to conduct Independent Validation Audits (IVAs). 

Sheila Muller

Roxanne brings Medicare prescription drug operational experience which has been used on a variety of projects for MA-PDs and PDPs.  As a member of both mock and CMS audit preparation teams, she specializes in the Part D elements of CDAG CDM, FA, grievances, and call logs.

Prior to her work with [Rebellis Group](/org/rebellis-group), Roxanne was a Senior Consultant for Gorman Health Group (GHG) as well as an independent pharmacy consultant.  She previously served as the Wyoming State Pharmacist, Wyoming Medicaid Pharmacy Director, and Deputy Medicaid Director, as well as an adjunct professor at the University of Wyoming School of Pharmacy.

Roxanne is pursuing a Masters in Health Economics and Outcomes through the University of Wyoming School of Pharmacy with an expected 2020 graduation.  She is also a graduate of Leadership Wyoming and Advanced Leadership Training through the University of Colorado Health Sciences Center.

Roxanne Newland

Deb is a nationally recognized pharmacy expert with a diverse background in acute care, government programs and managed care, bringing to the table more than 30 years of clinical and regulatory expertise combined with a successful track record in business operations and leadership. Areas of focus include Medicare Part D operations, quality, compliance, benefit design, care management, population health assessment and formulary/specialty drug management. Deb’s wide-ranging experience includes working with both state Medicaid programs and in academia having served in a pharmacy leader role at an academic medical center.
 
Prior to founding [Rebellis Group](/org/rebellis-group), Deb was SVP of Pharmacy and Clinical Solutions at the Gorman Health Group where she drove successful outcomes for over 300 clients, including the nation’s leading managed care and pharmacy benefit management companies, oversaw profit/loss, and drove employee growth and engagement.

Deb is a past president of American Society of Health – System Pharmacists (ASHP) and has served on several councils, commissions and committees for [ASHP](/org/american-society-of-health-system-pharmacists-inc). She is also the recipient of the Distinguished Coloradan Award from the University of Colorado School of Pharmacy. Deb presents at global pharmacy conferences and her work has been published on topics including drug utilization, mentoring, SNPs, Star ratings, and strategic planning (AJHP, [ASHP](/org/american-society-of-health-system-pharmacists-inc) Publications).  She received her pharmacy degree from the University of Colorado and an MBA from [Regis University](/org/regis-university).

Debra Devereaux

April is an accomplished executive with almost twenty years’ experience in the Medicare Advantage and Part D managed care industry.  During her years of consulting, she assisted hundreds of plans and associated entities in the areas of compliance and operations by managing and performing audits, implementing new plans, providing interim staffing, spearheading operational improvements and re-engineering, and managing both internal and CMS corrective actions.

​April has an extensive software development background, having managed the development of multiple SaaS products, including software design, programming, testing, implementation, and client support.  She brings to [Rebellis Group](/org/rebellis-group) an affinity for translating complex regulatory guidance and business needs into technical requirements and operational practices.

April previously served as the Senior Vice President at a national Medicare consulting agency where she was responsible for oversight of the development, operations, and content of Medicare Part C and Part D software solutions in the areas of compliance and operations, sales onboarding and oversight, appeals and grievances, and enrollment reconciliation.  April also formerly worked in a large MA-PD health plan in a Compliance role.

April Fleming

Betsy is a nationally recognized leader in the managed care industry with over 17 years of experience. Betsy has been quoted in numerous industry publications, including USA Today.  Bringing to the table a solid mix of leadership and business acumen, as well as regulatory and strategic knowledge within the Managed Care landscape, Betsy’s expertise is focused in the areas of mergers and acquisitions, compliance, sales and marketing, strategy, supplemental benefit landscape, innovative benefit design to address social determinants of health (SDoH) and health plan operations.

 
Prior to founding Rebellis Group, Betsy served as the Chief Consulting Officer for Gorman Health Group (GHG). In this role, Betsy managed the Medicare consulting practice, including implementation of strategic initiatives, development of new practice areas, and oversight of day-to-day consulting operations. Prior to this, Betsy served as Senior Vice President of Compliance Operations where she assisted Medicare Advantage Organizations (MAOs) and Part D Sponsors to attain and maintain compliance with the Centers for Medicare & Medicaid Services (CMS) regulations and guidance by conducting risk assessments, preparing organizations for CMS audits, performing mock CMS audits, and creating and implementing internal and delegated entity oversight programs.

