www.optumas.com - Health Care Reform Consulting

Meet The Team PDF Print E-mail
steve schramm_2.jpg Steven P. Schramm
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As the founder of Optumas, Steve is responsible for the design, development, and implementation of health care reform projects across the country.  Steve’s expertise is in developing innovative health care purchasing strategies for large health care purchasers that address not only who has access to health insurance (addressing the under-insured as well as the uninsured), but also how health care is provided to all individuals and groups in a given health care marketplace.  Steve’s primary responsibility for his clients is strategy development, risk management and analysis, public and expert witness testimony, and communications and messaging.



mita lodh_2.jpgMita Lodh, FSA, MAAA, MBA, PhD
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Mita is the Senior Actuary at Optumas. She helps client states implement health care reform initiatives.  Her work includes determining budgetary impacts of specific initiatives, estimating the risk profiles of the uninsured who will be covered by expansion programs, and setting CMS-compliant actuarially sound capitation rate ranges for health plan negotiations.  Mita also consults to health plans and provider groups and stays involved via presentations or committees in her other areas of experience: health plan efficiencies, provider performance management, clinical guidelines, Medicaid managed care, risk adjustment, and disease management evaluation.


tim doyle_2.jpg Tim Doyle, FSA, MAAA
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Tim is a Senior Actuary at Optumas. He provides program, strategy, and operational consulting services and actuarial analysis for a variety of projects related to health care reform. Tim also develops and certifies to rates for Medicaid populations compliant with the CMS Rate Setting Checklist for use by states in contracting with managed care organizations, including long-term care and behavioral health populations. In addition, Tim has developed upper payment limits for use in PACE programs compliant with the Upper Payment Limit (UPL) Checklist.



zach aters_1.jpgZach Aters, ASA, MAAA
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Zach Aters is a Lead Actuary here at Optumas consulting.  Zach is an Associate of the Society of Actuaries as well as member of the American Academy of Actuaries.  He has a strong background in product development, rate development and contracting for both commercial and government sectors.  He has experience in setting actuarially sound capitation rates and assisting States in evaluating risk for various Medicaid programs including Managed Long Term Care programs, Behavioral Health programs, and Physical Health programs.  In addition, Zach is familiar with the CMS guidelines surrounding Medicare Advantage plans and has experience auditing Medicare Advantage plans as well as Medicare Part D plans.



mike sawyer_2.jpg Mike Sawyer
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Mike is a Senior Consultant at Optumas and manages our Data Center.  He has more than 10 years experience in Medicaid data management, having worked in both the public and private sector on Medicaid managed care initiatives, including managing a State Medicaid program data operations.  Mike’s particular area of expertise is data development and standardization, having built standardized datamarts for his public sector clients. Mike's role for Optumas is to ensure that we ask only for the data that we need and minimize our impact on our client's data operations.

 



Wendy Barry 

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Wendy is a Senior Consultant at Optumas and is our Senior Project Manager.  She has more than 10 years experience consulting to Medicaid managed care initiatives, having worked for a large private consulting firm previously that specializes in government human services consulting.  Wendy specializes in project managing large, complex projects focused on reforming the delivery of health care services to Medicaid members. During Wendy's career, she has specialized in creating innovative health systems reforms for special needs populations such as developmentally disabled, behavioral health, and substance abusers to ensure their special socio-economic needs are addressed along with their health care needs.


kyle edrington_2.jpg Kyle Edrington
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Kyle is an Actuarial Consultant for Optumas pursuing his ASA designation with an educational background in Mathematics and Business.  He has worked on health care reform and rate-setting projects with multiple clients focusing on rate development strategy, rate methodology development, trend analysis, capitation rate-setting, and predictive modeling.   He specializes in model development and complex rate-setting methodologies.  As part of his responsibilities, Kyle leads capitation rate development projects and calculates all adjustments necessary to lead to actuarially sound rate ranges, presenting the results in public meetings on behalf of our clients.



gabi ursu_2.jpg Gabriela Ursu
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Gabi is an Actuarial/Data Consultant pursuing her ASA designation with Optumas. She has worked on numerous rate-setting projects with State Medicaid programs as well as Health Plans contracting with Medicaid Managed Care focusing on large data-set manipulation, rate-setting, predictive modeling, and risk-adjusted rate modeling.   She specializes in data collection, data validation and claims re-pricing while using her SAS skills dealing with individual level claims experience.  Gabi provides support for our capitation rate development projects, calculates all adjustments necessary to lead to actuarially sound rate ranges, and presents the results to our clients in both draft and final format.


chris dickerson_2.jpg Chris Dickerson
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Chris is an Actuarial Consultant pursuing his ASA designation. He has worked for Optumas for two plus years, first starting with the team as an Intern.  As a recent graduate with a degree in Mathematics, he has worked on numerous rate-setting projects with multiple clients focusing on trend analysis, capitation rate-setting, and predictive modeling.   He specializes in data collection and management while using his SAS skills dealing with individual level claims experience.  Chris provides support for our capitation rate development projects, calculates all adjustments necessary to lead to actuarially sound rate ranges, and presents the results to our clients in both draft and final format.


jack pierce_2.jpg Jack Pierce
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Jack is an Actuarial Analyst at Optumas and is pursuing his ASA designation, which he hopes to have completed in the next year. He has a degree in Actuarial Science from the University of Iowa, and has recently joined the Optumas team after interning for the 2nd quarter of fiscal year 2011. Jack was an integral part of data manipulation for Optumas' rate setting project for the State of Kansas' Medicaid population, using advanced statistical analysis software such as SAS. He also does work as an Excel spreadsheet creator, and uses these skills to help create client deliverable products.

 

joe costa_2.jpg

Joe Costa
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Joe is an Actuarial Analyst at Optumas and is pursuing his ASA designation. He is a recent addition to the Optumas team after interning with the company for the January '11 through March '11 season. He is a recent graduate of Arizona State University with a degree in Mathematics. His population demographic analysis has been crucial to the durational analysis for several counties in California, specifically San Francisco, Sacramento and Los Angeles.  His data gathering and validation through SAS as well as his work in summarizing results in Excel have been an integral part in creating client deliverable material on short deadlines.

 

seth adamson_2.jpg Seth Adamson
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Seth is an Actuarial Analyst at Optumas, and is pursuing his ASA designation. He was an intern for Optumas from Jan'11 to Dec '11, where upon his graduation from ASU with a degree in Mathematics in Dec '11 was hired full - time for Optumas. Seth's work as an Excel spreadsheet architect and his work in data analysis was an essential part of the rate setting process for Kansas' Medicaid population. He has experienced the many sides of Optumas through his peer review of multiple projects, checking for precision and accuracy before the final product can be sent to the client.


sam shott.jpg
Sam Shott
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Sam is an Actuarial Analyst for Optumas and is pursuing her ASA designation. She graduated from Arizona State University in December 2010 with a degree in Mathematics. Sam has helped clients in New England work on their health reform initiatives, including: researching Medical Home opportunities and reviewing Managed Care expansion data and rates.


 

 

carol dawson_2.jpgCarol Dawson
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Carol is the Controller at Optumas  she oversees the  contracting and invoicing process and is responsible for the flow of all  our financial analyses on a day to day basis. She also directs the administrative support for all members of the Optumas consulting team.   In addition, Carol is our work-flow coordinator, overseeing the assignment of staff, data, and IT resources for all of our consulting projects to ensure we exceed our client expectations by consistently delivering our analyses on or before our deadlines and at or below our contracted budgets.

 

 
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