Joe Weber

Rich Albertoni

Manager / Health

Mr. Albertoni has 16 years of experience working in state public health programming and Medicaid. He has held leadership positions in eligibility, budget and finance, and benefits and waivers. He understands the challenges government leaders face reforming large, complex programs, and is committed to helping clients achieve goals to optimize local and regional healthcare access. Mr. Albertoni manages a consulting services team focused on healthcare access and markets, including health plan regulatory compliance consulting for both state insurance departments and Medicaid managed care programs.  Mr. Albertoni’s team also helps states and counties build behavioral healthcare system access and capacity. Finally, his team helps states proactively plan eligibility criteria for Medicaid, the Health Insurance Marketplace, and other state healthcare programs using federal waiver authority (1115, 1332, 1915, etc.) and state plan options.

Thomas Aldridge

Manager / Health

Mr. Aldridge is a Manager with Public Consulting Group (PCG) and has been with the firm for more than 20 years. Throughout his tenure, he has managed dozens of engagements within Health and Human Service agencies across the country.  Mr. Aldridge heads the Payer Services unit of PCG’s Health practice area, leading efforts to control costs for payers, including Medicaid programs and MCOs, through placement of tighter controls on member eligibility, provider oversight, and monitoring and consumer assistance initiatives.  Specifically, Mr. Aldridge has led large-scale project teams in North Carolina, Ohio, Maine, Massachusetts, Michigan, West Virginia, and Louisiana. He also led PCG’s Medicare Part D State-to-Plan claims reconciliation project with the Federal Center for Medicare and Medicaid Services (CMS).  Through these efforts, PCG’s project teams strive to improve efficiency and precision in the administration of various public sector health programs. As a result, PCG has generated hundreds of millions of dollars in revenue and cost savings direct to the program and measurable efficiencies through technological and administrative improvements. Mr. Aldridge’s educational background includes an undergraduate degree in Economics from Clemson University and a Master of Health Care Administration degree from the University of North Carolina at Chapel Hill.

John Blowers

Associate Manager / Health

Mr. Blowers leads the newest PCG Health Center of Excellence known as Staffing Solutions Organization (SSO). While SSO just celebrated its one-year anniversary on May 1st, Mr. Blowers has over 25 years of HR experience, with approximately 2/3rds of that time holding leadership roles with General Electric, India-based Crompton Greaves, and Price Chopper, a 20,000-employee food services company. The rest of his career has focused on consulting work with companies such as Kellogg, AT&T, Constellation Energy, the City of Albany, and Mead West Vaco.

At PCG, Mr. Blowers leads SSO as it serves its flagship client in Albany, NY, New York State Department of Health’s Office of Health Insurance Program, by delivering staff augmentation and consulting services for NY’s Medicaid program. SSO currently employs 350 embedded staff in roles ranging from entry level administrators, doctors, nurses, pharmacists, architects, lawyers, and various program management roles.

Kevin Carlson

Chief Technology Officer / Health

Mr. Carlson has more than 20 years of experience in the health care technology sector. He has overseen the development and implementation of numerous electronic health record, revenue cycle management (RCM), business intelligence, and health information exchange (HIX) systems across the United States. For PCG Health, he oversees the Health Software Development team, which develops and deploys a wide scope of SaaS applications. Mr. Carlson holds a BS in Computer Science from Northeastern University.

 

Peter Cheesman

Associate Manager / Health

Mr. Cheesman leads PCG Health's Member Eligibility Solutions group. In this capacity, he has overseen the implementation and operation of high-profile benefits eligibility verification systems and data broker solutions for health and human services agencies in Texas, New York, North Carolina, Colorado, New Jersey, Maine, Massachusetts, Maryland, Wisconsin, Nevada, Delaware, West Virginia, Iowa, Tennessee, Vermont, Oklahoma, South Dakota, District of Columbia, Utah, and New Hampshire, as well as on behalf of the UAW Retiree Medical Benefits Trust, Caterpillar Corporation, and Whirlpool, Inc. Mr. Cheesman has more than a decade of public sector consulting experience, including working on behalf of more than 50 federal, state, and commercial organizations to identify more than $1 billion in revenue generation and cost savings opportunities. Mr. Cheesman specializes in designing and deploying creative technical solutions which allow agencies to use federal, state, financial, public records, and commercial data sources and predictive analytics to better identify fraud and ineligibility while automating and expediting manual case processing activities. As a leading subject matter expert in this area, Peter regularly assists government agencies and commercial vendors in defining and deploying critical data solutions used to reduce public assistance program expenditures and identify potential fraud. Mr. Cheesman received his B.S. in Business Administration from Northeastern University and his M.B.A. from Clark University.

