Sheila Cooper is Stephen Group Senior Consultant who was most recently a client executive with CSG Government Solutions. Leveraging over 18 years of state government experience, her background includes wide-ranging work in Medicaid including experience with Medicaid Management Information Systems (MMIS), Medicaid Information Technology Architecture (MITA), health insurance exchange, Medicaid managed care, and performance based contracting. As an independent consultant, her current client work includes consulting on Medicaid modularization and managed care IT readiness. Sheila has extensive background in functional requirements development, business and use case analysis, clinical business intelligence, advance planning document (APD) preparation and negotiation, integrated eligibility for health and human services programs, Health Insurance Portability and Accountability Act (HIPAA) privacy and security, HIPAA electronic data interchange, and project management.
Sheila’s most recent work includes assisting several health plans with the implementation of a new line of Medicaid managed care business for SSI children, a complex program that includes both acute care services and long term services and supports. Sheila works with multiple health plans to ensure their organization and infrastructure is operationally ready to efficiently and effectively implement the new program. This includes review and improvement of the current organizational structure, current systems, workflows, and all aspects of the client’s implementation planning. Sheila facilitates executive level decision making and is an experienced facilitator, able to assist groups in achieving consensus.
While at the Texas Health and Human Services Commission (HHSC) Sheila served as Project Manager for Medicaid Information Technology Architecture (MITA) State-Self Assessment (SS-A) and to-be road map for the 52,000-employee health and human service agency. She worked with over 240 subject matter experts and obtained a far-reaching and in-depth knowledge of the all aspects of Medicaid. Sheila facilitated sessions with HHSC executive management to develop a strategic plan for MITA, producing a proposed project portfolio that was standards based, moved HHS toward inter-operability, and was centered in improving HIT and health information exchange (HIE) for the Medicaid Enterprise.
During her tenure at HHSC, Sheila served as the lead for all MMIS Advance Planning Documents (APD). She developed and delivered over 50 APDs resulting in federal approval for millions of dollars of enhanced funding for the State of Texas. She utilized extensive knowledge of state and federal regulations and the state and federal budgeting process and prepared detailed project documentation and budgets. She worked closely with Centers for Medicare and Medicaid Services (CMS) regional and central office staff, building close relationships and using negotiation skills to maximize federal funding. Educational background: Sheila received her BA (Psychology) from Dartmouth College in Hanover, New Hampshire and her Masters in Business Administration from the Anderson School of Management at the University of California, Los Angeles.