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Denise Marshall Rainey
Partner and Chief Executive Officer
Throughout a notable career that spans 25+ years, Ms. Rainey has led multi-billion dollar projects that have advanced commercial and government health care programs, including Medicare, Medicaid, DoD TRICARE, and Federal Employee Health Benefits Program (FEHBP). Ms. Rainey is known throughout the health care industry for her extensive knowledge of health care policy, innovative strategic planning skills and considerable operational experience.
Ms. Rainey has held senior executive positions at industry leading health care organizations, including Blue Cross and Blue Shield and Sierra Military Healthcare Services. Her consulting career includes senior positions with world class organizations such as Booz Allen Hamilton, BearingPoint, and Perot Systems. She has served many satisfied clients across the government sector, including Centers for Medicare and Medicaid Services, Military Health System and the Department of Veterans Affairs.
- Developed and implemented multiple complex commercial and government program managed care organizations for Medicare, TRICARE, FEHBP and Blue Cross Blue Shield serving millions of members.
- Contributed to significant cost savings and operational efficiencies in health care program administration through strategic, customer-focused application of solutions in health care benefit design, fraud and abuse detection, business process re-engineering, organizational redesign, and information technology.
- Provided thought leadership and strategic planning expertise to support executive decision making in organizations such as Aetna Government Health Plans, Humana, and Centers for Medicare & Medicaid Services.
- Provided technical expertise and strategy development services to commercial health care organizations which resulted in multi-billion dollar government contract awards.
- Numerous health plan operational achievements in the areas of claims processing, medical management, marketing, customer service, provider network management and appeals.