Cheryl A. Wasserman, JD, CHC, CHPC is a Senior Consultant with 26 years of experience in managed care, indemnity insurance and government programs (Medicare and Medicaid). She has a broad range of experience in regulatory compliance and healthcare operations, advising health plans and similarly regulated entities on compliance programs, auditing, delegate oversight, HIPAA privacy and security concerns, as well as day-to-day operational management concerns. Throughout her career, Cheryl has conducted and supported numerous audits with her primary expertise in Part C Organizational Determinations, Appeals, Grievances (ODAG), Compliance Program Effectiveness (CPE) and Medicare-Medicaid Plan Service Authorization Requests, Appeals and Grievances (MMP_SARAG).
Prior to consulting, Cheryl worked at several large Medicare and commercial health insurance payors. At Medical Card Systems, Inc. (MCS), she served as Vice President and Medicare Compliance Officer with responsibility for the Medicare Compliance Program, including Compliance Auditing and Monitoring, Delegation Oversight, Sales Oversight, and the Special Investigations / Fraud, Waste and Abuse function.
Previous to her position at MCS, Cheryl was Senior Director and Chief Privacy and Security Officer for WellCare, Inc. While at WellCare, she also served as a Director in the Claims Operations area, overseeing claims processing and adjustment functions for both the Medicare Advantage and Medicaid lines of business. Before joining WellCare, Cheryl was employed by HealthNow New York, Inc. serving in the roles of Senior Director for HIPAA Compliance, Director of Claims & Service, Director Special Services and Support (including Enrollment, Front End, Performance Guarantee Groups and Claims Quality) and Corporate BlueCard Executive.
Cheryl is a New York licensed attorney, and a member of the Health Care Compliance Association (HCCA), certified in both Health Care Compliance (CHC) and Health Care Privacy Compliance (CHPC).