Our team has hands-on-knowledge as well as advising at the highest levels of our rapidly changing industry for decades. Whatever problem you need to solve, from compliance to remediation services, to reconciliation or data analytics, we understand and we can help. We know the stress of government audits, backlogs of unreconciled data, or software systems that don’t support your needs.
We’re here for you. The Madena team is committed to providing support end-to-end services, and real world solutions to your challenges. We support all Government Program Sponsors including Medicare, Medicaid and Healthcare Exchanges.
Denyse and her team have conducted a number of full-scale reconciliation projects, recovering millions of dollars for Plan Sponsors. Under Denyse’s management, Madena leads the industry in audit and reconciliation support, software interfaces, and data mining and analysis.
From the inception of Madena, Denyse’s focus has been to bridge the gap between government agencies and plan sponsors, creating end-to-end compliance and success.
Prior to founding Madena in 2012, Denyse served as the Program Director for the CMS Retroactive Processing Contract (RPC) leading the design for the programs and operations still in practice today. During this time, Denyse worked directly with CMS leadership, coauthoring and developing a number of Medicare regulations and programs including the Enrollment Data Validation (EDV) program, the eRPT system, Enrollment Guidance and LIS/BAE Policy.
Denyse is a problem solver and enjoys creating partnerships between the varied organizations that serve the government-sponsored healthcare industry. She is a natural teacher and sought-after trainer, and enjoys sharing her knowledge. Denyse’s enthusiasm for connection carries into her personal life, where she mentors at-risk children through the Denver Kids’ Program and was named Mentor of The Year for 2015.
As Madena’s Chief Operating Officer (COO), Mike has implemented a team centric management style that helps drive Madena’s service offering while maintaining viable and effective communication with clients and partners. Mike is adept at quickly understanding complex customer issues and being able to implement solutions that are effective, measurable and provide significant business value. Mike’s leadership style fits Madena’s fast-paced, technologically based, customer-centric approach and his ability to communicate effectively allows service teams to provide measurable value to clients.
Jennifer comes to Madena from WellPoint where she was National Director of Business Reconciliation/Revenue Enhancement responsible for national oversight and monitoring of all Medicare (MA, MA-PD, PDP) end to end reconciliation and revenue strategies. Prior to that, Jennifer spent 10 years at Kaiser Foundation Health Plans as the National Medicare Finance and Reconciliation Manager leading auditing, end to end system and process reviews (including delegated entities), new system implementation and operations and revenue management. She had national oversight of plan payment reconciliation with quantification and qualification of payment and reporting issues for financial accruals for all Medicare (MA, MA-PD, Cost, Cost-PD) Managed Care membership of 950,000.
Jennifer has an MBA in Healthcare Management from the University of Phoenix and a Bachelor of Arts in Organizational Psychology from Kent State University.
Having had both a Sales and Corporate Operations background gives George a unique perspective and high degree of credibility in understanding how to best integrate Madena’s product offerings to serve client needs.
At Anthem, Dee Dee led a staff of fifty associates responsible for Medicare enrollment processing and reconciliation functions. She established departmental policies and procedures for increased efficiency and adherence to Medicare guidelines and compiled monthly reporting for the Medicare attestation used in the financial accrual for the Medicare line of business. She created effective inventory oversight for front end enrollment intake and processing from multiple sources including enrollment, disenrollment, reinstatement processes, and Medicare rejections, Medicare special programs including Low Income Subsidy (LIS), Best Available Evidence (BAE), Late Enrollment Penalty (LEP) COB/MSP and State Prescription Assistance Program (SPAP). Internal and external audit requests including monthly audits by Medicare (Enrollment Data Validation-EDV). Dee Dee increased associate engagement, implemented end-to-end process improvements, root cause analysis, increased inter-department communication and associate cross training to enhance department productivity, quality and flexibility. She oversaw a decrease of 68% in CATEGORY 3 retroactive submissions to Medicare third party vendor from 2011 to 2014.
Dee Dee is a graduate of the University of Kentucky where she graduated with a Bachelor of Marketing from the Gatton School of Business & Economics.
Dana’s practical and detail oriented approach to her professional life has been served an integral role in delivering specialized solutions that regularly exceed customer needs.
Her comprehensive understanding of the Medicare federal regulations and Medicaid state requirements allows her to operationalize requirements with insight into the most compliant and efficient operational performance and best practices. She provides strong leadership and hands-on operational experience to health plans, while leading and supporting teams of employees. Her extensive knowledge allows her to develop comprehensive policies and procedures, business process improvements and streamlining day-to-day activities to ensure work is in accordance with the Centers for Medicare & Medicaid Services and Medicaid compliance guidelines. Recovered over $500k through research and analytics for a health plan and developed an Enrollment Services department training program for team members for the overall member-facing and customer service functional areas. She provides best practices, gap analysis, end-to-end process improvements, audit services for Part C and Part D Enrollment, start-up plan and system implementations, expert direction on enrollment and reconciliation processes.