Nancy Nelson

Background

About Nancy Nelson

Principal and Managing Actuary at Cirdan Health Systems and Consulting, a consulting firm providing actuarial, financial and encounter data submission services to health plans and providers. Cirdan’s actuarial, financial and data teams work closely together; the combination of a practical understanding of the ways risk adjustment impact health plan revenue along with deep expertise on the nuances of encounter data submissions are leveraged to the benefit of our clients. As a health care actuary, I draw on more than 30 years of experience working in health insurance to serve our clients. During my career, I have managed the actuarial and underwriting functions for a broad range of health products including individual, small group, large group, self-insured, Medicare Supplement, Medicare Advantage and managed Medicare. Areas of expertise include valuation of actuarial assets and liabilities, rate filing preparation, trend analysis, rating formulas for large group insured and self-insured products, stop loss insurance pricing, and management of related underwriting processes, and Medicaid Contracting. I have also supported state insurance departments with rate reviews, and providers working with managed care contracts. My experience also includes a variety of leadership roles that are outside the typical scope of work for an actuary. These include management of membership and group and benefit set-up functions, treasury operations, cost accounting and financial forecasting for a health plan; expert testimony, and work to support provider contract negotiations. I have had a long-term interest in health care reform that began with small group market reform, followed by the introduction of Medicare Part D, and the extensive changes required by the Affordable Care Act. All of these experiences have provided me with a ‘big picture’ perspective of the health insurance market and provide insights into the ways that changes in healthcare delivery will impact health plans. I enjoy working with clients to support their success in achieving their business goals. Assignments that require both strategic and "in-the-weeds" analyses allow me to do my best work. I like to connect people in my network who can assist each other. Collaborating and helping other people to meet their personal career goals is satisfying t to me.