Debra Nuckols, a Consultant at BluePeak Advisors, a division of Gallagher Benefit Services, Inc. has been in the managed care industry for 20 years, specializing in Medicare compliance, corporate compliance, auditing and monitoring, and new-to-Medicare health plan start-ups. Prior to becoming a consultant, Debra worked for several national managed care organizations where she worked her way up to becoming a corporate Medicare compliance subject matter expert and served as Medicare Compliance Officer. She has also served as Medicare Compliance Officer for both local and regional health plans. In addition to her extensive health plan experience, Debra worked at the Centers for Medicare and Medicaid (CMS) in the Seattle Regional where she was plan manager for national and local Medicare MA-PD plans.
Debra has overseen the submission of multiple CMS Medicare initial and service area expansion applications and successfully developed and implemented various Medicare Compliance Programs over her career. She has experience working within health plan operational areas to implement MA-PD plans, including sales and marketing, CMS bid submission, appeals and grievances and network contracting. On a national level, Debra has experience establishing a compliance oversight program that includes compliance program staff training, first tier entities (FTE) oversight, sales and marketing, customer service and appeal and grievances. In addition, she has chaired various health plan compliance committees at the national and local levels. Debra has overseen complex compliance projects and led operational teams through corrective action plans with routine reporting to CMS. She has managed compliance teams that ranged from 3 to over 20 direct reports.