Danielle Bivins’ Medicaid experience includes developing state-specific Medicaid risk adjustment weights, managed care savings evaluation, reviewing and analyzing State capitation rate development, performing program financial analysis, and developing a single PDL analysis. She has also worked with a variety of large and diverse claim, enrollment data sets as part of developing financial models for commercial insurers, government agencies, and for internal firm use. Danielle has been the lead analyst for developing Medicare Advantage Prescription Drug (MAPD) bids for CMS. She has summarized and compared national average Medicare Advantage (MA) benchmark rates, average MA benchmark rates in client’s service state as well as client’s specific service areas. She has performed Incurred but Not Reported (IBNR) studies to calculate completion factors and she has integrated Part D bids into overall MAPD bids.
Danielle assisted Medicaid health plans in the review and analysis of State capitation rate development and other State directed initiatives. She’s served as lead analyst for the development of Medicaid bid rates for a regional Medicaid health plan and assisted with year-end financial statement opinions through the analysis of Incurred but not Reported (IBNR) reserve estimates for various populations, including Medicare and Medicaid.
Danielle worked with a variety of large and diverse claim and enrollment data sets as part of developing financial models for commercial insurers, government agencies, and for internal firm use. She has provided actuarial support for regional health plans’ provider shared risk model development and implementation. Her key responsibilities include database design, data transformation logic, financial modelling, and monthly operation reporting. She has supported the development of ERG risk adjustment analysis for the state of Arizona’s Medicaid program.
Danielle earned her bachelor’s degree in actuarial science from the University of Nebraska-Lincoln.
