Jill Brostowitz

Jill’s primary area of actuarial expertise is government-managed care programs. She has over 30 years of health actuarial experience, including over 20 years working with Medicaid, Medicare Advantage, and Part D. Jill develops capitation rates for state Medicaid agencies and assists Medicaid Managed Care Organizations (MCOs). Examples of her experience include:

• Working with the Wisconsin Medicaid program for over 20 years, developing capitation rates for the State after previously managing the actuarial responsibilities for an MCO
• Designing a comprehensive financial template to use for capitation rate development, encounter data validation, and medical loss ratio (MLR) reporting
• Evaluating the financial implications of using high-cost prescription drugs to treat members infected with hepatitis C
• Developing capitation rates for Florida and Minnesota
• Assisting MCOs with capitation rate advocacy, financial projections, and provider risk sharing arrangements
• Analyzing expansion feasibility into new eligibility categories and service areas

Jill’s Medicare Advantage and Part D expertise includes:

• Certifying bids for over 20 years
• Leading bid audits and participating in financial audits
• Developing in-house pricing models and reporting from CMS files while employed by an MCO
• Contributing to product design, service area expansion, strategy, and policy
• Preparing budgets, re-forecasts, reserves, and accruals for financial reporting
• Developing provider capitation rates and risk-sharing arrangements

In a prior role, Jill led rate development and submitted rate filings in 17 states for individual major medical and Medicare Supplement policies, including launching new products and expanding into new states. She also previously developed pricing, provider capitation, and risk sharing arrangements for commercial health insurance.