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Shelley Mueller Stevenson
Shelley has more than 33 years of healthcare experience working with health plans on all aspects of plan operations, compliance, performance, compliance plan auditing, service quality improvement, process improvement, and innovation. She has expertise in Medicare Advantage and MAPD, ACOs, Medicaid, Medicare managed care startups, business process redesign, accreditation, special needs plans, CMS compliance and program audits, STARS and best practices, training and presentations, medical management support, and mergers. Shelley specializes in NCQA, URAC, AAAHC, MBHOs, physician practices, and PCP relationships.
Experience
- Has over 33 years of healthcare experience, including leadership positions in strategic and tactical planning, compliance, organizational and workflow design and improvement, and accreditation across all lines of business, including Medicare, Medicaid, ACOs, and commercial and individual plans
- Led implementations of plans new to Medicare to apply for CMS approval with fully compliant go live, achieving 4.5-to-5 STAR ratings
- Experience in successful accreditation with NCAQ, URAC, and AAAHC
- Delivered successful turnarounds of newly merged health plans and has extensive experience as a CMS auditor
Qualifications
- CMS Auditor
- Member of IHI
- Adjunct Faculty, Northeastern University, University of Wisconsin
Education
- Bachelor of Arts in Psychology, University of California
- Adjunct Faculty, Northeastern University
- Adjunct Faculty, University of Wisconsin