Tony Curatola

Associate Manager / Health

Mr. Curatola, an Associate Manager with PCG and certified PMP, has more than 29 years of experience in the Information Systems industry with over 22 years in project management and 18 years in Medicaid.  He has extensive project management experience in both the public and private sectors including: state government, property and casualty Insurance, healthcare insurance, and banking.  Mr. Curatola is a proven leader with excellent communication and interpersonal skills, and has extensive experience in resolving conflicts within teams, as well as across functional areas.  He has successfully led and implemented numerous medium to large-scale systems and projects.

James Dachos

Associate Manager / Health

Mr. Dachos, an Associate Manager in our Healthcare Financing Solutions division, has 12 years of Medicaid and Healthcare experience with PCG. He leads PCG’s Emergency Medical Services (EMS) division, where he oversees cost recovery and revenue maximization initiatives. In this capacity, Mr. Dachos is directly responsible for the development, design, implementation, and ongoing administration of EMS reimbursement programs. He manages these programs for over 200 providers in Texas, Florida, Washington, and Oregon, as well as the state-wide program in Colorado. Mr. Dachos also serves as the Program Manager for six state-wide School Health Services Medicaid reimbursement programs, supporting more than 1,000 school districts across the country. Through these engagements, Mr. Dachos oversees the programmatic areas of revenue maximization and compliance. He possesses a deep understanding of the modeling requirements and analysis necessary to design and implement supplemental reimbursement programs. He has vast experience working with Centers for Medicare and Medicaid Services (CMS) throughout the program approval process, including composing legislation and State Plan Amendments, developing compliance-driven reimbursement strategies, and negotiating federal approval. Mr. Dachos graduated from Bates College with a Bachelor of Science, and received his Master of Business Administration from Clark University.

Rick Dwyer

Manager / Health

Mr. Dwyer, a Manager located in our Boston office since 1993, has over thirty years of experience in financial and operations management in corporate and healthcare provider and payer environments.  For providers, Mr. Dwyer has been actively involved in improving revenue and management operations to optimize program revenues and to bring healthcare facilities into compliance with federal, state, and other third-party requirements.  This work covers various provider settings and programs including hospitals, community mental health centers, federally qualified health centers, public health clinics, partial hospitals, and pharmacy (Medicare Part D) services.  For payers, he has directed third-party administration and related services for state agencies and private insurance companies who chose to outsource those functions.  Mr. Dwyer has also directed numerous planning and evaluating projects involving mental health hospital and community-based programs. Throughout many of these engagements, expanded use of automated systems and system implementation and change management services were provided to achieve optimal results.  Mr. Dwyer has earned both a BSBA and MBA from Babson College located in Wellesley, Massachusetts.

Tom Entrikin

Manager / Health

Mr. Entrikin has 45 years of experience with the Medicaid and Medicare programs. From 1981 to 1992, he was a Medicaid policy specialist with the US Health Care Financing Administration (HCFA), now the Centers for Medicare & Medicaid Services (CMS), providing technical assistance to states on Medicaid eligibility, coverage, and reimbursement; provider certification and enrollment; program integrity; recovery of third party liabilities; Medicaid Management Information System (MMIS) performance specifications and operations; interagency agreements; contracts with managed care organizations; health standards and certification requirements; and Medicaid waiver programs. Since coming to PCG in 1992, Mr. Entrikin has assisted in the design, development and implementation of revenue projects for school-based health services; hospital-based and municipal projects for pregnant women, infants, and children; state services offered through youth services, child welfare, mental health, substance abuse, developmental disabilities, and public health agencies; and reimbursement systems for hospitals, long term care facilities, and home and community-based services waiver programs. He has made presentations on home and community-based services waiver programs at national conferences sponsored by the Robert Wood Johnson Foundation as well as presentations on Medicare/Medicaid claiming and waiver options at the National Association of Reimbursement Officers and the National Association of State Human Services Finance Officers.

