Rich Albertoni

Mr. Albertoni leads a team of PCG consultants who help clients establish state-based solutions to health insurance coverage that is efficient, cost effective and responsive to local needs. His experience working with both state insurance departments and Medicaid agencies facilitates system-wide innovations. He supported efforts in Arkansas and New Hampshire to leverage commercial insurance products as the delivery system for Medicaid. Areas of focus include Medicaid waivers as well as enhancing the competitiveness and solvency of state insurance markets.

 

 

 

 

 

 

 

Expertise

  • Health Insurance Exchange and Medicaid policy and program management

Experience

Prior to joining PCG, Mr. Albertoni served in a variety of leadership positions for Wisconsin Medicaid. As Eligibility Director, he led the workgroup that established business requirements for Medicaid and Health Benefits Exchange (Exchange) systems integration. He directed an initiative to establish an online health plan enrollment tool as part of the electronic Medicaid application. And he was a member of the Small Business Health Options (SHOP) implementation group and supervised staff developing Exchange marketing and user engagement tools.
As Deputy Director of the Bureau of Fiscal Management, he managed implementation of a statewide hospital assessment. This finance mechanism provided funding for the state's childless adults Medicaid expansion waiver. Mr. Albertoni also gained experience administering Medicaid benefits as Chief of the Pharmacy and Hospital section. He helped implement a preferred drug list and a benchmark plan that was adopted with the implementation of BadgerCare Plus in 2008.


Mr. Albertoni was also a key member of the state's Medicaid HMO management team, which developed plan contracts, capitation rates, risk adjustments and quality benchmarks. As Deputy Director of the Medicaid agency's Bureau of Fiscal Management (BFM) from 2007-09, Mr. Albertoni supervised the development of MCO capitation rates and incentive payments developed to promote plan adherence to performance benchmarks. Additionally, Mr. Albertoni served on Wisconsin's Health Care Reform Steering Committee in 2010 and 2011. This committee was comprised of executive staff of both the Department of Health Services (DHS) and the Office of the Commissioner of Insurance (OCI).

Education

Mr. Albertoni received his Bachelor of Arts in English from Santa Clara University and completed a Master's of Public Administration from the University of Washington – Seattle.

Contact

To learn more about Richard Albertoni or other PCG Health Subject Matter Experts, contact us at info@publicconsultinggroup.com or 1-800-210-6113.