Shelley Segal

Shelley Segal is a Medicare industry expert whose experience in Medicare program leadership and day-to-day operations provides Gorman Health Group clients a highly experienced resource for compliance, strategic planning, program development, and business process engineering.

Prior to joining GHG, Shelley was most recently Compliance Director for SCAN Health Plan, an HMO serving over 110,000 beneficiaries in the greater Los Angeles market. Before SCAN, Shelley served as National Associate Vice President, Medicare Compliance and Associate Vice President, Medicare Operations at Health Net as well as holding numerous other positions with Medicare programs at Foundation Health and FHP.

As a compliance and regulation expert, Shelley is often called upon to translate the regulatory requirements of Medicare Part C and Part D into concrete operational procedures and work processes in the managed care and insurance industry.  Shelley recently was hired by the MEDIC to conduct the 2010 CMS Compliance Program audits.

Shelley’s expertise extends to Medicare regulatory compliance, sales and marketing, enrollment and reconciliation, and member services.  In addition to her operations experience, she has served as project manager for numerous start-up, product development and business process re-engineering initiatives.