Jessica Dye

Jessica Dye brings over twenty years of experience developing corporate strategies and initiatives that adapt to policy changes and evolving operations.

She has held positions of accountability for Medicare Advantage, Managed Medicaid, and the Affordable Care Act (ACA). She has led health plan efforts to implement commercial risk adjustment operations, technical data support, financial analysis, end-to-end risk adjustment, and value-based care contracting.

Mrs. Dye has been instrumental in restructuring risk adjustment to become more of an enterprise-wide function. Her responsibilities have included bid process support, vendor selection and oversight, analytical specifications for interventions such as retrospective and prospective, provider education, data integrity and reconciliation for data submissions, and RADV (Risk Adjustment Data Validation) audit processes. She was also a co-founder and chief strategy officer of a healthcare software company that focused on the development of applications to support value-based services, data management, and chart storage.

Mrs. Dye has advised clients on federal investigations, state regulations, general reimbursement contracting disputes, and billing/coding practices. In addition to health plan and vendor positions held, Jessica is a certified risk adjustment coder (CRC) who provides industry insights through conference presentations, webinars, cowriting white papers, and general advisory services. For two decades, she has focused on public-private healthcare market interactions in the context of ongoing analysis of key financial and public policy trends as they impact profitability and compliance processes in the industry.”