Mark Bigelow
Principal @Bigelow Healthcare Consulting
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WORK HISTORY
Principal @Bigelow Healthcare Consulting
US
Bigelow Healthcare Consulting helps health plans and provider organizations find and fix what\'s broken in their risk adjustment programs.Every RA program has gaps — in data flow, submissions, reconciliation, analytics, or how policy changes translate into operations. Most of these gaps are invisible until someone traces the process end to end. That\'s what we do.We conduct independent, end-to-end assessments across ACA, Medicare, and Medicaid risk adjustment programs, covering: Policy-to-operations translation and readiness Encounter submission monitoring and acceptance optimization End-to-end data reconciliation and accounting Analytics, reporting, and predictive model evaluation Strategic alignment across clinical, IT, finance, actuarial, and compliance RADV and audit preparednessFounded by Mark Bigelow, a 13-year risk adjustment veteran with VP-level experience at health plans, provider organizations, and vendors. His track record includes 10% improvement in documented accuracy, encounter acceptance rates improved from 65% to 99%+, and a 2022 Best-in-KLAS award for Risk Adjustment Analytics.The goal is never to maximize risk scores. It\'s to ensure they\'re complete, accurate, and fully compliant — so you can stand behind them. Reach out to start a conversation: m•••@bigelowhealthcare.com
EDUCATION
Brigham Young University
Bachelor's, Economics
UW Foster School of Business
MBA, Finance, Strategy, Org. Development, Marketing, Entrepreneurship
SKILLS
ABOUT MARK BIGELOW
Finance & Analytics leader with track record for building and leading teams to deliver excellent results.Diverse background spans healthcare, private equity, startups and manufacturing.Highlights include:• Transformed Risk Adjustment Analytics team into a world-class team that delivers predictive analytics and insightful, automated reporting and dashboards.• Hired and developed a leadership team focused on employee engagement and development.• Led improvement of RAPS and EDPS submissions to 99% acceptance from 67% in 1 year.• Led regional team that generated >$100M in risk adjustment revenue across 4 states.
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