Meet the Optumas Team

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.

Dr. Pelberg, with over 35 years of medical experience, is the chief medical consultant at Optumas. His experience includes: overseeing all clinical operations of six managed care organizations, advising health care start-up companies in operations and strategies, heading the CMS quality review team in Florida and New York for troubled Medicare risk programs, and developing and teaching managed care programs for Medicaid managed care programs in several states.

Carol 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.

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.

Barry is a Consulting Actuary at Optumas. He is a Fellow of the Society of Actuaries and a member of the American Academy of Actuaries. Barry has 10+ years of experience with Medicaid and CHIP capitation rate-setting and risk assessment in various states, including Physical Health, Behavioral Health, Integrated Care and Managed Long Term Care, and PACE programs. Additionally, he has worked with states to help develop savings estimates for State Innovation Models.

Seth is a Consulting Actuary at Optumas, and has 10+ years of experience with Medicaid managed care rate setting and other actuarial analyses pertaining to public health programs. His Medicaid managed care experience includes physical health capitation rates, mental health/substance abuse capitation rates, PACE AWOP development, case rate development, and rate development for populations/services with limited Medicaid data. This work includes detailed statistical and actuarial analysis, such as risk adjustment, full credibility testing, and trend analysis to inform the appropriate actuarial adjustments for accurate rate development.

Jared is a Senior Consultant at Optumas. He has over 21 years of experience assisting state Medicaid agencies. Jared’s areas of expertise include strategic planning, healthcare economics, managed care operations, claims / encounter data collection and analysis, state/federal health policy including waiver (1915b/c and 1115) applications and actuarial rate setting for Medicaid managed care programs (acute, long term care, behavioral health, adult expansions). Jared’s prior client experience includes working for the State of New Mexico for over 18 years. Other state experience includes Florida, Louisiana, Nevada, New Hampshire, New Jersey, New York, and North Carolina.

Jim is a Senior Actuary at Optumas.  He has almost 20 years of professional actuarial experience, 15 of which were dedicated to working for a managed care organization (MCO).  Over that time, his focus was on MCO capitation rate and risk mitigation negotiations, CHIP rate filings, forecasting, and actuarial studies.  Jim’s work in over 20 states has given him a broad perspective on the various ways state agencies have handled the challenges confronting Medicaid over the last many years.