The Lewin Group Welcomes Jeff Smith
March 21, 2010
We want to welcome Jeffrey L. Smith to The Lewin Group as Practice Director for the States and Payers Practice. Mr. Smith has worked with Medicaid managed care programs for over 20 years and has over 30 years of experience in the health care industry. Most recently, Mr. Smith served as Vice President in AmeriChoice’s Finance department where he led the actuarial pricing, risk adjustment, and encounter teams. In this role, he oversaw actuarial pricing activities for all of AmeriChoice’s Medicaid managed care and long-term care plans across the country. Under his direction, AmeriChoice implemented new procedures to submit complete and accurate encounters significantly increasing its average risk score in risk adjusted markets. Mr. Smith also implemented a unique provider profiling project to identify providers who were under-reporting encounters based on the risk of the Medicaid population they served and implemented a provider outreach program to train those providers on proper encounter submission procedures.
Prior to his work at AmeriChoice, Mr. Smith enjoyed a 23-year career with Mercer Consulting as a principal in their Government Human Services Consulting group. There, he served as a member of the Leadership group and the Strategic Planning Committee. Mr. Smith also led the actuarial and risk adjustment teams for Mercer’s GHSC and served as the client lead for a number of Mercer’s major Medicaid clients including Colorado, Georgia, Maryland, New Jersey, New Mexico, New York, North Carolina, Oklahoma, South Carolina, and Vermont. In this capacity, Mr. Smith worked with his clients on a number of major Medicaid managed care initiatives including the design and implementation of 1115 waivers, 1915(b) and (c) waivers, a 636 waiver, CHIP design and implementation, capitation rate development and health plan negotiations, initial design and implementation of many of the risk adjusted models currently in use by state Medicaid programs, development of state budgeting models, design and implementation of competitive bids, analysis of various governor and legislative health care reform initiatives to cover the uninsured, PACE and capitated LTC programs, design and implementation of MAC programs to control drug spend, design and implementation of pay-for-performance programs, efficient network analysis and development, and various cost containment strategies.
Mr. Smith started his career as an underwriter of group life and health insurance at General American Life.
Until recently, Mr. Smith served on the Board of Directors for the Foundation for Senior Living in Phoenix, AZ, a statewide organization providing personal and health care services for the elderly and disabled in order to preserve independence and enhance quality of life.
Mr. Smith earned a Bachelor of Science degree in Finance at Arizona State University.