Director, Operational Performance
Roshan Desai is Director of Operational Performance at GHG. In this role, he has been involved in projects for revenue maximization, Medical Loss Ratio (MLR) improvement, feasibility analyses, bid review, risk adjustment, and financial reconciliations. Roshan brings GHG clients more than 10 years of finance and operations experience. Roshan has extensive knowledge of the Medicare bidding process, creating actions to decrease medical expenses and increase revenues in Medicare and Medicaid, and financial reconciliations including Medicare Part D Risk Corridor, Low Income Cost-sharing Subsidy, Reinsurance, Coverage Gap Discount, and Monthly Membership Report. Roshan’s experience also includes financial forecasting and budgeting, incurred but not reported (IBNR) development, stop-loss reinsurance contracting and reconciliation, independent practice association (IPA) risk contract reconciliations, and benefit design and configuration.
Prior to joining GHG, Roshan held several positions at Universal Health Care Group, including Senior Director of Medical Economics, where he was in charge of the Effective Medical Management committee which created actions that saved the company millions and included provider contract renegotiation and termination, utilization management program changes, benefit design changes, claims configuration and recoveries, and pilot programs. Roshan also oversaw ancillary contracting and worked with outside actuaries on bid development.
Roshan earned his MBA in Finance from the University of Illinois at Urbana-Champaign and his BS degree in Biomedical Engineering from Washington University in St. Louis.