Emily Vandermause

About Emily Vandermause

I am a Principal and Consulting Actuary in Milliman\'s Chicago-Milwaukee Health practice. I assist Medicare Advantage (MA) organizations, state Medicaid agencies, employers, managed care organizations, brokers, and numerous other clients in the healthcare market.I have been involved in MA bid development since I began at Milliman and have assisted large MA organizations as well as start-ups and special needs plans. I also have several years of experience assisting clients in the Medicaid sector. In particular, I assist with the development of capitation rates for the acute care Medicaid program in the State of Wisconsin.My other areas of focus include- Development of cost and revenue projections - Liability estimation - Benchmarking experience to fee-for-service utilization levels - Strategic analysis around service area expansion and the feasibility of new product offerings - Analysis of CMS-HCC risk adjustment models and the impact to special needs populations - Reconciliation of encounter data to financial statements submitted by managed care organizations participating in the Medicaid program - Development of FFS reimbursement rates for Medicaid eligible children enrolled in special needs programsDuring my time at Milliman, I have also been a key contributor to the development of CORAL, a Milliman web-based benefit relativity comparison tool. The tool allows employers, insurance companies, and brokers to quickly evaluate change medical / prescription drug benefits and evaluate the impact on a plan’s actuarial value and overall cost relative to other plans.

Experience

1. Principal and Consulting Actuary

   Milliman

   Sep 2022 — Present · Milwaukee, WI, US

Education

• University of Wisconsin-Madison

  Actuarial Science

  2005 — 2009

• Ashwaubenon High School

  High School

  2001 — 2005

Skills

• Health Insurance