Amy Ferraro

Manager / Health, Human Services

Ms. Ferraro has over 22 years of public sector consulting experience and has worked on a variety of revenue management, revenue optimization, and consulting engagements in more than 35 states across a variety of different agencies. She has also worked with various county governments and tribal organizations. Her specific areas of expertise are within public assistance cost allocation, indirect cost rates, time studies, administrative claiming, rate setting, and training. Her cost allocation expertise crosses Medicaid, child welfare, income maintenance, public health, behavioral health, developmental disabilities, and other health and human services programs. She has led revenue optimization projects in states including Colorado, Louisiana, and Montana and large scale cost allocation engagements in states including Arkansas, Delaware, Massachusetts, Michigan, Nevada, Vermont, and Maine. Ms. Ferraro led PCG’s efforts to develop our AlloCAP™, AlloTrac™, and EasyRMTS™ web-based software tools. For the last fifteen years, Ms. Ferraro has conducted nationwide training sessions, many on behalf of the National Association of State Human Services Finance Officers (HSFo), in the areas of Medicaid and cost allocation. She holds a Master’s Degree in Public Administration from the Maxwell School of Citizenship and Public Affairs at Syracuse University and earned a Bachelor of Arts cum laude in Politics at Mount Holyoke College.

Kelly Gallagher

Associate Manager / Health

Ms. Gallagher has been with PCG for 10 years. Ms. Gallagher helps lead the Cost Allocation Center of Excellence, specializing in cost allocation, time studies, Medicaid and Title IV-E claiming programs, business process review, Targeted Case Management (TCM) and Medicaid administrative claiming (MAC), and training initiatives for PCG with experience in health agencies, human service agencies, and tribal organizations in dozens of states. She works, or has worked, on large scale efforts in states including Texas, Colorado, Indiana, Arkansas, Massachusetts, Rhode Island, and Arizona. Many of these efforts include Random Moment Time Study reviews and redesigns, organizational reviews, and revenue enhancement work. Ms. Gallagher has conducted several nationwide training sessions, many on behalf of the National Association of State Human Services Finance Officers (HSFo), in the areas of child welfare financing, Medicaid, and cost allocation. Ms. Gallagher earned a Master of Business Administration degree from Clark University and holds a Bachelor of Science Degree in Business Administration from Boston University.

Aaron Holman

Associate Manager / Health

Mr. Holman has been working in health policy for the past decade, starting in the United States Senate working on Medicare, CHIP and Health IT areas for Senator Debbie Stabenow (D-Michigan) and the Finance Committee. Mr. Holman also worked as a lobbyist in Washington focusing on health IT financing and standards development, primarily in the areas of privacy, security and confidentiality, as a drafter of the legislation ultimately creating the Meaningful Use program. Mr. Holman’s private sector experiences have focused primarily on operations improvements and the development of growth strategies for commercial hospital and insurance companies. Many of his clients represented the largest companies in health care in America, including HCA, United Health, Cigna, and Partners Healthcare. Since the passage of the Affordable Care Act, Mr. Holman has worked with various Partnership and State-based Marketplaces in assisting with the certification of their Qualified Health Plans, as well as on various Medicaid waiver programs. Mr. Holman currently oversees PCG’s work on Delivery System Reform Incentive Payment (DSRIP) waiver programs across various states such as New York, New Jersey and Massachusetts. Mr. Holman has a Bachelor of Arts from University of Michigan and a Master of Science from Harvard University.

Sean Huse

Manager / Health

Mr. Huse (MBA, CHFP), a Manager at Public Consulting Group, is an experienced health management consultant who focuses on financial management, strategic planning, policy analysis, information technology assessments, and management reporting for Medicaid agencies. He currently serves as the Center of Excellence (COE) lead for PCG’s Health Innovation, Policy, and Information Technology (HIPIT) unit. The HIPIT unit leads the firm’s national efforts in Health Delivery System Transformation, Health Policy, and Health Information Technology consulting. These projects include delivery system reform efforts, payment reform, patient centered medical home and health home program design, health data analytics, behavioral health system design, dual eligible population management, health exchange development, MES IT assessments, PMO, and system innovation consulting. Mr. Huse received his Bachelor of Arts in Economics and Neuroscience & Behavior from Wesleyan University and completed a Master’s Degree in Business Administration (MBA) with a concentration in health care administration from Clark University. He is also a Certified Healthcare Financial Professional (CHFP) with the Healthcare Financial Management Association (HFMA).

