Alisa Gordon
FSA, MAAA
Consulting Actuary
Brookfield, WI, US
Alisa Gordon is a consulting actuary in the Milwaukee office of Milliman. She joined the firm in 2017.
Experience
Alisa’s primary area of expertise is Medicaid and managed Medicaid programs, including developing provider rates and pharmacy trends. Alisa also has experience with 1332 public option and reinsurance waivers. She has more than 25 years of actuarial experience, including experience as a consultant and as a corporate actuary in the Medicaid and Pharmacy Benefit Management sectors.
Alisa’s past projects include:
- Managed Medicaid capitation rate development for MLTSS, dental, PACE, and NEMT programs
- Functional-based risk adjustment for HCBS members in an MLTSS program
- Pharmacy trend development for managed Medicaid programs
- Cost and funding projections for a high-cost drug risk pools
- 1332 waiver analyses for public option and state reinsurance programs
- Review of state Medicaid managed care rate setting and forecasting processes
- Evaluation of the impact of Medicaid hospital fee schedule changes and managed care state-directed payment arrangements on hospital revenues
- Medicaid fee-for-service provider reimbursement rate modeling for waiver services
- Development of performance-based withhold mechanisms for Medicaid managed care programs
- Development and negotiation of risk-sharing provider payment structures
- Analysis of the financial impact of pharmacy-related initiatives and pricing mechanisms, including step therapy and rebates
Professional Designations
- Fellow, Society of Actuaries
- Member, American Academy of Actuaries
Education
- BA, Statistics, University of Missouri - Columbia, 1993
Publications
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