Team

EXECUTIVE TEAM

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Denyse Wise

CEO & Founder

Denyse brings passion to every working experience. She excels at creating and maintaining strong and enduring business relationships.

As CEO of Madena, Denyse directs the development and growth of Madena’s suite of healthcare solutions and tools. She has helped to revolutionize the industry with the proprietary Synchronicity™ Tool and the Independent Certification of Plan Enrollment & Payment Data for CMS Attestations.

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.

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Michael Gilliland

COO & Partner

For over 30 years Mike has been helping large and small businesses grow through expanded market penetration, development of strategic relationships and high-quality service delivery.

As Madena’s Chief Operating Officer (COO), Mike has implemented a team-oriented 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 roles have included strategic planning, business development, relationship management and project management. He has managed small task-centric teams to multi-million-dollar system development projects for the Department of Defense, the Centers for Medicare & Medicaid Services (CMS), and Fortune 500 companies. This experience has taught Mike that the best technological solutions are user-driven and require true collaboration between the technology provider and the customer’s end users.
Jennifer Young

Jennifer Young

Vice-President, Healthcare Operations & Partner

Jennifer brings nearly 20 years’ experience in Medicare Advantage with a unique perspective from both the provider and payer organizations.

Jennifer’s experience includes reconciliation and revenue enhancement and solutions, system and process reviews, and new system implementation, operations, and management. She served WellPoint as National Director of Business Reconciliation/Revenue Enhancement, and Kaiser Foundation Health Plans as the National Medicare Finance and Reconciliation Manager.

Jennifer works with health plans in performing end to end system and process assessments to identify areas of non-compliance and opportunities for efficiency. Her in-depth knowledge of CMS’ policies and procedures for enrollment, claims, customer service, compliance, pharmacy, grievance and appeals allows her to help health plans focus their compliance and improvement efforts.

Jennifer has an MBA in Healthcare Management from the University of Phoenix and a Bachelor of Arts in Organizational Psychology from Kent State University.

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Seth Jordan

Vice-President of Product Development

Seth is leading the growth of our Synchronicity™ SaaS tool with his 20 years of experience designing and developing enterprise scale software solutions.

He brings years of relevant experience with the following applications and systems development to the Madena team:

- Docker & containerization of legacy enterprise applications
- Enterprise integration work using microservice, Docker and MuleSoft
- Implementation of an enterprise CI/CD platform to support multiple development teams working on heterogenous stacks
- Mobile application development for consumer and corporate business systems
- REST-based API development
- Enterprise API management deployment
- Enterprise single sign-on deployment for internal and cloud-based applications

COMPLIANCE & BUSINESS LEADERSHIP

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Dee Dee Stevens

Director, Compliance Solutions

Dee Dee has over 10 years’ experience in the Health Care Industry including management of the Medicare Enrollment and Reconciliation departments as well as Commercial Customer Service and Provider Inquiry areas for Anthem Health.

She worked with Medicare Advantage Plans (MAPD), Prescription Drug Plans (PDP) and Duals Special Needs Plans (DSNP). Her expertise includes creating efficient workflow processes for enrollment, reconciliation, customer service and pharmacy compliance areas.

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.

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Sue Dahlkamp

Director, Operations & Implementation

Sue has been supporting the health insurance industry and hospital systems for decades, including BCBS of Illinois for 6 years.

She has 11 years’ experience in Medicare system implementations, project management, data analytics, data mapping and data migration. Sue has exceptional problem solving and process improvement skills and experience. She has extensive experience in new system implementation, reporting, and compliance.
Dory Troutman

Dory Troutman

Senior Consultant, Chief Financial Officer

Dory Troutman, CPA, has more than 10 years of experience in tax, financial, and business consulting in her role as a Certified Public Accountant.

Dory has gained extensive accounting experience through senior accountant and management roles with public accounting firms ranging from tax and business advisory services with small firms to tax preparation with KPMG, one of the big four accounting firms. Dory has expertise in providing comprehensive accounting services for small to medium-sized businesses, focusing on startup companies and professional service businesses.

Dory works closely with Madena’s management team to improve the accounting systems and procedures. She has assisted in updating the presentation of data so that Madena can provide a more accurate view of the company’s financial health.

KEY CONSULTANTS

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Dick Warren

Senior Consultant

Dick Warren is a versatile, seasoned, professional healthcare executive with proven experience in health plan finance, operations and IT.

He provides strategic, operational and financial consulting services to government sponsored help plans. Dick offers clients more than 30 years of proven executive leadership experience as the CFO of both a national Medicare Advantage plan and a regional provider owned HMO. Prior to consulting Dick was Vice President at a Medicare Advantage membership applications vendor where he was responsible for all customer relationship management and led the successful implementation of the Medicare membership system at one of the country’s largest health plans.
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Brent A. Hiley

Senior Consultant

Brent Hiley, PharmD, MBA, has 20 years’ experience working in healthcare, and brings a deep level of expertise in Pharmacy Benefit Management to Madena’s team.