Kevin Hutchinson

Manager / Health

Mr. Hutchinson oversees PCG's Program Integrity and Provider Management solutions, advising and aiding Medicaid agencies and healthcare care plans in improving compliance and quality, while preventing fraud, waste, and abuse. He leads a team that provides an innovative solution to program integrity that is unique in the marketplace. This seamless solution integrates provider enrollment and credentialing, provider screening, assessments and authorizations, investigations, prepayment and post-payment reviews. His team conducts thousands of screenings, reviews, and investigations each year, resulting in millions of dollars in cost avoidance and identified overpayments. Mr. Hutchinson's consulting services include policy enhancement, business process redesign, data analytics, and performance management. He leverages his extensive experience in state government, health and human services, technology, and management consulting to serve his clients. Prior to joining PCG, Mr. Hutchinson served in the North Carolina Office of the Governor, working with public policy, budget, and management.

Lisa Lee

Associate Manager / Health

Ms. Lee has been with PCG for 1 year and helps lead the Health Innovation, Policy and Information Technology Center of Excellence, specializing in Medicaid, CHIP, and ACA policy. Project accomplishments include the creation of Mississippi’s 1115 Waiver Application designed to assist Medicaid members with workforce training opportunities. Prior to joining PCG, Ms. Lee worked in a variety of roles, including Commissioner for the Kentucky Department for Medicaid Services. In addition, Ms. Lee served as Director of the Kentucky Children’s Health Insurance Program (KCHIP) for approximately 15 years. Ms. Lee graduated Summa Cum Laude with a Bachelor’s Degree in English from Kentucky State University.

Dale McCourt

Associate Manager / Health

Mr. McCourt, Associate Manager, has been a member of the PCG team since 2011. Dale brings over 25 years of experience spanning many industries where he has served in a variety of roles including Chief Operating Officer, Project Manager, Manager of Finance & Administration, and Sr. Actuarial Analyst. Dale’s innate curiosity and eagerness to solve problems using process improvement techniques and technology solutions has manifested itself in the development of new product lines aimed at proactively guarding against Medicaid provider fraud, waste and abuse, as well as educating providers on Medicaid compliance through high-touch, technology-driven provider oversight techniques. Dale McCourt holds a Bachelor of Science degree in Mathematics and Computer Science and is a certified Project Management Professional (PMP). Dale resides in Asheville, NC with his wife, Willie, and they’re avid triathletes, enjoying swimming, cycling and running.

Jay Peck

Associate Manager / Health

Mr. Peck has been with PCG for over 13 years, specializing in Medicaid Program Integrity, Quality Improvement, and Beneficiary Due Process. He has successfully led the implementation of large-scale projects, such as a Provider Oversight effort in Ohio, as well as more focused efforts like PCG’s Prior Authorization and Due Process Monitoring in North Carolina. Mr. Peck has developed a team of Program Integrity (PI) professionals, including clinical reviewers, data analysts, and Medicaid experts, which has assisted numerous states in improving and optimizing their PI operations. Accomplishments of this team run the spectrum of Program Integrity operations, from data analytics and predictive modeling, to medical record reviews and audits, to organizational operations consulting. By understanding the Medicaid landscape and the realities of state budgets, Mr. Peck's team has assisted their clients in recognizing millions of dollars in not only recoveries, but in cost avoidance as well, thus helping to modify provider behavior, improve compliance, and maximize the impact of limited Medicaid dollars. In addition to Medicaid, Mr. Peck has experience in compliance reviews under the Social Security Act and auditing similar claims as part of a quality control initiative. He has also assisted multiple states in completing ACF Federal Title IV-E Audits. Mr. Peck graduated from Syracuse University with a Bachelor of Science in Law & Public Policy, and received his Master of Business Administration from Clark University.

Matthew Sorrentino

Manager / Health

Mr. Sorrentino, a Manager and Center of Excellence (COE) lead for our Healthcare Financing Solutions division, is a management consultant with 15 plus years of extensive Medicaid and healthcare experience. Mr. Sorrentino specializes in the design, implementation, and evaluation of healthcare operations and payment systems. Specific to healthcare operations, Mr. Sorrentino has national oversight over PCG’s claims processing services and solutions, data intermediary services, and revenue cycle management services. He has assisted Medicaid agencies, private payers, and providers in implementing efficient and cost effective outsourcing solutions to process claims and supporting functions, streamlined the collection of important healthcare data to empower policymakers to make informed decisions on healthcare programs and resources, and optimized funding streams to providers, with a specific focus on public providers critical to the healthcare safety net. In terms of payment and reimbursement systems, Mr. Sorrentino has led rate setting, provider assessment, and other critical financial management efforts for public payers for institutional and community-based services. He has helped Medicaid agencies and other publicly-funded programs move from cost-based reimbursement programs to acuity-based reimbursement methodologies, and now to value-based reimbursement strategies. In addition, Mr. Sorrentino has advocated for safety net public providers that provide a disproportionate share of healthcare services to the Medicaid and uninsured patient populations. He has helped secure significant and new Medicaid funding streams to public hospitals, community-based providers, first responders, and school districts by pioneering innovative supplemental payment strategies and programs. Mr. Sorrentino has navigated Medicaid agencies and other healthcare programs through all facets of these strategies from program design, to facilitating stakeholder engagement and feedback, to negotiating federal approval, and ultimately program implementation.

