Client Solutions Architect, National Payer Segment

HI, I’M Melissa

I’m here to help you obtain the analytics and insights needed to help you make strategic decisions about your network and achieve the best possible care for your members.


Melissa is an esteemed thought leader in the realm of provider network management, leveraging her extensive expertise for nearly two decades to transform data and analytics into actionable insights that drive significant value for America’s healthcare organizations and regulatory programs alike. With a background as an Actuary and in Medical Economics, Melissa has seamlessly collaborated with diverse departments, fostering a profound understanding of the intricate workings of health plans. Possessing an innovative mindset, she actively collaborates with clients, striving to pioneer out-of-the-box solutions and tailor-made reports that empower customers to achieve their organizational objectives.

Case Studies

“Are We Compliant — or Not?”
They had no effective way to find their own adequacy gaps — but CMS and state regulators were finding plenty
Too Bad to Ignore, Too Big to Fix
Provider data accuracy issues could have jeopardized their partner relationships — but they didn’t have an effective way to address them.
Building Their Own HMO
Wanting to set up their own HMO, they needed to build a county-wide Medicare Advantage network — with no previous experience managing CMS network adequacy requirements
Oversight, Meet Insight
They had manual oversight of provider network adequacy—but zero insight into provider availability, provider data accuracy or performance across health plans.
A Tale of Two Networks
Having struggled to build a Medicaid network, they now faced the more complex requirements of Medicare — with only one shot to get it right.
More Than Meets the ROI
A costly CMS penalty proved they couldn’t keep managing their provider networks the same old way. For a New York health plan, smarter provider network management was a better investment...


Our team is ready to help you address the challenges provider data presents. We want to help you take your member experiences to the next level and avoid regulatory risks, like audits, and meet the mandates around surprise billing.

Contact us today to book a strategy session to understand and provide guidance to limit your exposure.

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