Nick has served many types of clients in his time with Milliman. He has performed actuarial work for state government agencies, Medicare Advantage organizations, and other healthcare clients. His experience with these clients has allowed him to gain insight into the perspectives of different stakeholders for a variety of health care coverage types.
Public Program Consulting Experience
Nick has extensive experience working for public health care program clients, including state Medicaid agencies on the following:
- Development and certification of actuarially sound Medicaid managed care capitation rates
- Medicaid MCO procurement and capitation rate negotiation
- Medicaid provider reimbursement rate setting
- Medicaid MCO provider contracting analysis, including development and analysis of provider incentive programs
- Medicaid program expenditure projections in support of budget development
- Development, implementation, and analysis of §438.6(c) state-directed payment arrangements
- Development and implementation of risk adjustment, high-cost risk pool, and performance-based withhold mechanisms for Medicaid managed care programs
- Analysis of other Medicaid program changes
- In-depth encounter data analysis
- Communication with Medicaid MCOs, CMS, and other stakeholders
Public Program Clients
Nick has worked with five state Medicaid agencies:
- Florida Agency for Health Care Administration (2012 through present)
- Mississippi Division of Medicaid (2023 through present)
- Oklahoma Health Care Authority (2023 through present)
- New Hampshire Department of Health and Human Services (2014 and 2015)
- Minnesota Department of Human Services (2010)
Additionally, Nick has also worked with Medicaid MCOs in two additional states.
Medicare Advantage Experience
Nick has also spent significant time working for organizations that offer Medicare Advantage plans. His Medicare Advantage experience includes the following:
- Develop cost and revenue projections to assist clients in making strategic decisions
- Assess strategic considerations of product and benefit offerings
- Develop bids and supporting documentation for submission to CMS
- Prepare responses to questions from CMS reviewers
