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Deb Faulkner, MBA

Senior Consultant

Deb is a dynamic executive leader with over 25 years of experience in healthcare

administration, Medicare, Medicaid, and ACA health plan and BPO operations and has been consulting in the healthcare industry for over 15 years.  

Deb is adept in all facets of healthcare management, including new business development, strategic planning, multimillion-dollar P&L oversight and development, vendor management, operational and workforce management, and oversight for national customer service operations.  She has been instrumental in leading large health plan turnarounds and has been key to building out multiple operational departments from claims administration to risk adjustment.  Her subject matter expertise includes CMS risk adjustment, Medicare/Medicaid Plans (MMPs), health plan operations, and system technology as well as extensive knowledge of CMS and State regulatory requirements related to Medicare Advantage, D-SNP, MMP, and Medicaid State programs.  She has broad experience in developing and responding to health plan and government RFPs, RFIs, and regulatory requests.  

Deb has led cross-functional/purpose-driven products and services and has been instrumental in the design, development, and implementation of multifaceted systems supporting Medicare/Medicaid/ACA utilization review and Fraud, Waste and Abuse (FWA).  She is an expert with Facets, Amysis, and many population health and risk adjustment systems. 

Deb has been a keynote speaker at various industry trade shows on the topics of risk adjustment, dual eligible programs, and FWA.  She holds a BA and MBA in Health Care Administration from St. Leo University.