Marc Staubley

Practice Area Director / Health

Mr. Staubley is Practice Area Director (PAD) of PCG’s Health division and a PCG shareholder. In this role, he provides executive leadership to over 400 staff who manage a portfolio of over 200 projects that span across more than 35 states. Mr. Staubley is an experienced health and human services leader, having partnered for more than twenty years with state and local health and human services agencies. He has provided executive leadership of various reimbursement transformations, including oversight of the conversion to resource-based payment methodologies, pay-for-performance implementations, and business process reengineering of provider claiming approaches to accommodate payment reform efforts. Since joining PCG in 1994, Mr. Staubley has also been deeply involved in the determination and reporting of provider costs as part of cost-based and/or cost settlement reimbursement mechanisms for federal health and human service programs.  He supports our clients with various ongoing reimbursement operations, including annual rate setting efforts, cost settlement functions, and the review and evaluation of provider-submitted cost and utilization data. Mr. Staubley’s work has covered a broad and diverse set of programs, such as home- and community-based services, school-based services, transportation programs, traditional state plan community-based services, institutional services, and more recently, delivery system reform programs.  In addition to his role as PAD, Mr. Staubley serves as President of Staffing Solutions Organization (SSO), a wholly-owned subsidiary of PCG specializing in talent acquisition and management.

James Waldinger

Associate Manager / Health

Mr. Waldinger, an Associate Manager at PCG, is an experienced Medicaid policy and reimbursement professional who focuses on healthcare operations, mental health and substance abuse policy and integration, and health care reform and its impact on Medicaid programs and providers.

As the former Chief Financial Officer and Budget Director for the Massachusetts Medicaid Program, MassHealth, and CFO for the Massachusetts Behavioral Health Partnership (MBHP), Mr. Waldinger was responsible for understanding the fiscal impacts of all programmatic and policy changes, including the building, updating, and tracking of all provider reimbursement calculations, policies, and impacts.  At MassHealth, Mr. Waldinger led all financial efforts related to multiple successful State Plan Amendments (SPAs) and 1115 Waiver submissions, including Massachusetts’ landmark health care reform waiver in 2005-6. At MBHP, Mr. Waldinger led efforts to implement a sophisticated inpatient psych hospital pay-for-performance initiative. 

Mr. Waldinger’s current role at PCG includes heavy involvement in claims processing and Medicaid reimbursement policy transformation. His experience speaks to multiple behavioral health engagements, from provider strategic planning, to statewide behavioral health services assessments, to the development of reimbursement methodologies that incentivize integration of community-based services. Mr. Waldinger’s in-depth understanding of provider costs, cost reporting, cost modeling, and cost settlement experience, provides clients with a unique understanding of the behavioral health system and potential impacts of policy changes.

Joe Weber

Associate Manager / Health

Mr. Weber, PMP, has been with PCG for 13 years. Mr. Weber helps lead the Health Care Financing Solutions (HCFS) Center of Excellence with over twelve years of public sector consulting focusing on publicly funded healthcare programs including Medicaid, CHIP, and Medicare, with an emphasis on Medicaid reimbursement in institutional and community-based programs. He has led PCG’s statewide efforts to develop and implement CMS-approved reimbursement methodologies for community, EMS, and school based service programs in New York, New Jersey, Massachusetts, Pennsylvania, West Virginia, Georgia, and Wisconsin. Mr. Weber also has extensive experience with institutional cost reports and rate setting, including the preparation of Medicare and Medicaid cost reports for state-operated psychiatric, acute care, and long term care facilities. In addition to his health care financing expertise, Mr. Weber has also led statewide programmatic and financial assessments of publicly funded behavioral health services in Texas and West Virginia. Mr. Weber’s experience also includes leading PCG’s efforts supporting the New York State Department of Health in the implementation and operation of the state’s Delivery System Reform Incentive Payment (DSRIP) Program. Mr. Weber graduated with a Bachelor of Arts in Economics from the College of the Holy Cross in 2005 and a Masters of Business Administration from Clark University in 2009.