Yelena Barzilla is a director with more than 14 years of experience monitoring public healthcare programs, managed care oversight, and federal and state regulatory compliance, working on issues related to program operations and quality, benefit design and implementation, and program integrity. She serves as a policy expert for Guidehouse’s actuarial practice and assists states and CMS with program development and rate setting efforts. This involves supporting the agencies with their Medicaid rate setting strategy, healthcare reform consulting, state innovation model strategies, waiver development.
Yelena specializes in regulatory compliance of managed care operations (“Mega Rule” implementation). Her Medicaid policy experience includes conducting readiness reviews, moderating contract negotiations between agency staff and MCOs, preparing Section 1915, 1115, 1332 and 1135 waiver applications, and developing State Plan Amendments.
Prior to joining consulting, Yelena worked for the state of Texas on issues related to managed care operations, benefit design, eligibility policy, claims processing, program implementation and oversight, as well as the federal and state regulatory compliance.
Master of Laws, LL.M., cum laude, University of Florida, Levin College of Law Bachelor of Laws, LL.B., LL.M., magna cum laude, Kazakh State University, College of Law