Before joining GHG in 2006, Betsy worked for Medicare Advantage Organizations where she served in Customer Service and Compliance with responsibility for creation and implementation of oversight programs, CMS audit preparation, implementation of internal corrective action plans, and the day-to-day management of Compliance operations. Betsy has also worked as a CMS sub-contractor to conduct Compliance Program Audits.

Betsy Seals

Cathy has over 25 years of health care industry experience working with government-sponsored (Medicare Advantage, Medicaid, HIX, and TRICARE) and commercial insurance programs. Her focus is assessing and transforming health care operations and establishing process controls for monitoring regulatory compliance, quality management, provider network contracting and maintenance, system implementations, and business development.

Cathy has worked across various health plan and physician group functional areas including utilization management, quality improvement, provider data management, claims, appeals and grievances, FWA, and credentialing and leverages her extensive knowledge of health plan operations and physician group management to assess current state operations and deliver exceptional solutions to managing financial risk and optimizing care.  Over the years, Cathy has helped clients to achieve operational efficiency, launch new service offerings, develop and deploy successful risk adjustment strategies, perform delegation oversight and monitoring, develop care coordination models, execute provider network incentive models, and employ quality improvement strategies to meet CMS, HEDIS, State and health plan quality measures.
 
Prior to consulting, Cathy served in various health plan leadership roles acting as VP of Commercial and Medicaid Products and VP of Health Services at Optum, Sr Director of Operations & Strategic Projects and Sr Manager of Clinical Training & Quality at Health Care Services Corporation, and Network Manager at Anthem Alliance Health Insurance Company. 

Cathy earned a Master of Health Administration from Governors State University.  She is also an alum of America’s Health Insurance Plans (AHIP) Leadership Development Program and current member of the Advisory Cloud Board Directory.

Cathy McClain Gordon

Wendy Karsten brings to the [Rebellis Group](/org/rebellis-group) and its clients more than 25 years of experience as a C-level executive, working on both the payor and the provider side of the health care industry and understanding the delicate balance between the two.  This includes serving as CEO of both a highly successful health plan in North Texas and, immediately prior, a large medical foundation in Southern California. She also has extensive experience in start-ups, mergers and acquisitions, change management, and the regulatory intricacies of Medicare Advantage products.  

Throughout her career Wendy has gained a reputation as a rational, strategic thinker who helps others see the big picture, formulate a clear vision, determine solid solutions, and build teams that execute on a vision in ways that help organizations meet or exceed their business goals. Her experience includes effectively working with a wide breadth of stakeholders including boards of directors, community leaders, elected officials, physicians, hospital executives, attorneys, accountants, staff, and vendors.  

With a strong background in finance and analytics, Wendy has effectively lead teams that put technology to full use in various settings.  This includes compliance teams that have excelled with CMS, customer service teams that have orchestrated five star customer service programs, sales teams that have achieved double digit growth, risk adjustment programs that have been achieved superior results, and the design of profitable CMS bids. 

Wendy holds a Master of Arts degree in education from California State University Los Angeles and a Bachelor of Science in finance and economics from Eastern Oregon University in La Grande, Oregon.

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Wendy Karsten

Jennifer brings over 15 years of expert project management experience, and has worked in the translation industry for companies in both the US and the UK.  She has managed projects for large clients and trained and managed teams of project managers.  She is experienced in the creation of corporate communication templates, a project tracking system, website content, and sales and project management training materials. 
 
In addition to working with large, global companies, Jennifer has worked with startups and was instrumental in one company’s transition and growth from two people to an international multi-million-dollar enterprise.  She is highly organized while providing excellent communication and customer service. 

Jennifer holds a Bachelor’s degree in Tourism Management from the [University of Hertfordshire](/org/university-of-hertfordshire), England. 

Jennifer Scanlon

Shiela Muller

Laura is a seasoned Medicare compliance professional with over 25 years of Medicare Advantage, Medicare-Medicaid, and Part D plan experience, providing targeted solutions to meet specific client needs. 

Laura’s areas of expertise include appeals and grievances, call center operations, and development of policies and procedures and monitoring tools to ensure compliance with requirements and best practices recommended by CMS, as well as extensive experience with CMS Program Audits.  She has a successful record of assisting clients and employers in the Medicare healthcare industry by developing programs and processes to maximize operational efficiencies while maintaining compliance and quality outcomes.

Prior to joining [Rebellis Group](/org/rebellis-group), Laura has held various management positions with Medicare Advantage, Special Needs, and Medicare-Medicaid organizations, including Director of Medicare Operational Compliance for [Blue Shield of California](/org/blue-shield-of-california).

Rebellis Group

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