He is skilled in every aspect of the industry, including prior authorization protocols, PA reviews, new client implementation, regulatory compliance, policy and procedure writing, clinical program development, medication therapy management consultation, P&T committee reviews, RFP writing, contract negotiation, and program audit coordination.

Brent received his Doctor of Pharmacy from the University of Iowa and his residency in pharmacy practice at UNMC. He earned board certification in pharmacotherapy (BCPS) and has an MBA in finance from Bellevue University.

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Mae Regaldo

Senior Consultant

Mae is a results oriented, seasoned healthcare executive with over 20 years’ experience in health plan and MSO operations.

She is a proven leader with deep experience with fast paced, rapidly growing organizations. Mae is well-versed in all aspects of healthcare and all product lines (Medicare, Medicaid, Commercial & Health Exchange) resulting in the ability to reach across functional lines to drive organizational improvement and change. She provides consulting services in the areas of claims adjudication, claims system conversions, business process review and engineering, and all aspects of Medicare/Medicaid compliance. Prior to consulting Mae served as Vice-President of Claims & Configuration for a nationwide health plan.

Cindy Pierce-Allen

Senior Consultant

Cindy brings over 20 years of experience in the legal and compliance industry, including healthcare state and federal regulatory compliance, contractual compliance, corporate transactions and office management.

She has an abiding commitment to ethical, legal and auditing principles in communicating the importance of corporate responsibility to executive management. Her areas of expertise include: Centers for Medicare & Medicaid Services' application and bid project management, interpretative guidance for federal and/or state regulatory requirements, identification and implementation of process improvements to close compliance gaps, and related corporate transactional projects.
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Nirali Patel

Senior Consultant

Nirali is an experienced, performance-driven Health Care Executive who excels in the implementation of effective compliance programs for Medicaid and MAPD organizations.

Her experience includes Medicare and Medicaid Regulatory Compliance, Product Implementation and Operational Process Improvements, as well as CMS and State Audit Assistance for operations and compliance.

Since 2004, Nirali has led compliance teams and programs, conducted face-to-face compliance program training for employees, sales agents, and board directors; conducted and reviewed audits and corrective action plans; and developed First tier, Downstream and Related Entity oversight programs and compliance audits.

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Karl Lissade

Senior Business Analyst

Karl has over 15 years of experience working in healthcare field; 12 years of those years were directly dealing with Medicare management. He has an in-depth knowledge of federal and state compliance regulatory policies for healthcare management and quality assurance.

Karl is a highly motivated and dedicated team player who is very knowledgeable with Medicare policies, procedures, End-User Training, and Reconciliation. He has worked both in the Operational and Information Technology sides of Health plans and has been the liaison between both. Throughout that time, he has gained an in depth knowledge of federal and state compliance regulatory policies for healthcare management and quality assurance.
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Sara King

Senior Business Analyst

Sara is a problem solver who excels under pressure and with deadlines. She is highly goal oriented, and derives satisfaction from setting and achieving goals both individually and through staff leadership.

She is a medical compliance, reconciliation, and enrollment specialist bringing a decade of varied industry experience to the Madena team.
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Caroline Rufino

Program Manager

Caroline is a proven leader of operations and compliance, offering over 16 years of experience in the healthcare administration industry. She is passionate about maintaining compliance and keeping abreast of changing mandates with Medicare and Medicaid regulations.

She brings a commitment to achieving revenue goals while keeping member satisfaction a priority. Caroline is a subject matter expert in the Centers for Medicare and Medicaid Systems (CMS) policies and regulations, eligibility, and enrollment requirements.

BPO OPERATIONS

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Kally Moore-Allen

Senior Reconciliation Analyst

Kally is an accomplished Senior Reconciliation Auditor with over 9 years of healthcare experience in commercial and Medicare Operations.

She proudly maintains consistent productivity and efficiency and is quality‐driven at all times. Her overall goal is to provide quality and excellence to those she serves and to always do what is best for the customer while following business best practices. She brings a keen eye for evaluation, reconciliation, gap analysis, research, and health coverage information validation.
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Debra Carlin

Analyst
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TeLee Taylor

Reconciliation Analyst

TeLee serves Madena through data management, reconciliation, and submission of corrections to CMS or its designees.

She brings experience in managing billing, claims, Medicare enrollment, and medical records, as well as strong communication skills and the ability to manage and analyze large data sets. She is an optimistic and positive member of Madena’s Aurora, CO team.

PRODUCT DEVELOPMENT