Melissa Bailey

Subject matter expert in government healthcare program compliance with 20 years of healthcare experience.  Experience includes MA, MA-PD, PDP, SNP’s, MMP, EGWP and Medicaid.  Expertise in performing mock audits, CMS audit preparation, audit remediation, and independent validation audits.

Experience

  • Provided support as a Senior Consultant, working with over 40 health plans in 22 States and Puerto Rico on a wide array of projects, developing extensive industry experience and knowledge of best practices.
  • Assisted clients by performing mock audits, CMS audit preparation, audit remediation, and independent validation audits.
  • Provided support as a Compliance Manager for a West Coast health plan.
  • Managed compliance activities during a period of exponential growth of the organization wherein the MA and MAPD business underwent a 200% growth.

Qualifications

  • Certificate in Healthcare Compliance (CHC), Health Care Compliance Association (HCCA)

Education

  • 20 years of healthcare experience 

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