Team

Madena Solutions > Team

EXECUTIVE TEAM

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.

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

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.

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 MANAGEMENT

Joe Berry

IT Systems Administrator

Joseph manages the IT infrastructure at Madena, including information security, compliance, and bridging the gap between the development and business operations teams.

Joe brings his experience as a systems engineer and support and hardware technician, as well as recent and relevant training in Cybersecurity (M.A., Sacred Heart University), advanced software engineering, vulnerability management, and network security to Madena’s IT and business management team.

Julie Ottomano

Executive Office Manager

Julie contributes a wealth of experience in both executive office management and business administration to the Madena team.

Her competent, positive, and can-do attitude are an asset to the Biddeford office and as the face and voice of day-to-day operations.

As a business owner, executive assistant, and teacher, Julie’s problem-solving skills, patience, and ability to multitask are a match for the fluid, complex healthcare industry.

Julie graduated from Boston University with a Bachelor of Science in Business Administration.

Debra Stevens

Director, Compliance Solutions

Dee Dee brings over a decade of experience in the Healthcare Industry, including management of Medicare Enrollment and Reconciliation department, 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.

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.

Elia Seely

Marketing and Content Management

Elia brings over a decade of experience as a writer, copywriter, editor, and project manager to Madena.

Her creative focus and eye for detail, as well as her passion for communicating a client's message in a clear and approachable way are an integral part of Madena's marketing and communications team.

Elia has worked as a writer, designer, and project manager her entire professional career: in the arts, non-profit management, as a freelance food writer, and content marketer. She graduated with a Masters of Science in Arts Administration and a Bachelor of Arts in English from the University of Oregon.

Dory Troutman

Acting 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

Annette Ayala-Martinez

Senior Consultant

Annette has been active in Medicare Advantage Organizations (MAO) operations since 1997, specifically in Enrollment and Appeals & Grievances.

Her deep knowledge of A&G policies and processes benefits Madena’s clients as well as supporting the rest of the consultant team. Annette is also experienced in the operational requirements for Medicare Enrollment/Disenrollment and compliance. She brings decades of executive management skills, including data analysis, reporting, leadership, and training to the team and the clients she serves.

Annette received her B.A. in Business Administration from California State University, Fullerton and is fluent in Spanish.

Nicole Izzolena

Program Manager

Nicole contributes over a decade of experience working in Medicare management and operations to Madena’s Key Consultant team.

She has deep knowledge of enrollment and reconciliation processes as well as a passion for training and quality assurance.

Karl Lissade

Senior Business Analyst

Karl has over 15 years of experience working in healthcare field. 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.

Nirali Patel

Senior Consultant

Nirali's 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.

She is experienced and performance-driven and excels in the implementation of effective compliance programs for Medicaid and MAPD organizations.

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.

Thomas Siedlik

Program Manager

Tom is an expert on CMS Retroactive Processing contracts and Managed Care Plans, and offers his considerable skills as a project/program manager to Madena’s Key Consultant team.

His deep understanding of current legislation and regulations assist Madena clients with compliance and accurate and timely reporting. Tom’s varied abilities include excellent research, analysis, communication, and management skills. His willingness and ability to collaborate, communicate, and promote the overall goals of his consultant teams and clients makes him one of Madena’s most valuable program managers.

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.

Sara King

Senior Business Analyst

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

She 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.

Cathy McClain Gordon

Senior Consultant

Cathy brings over 25 years of health care industry experience working with Commercial insurance programs (including HIX), and Medicare Advantage, Medicaid, and TRICARE.

Her passion is assessing and transforming health care operations, establishing process controls for monitoring regulatory compliance, quality management, provider network contracting and maintenance, system implementations, and business development. In her decades in the industry, Cathy has helped clients develop and deploy strategies for maximum efficiency, effectiveness, and compliance.

Cathy earned a Master of Health Administration degree and a Bachelor of Arts in Psychology from Governors State University. She is an alum of America’s Health Insurance Plans Leadership Development Program and current member of the Advisory Cloud Board Directory.

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.

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

Treva Baker

Supervisor, Healthcare Operations

Treva specializes in strategic and long-term planning and team leadership. Her skills in developing, training, and guiding teams contributes to the cohesion and productivity of Madena’s Colorado office.

She has a background in healthcare claims management, billing, enrollment, employee training and development, and direct patient and provider relations.

Debra Carlin

Analyst

Debra is the efficient, supportive glue of the Aurora office, providing administrative assistance to management and other staff. Her diverse skill set and ability to multi-task make her a crucial part of the everyday effectiveness of Madena’s Colorado team.

Shanna Malachin

Senior Reconciliation Analyst

Shanna is one of the reconciliation experts on the Colorado team. She brings an impressive skill set of data and financial analysis, lead generation, sales, and management to Madena, as well as a solid base in customer care and communication.

Lay Soemoe

Quality & Training Lead

Lay brings her 13 years of healthcare industry experience to the Madena BPO team. Her in-depth understanding of HIPAA regulations and CMS guidelines, and Medicare Parts A, B, C, and D is an invaluable asset in her role as Quality Assurance & Training Lead.

She is an integral part of Madena’s internal quality assurance auditing and training for analysts, and is responsible for identifying and resolving discrepancies in monthly reconciliation reports. She provides feedback to the management team in order to drive continuous improvement in training and QA systems.

Lay graduated magna cum laude with a Bachelor of Science in Business Administration-Finance from Regis University.

Tara Barrett

Reconciliation Analyst

Tara offers a diversity of experience in management, operations, and client and staff relations to Madena’s Colorado office. Her ability to multi-task, perform complex data analysis, and maintain accurate records and reporting are crucial for her position as a reconciliation analyst.

Erin Greene

Senior Reconciliation Analyst

Erin contributes a decade of experience with commercial health plans to Madena’s BPO team. Her expertise includes billing, claims processing, authorizations, benefits, and appeals. She also has extensive experience in accounting, staff education and training, and business management.

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.

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

Derek Durivage

Senior Developer

Sweta Panda

Senior Developer

Sweta brings her skills as a certified AWS Solutions Architect associate and SAFe Agile practitioner to Madena’s Product Development team.

She has over eight years of experience in the healthcare, government, and finance industries and offers deep experience in the latest enterprise microservice-based architecture, AWS Migration, database migration, and rule engine implementation.

Sweta has extensive facility with additional technologies, including J2EE-Spring boot microservices with Angular UI, JSF, Struts, Oracle-PostgresSQL database migration, and Elasticsearch engine. She received her professional BTech Electronics & Telecommunications degree at Biju Patnaik University of Technology, India.

Artin Malekian

Java Developer

Artin contributes his experience with Spring framework, REST-based API, MySQL and Angular to Madena’s Product Development team.

He is also experienced with microservices architecture and docker. Skills include Java, C, Phyton, HTML, CSS, JavaScript, XML, Spring, jQuery, Bootstrap, Node, PostgreSQL, Oracle, and Microsoft SQL among others.

Artin has a B.S. in Computer Science from George Mason University, and he is pursuing a Master’s degree in Software Engineering.