Wendy Edwards, MPA, CHC, CHPC
Area Vice President
Wendy is Vice President, Health Plan Services Consulting at BluePeak Advisors, a division of Gallagher Benefit Services, Inc. Wendy is a seasoned healthcare executive with over twenty years of experience working in commercial, Medicare, Medicaid, and self-funded insurance arenas. Prior to becoming a consultant, Wendy was the President and Chief Executive Officer of a commercial and Medicare Advantage plan in Oregon and oversaw expansion applications to move to the national stage. She maintained oversight over all executive duties and collaborated with board members and stakeholders alike to ensure that best practices were not only adhered to but also proactively sought out through an organizational culture of continuous improvement. Prior to this role Wendy was the company’s Chief Compliance Officer and HIPAA Privacy Officer and developed Fraud, Waste and Abuse (FWA) and Special Investigation Unit (SIU) teams. Since then, she served in several roles, including Chief Operating Officer and Executive Vice President. Wendy oversaw all compliance activity and exceeded financial and operational goals as the health plan leader. Wendy also served as the Director of Regulatory Affairs and Compliance officer for a regional health plan that operated Medicare, Medicaid, commercial and self-funded products.
Wendy started her career as a Critical Access Hospital Program Manager with the Office of Rural Health. Wendy then worked for the state of Oregon, first as Quality Improvement Coordinator and Medicaid Contract Administrator for all contracts. Wendy then served as the Actuarial Services Administrator where she was responsible for the biennial rate setting for the Oregon Health Plan, covering all Oregonians eligible for Medicaid. Wendy spent years as the Public Employees’ Benefit Board Director of Operations, where she served a diverse board made up of management and union representatives, to ensure the highest quality, lowest cost insurance for all State and University system employees.
At BluePeak, Wendy works with clients to implement overarching strategies for overall effectiveness and assists with the operations and strategic planning for start-up Medicare Advantage programs, PACE, and new products. Wendy serves as executive sponsor for BluePeak’s projects and is responsible for marketing and part-time casual resourcing. Wendy’s experience as a CEO of a MA and commercial plan, along with her deep expertise in all operational functions and financial acumen gives clients a unique perspective, especially important related to state and federal implications of decisions. Wendy has recent experience working with clients related to PACE, SNP, MA bid development and implementation, marketing materials, and compliance program effectiveness.
Wendy holds a master’s degree in public administration emphasizing health administration from Portland State University and a bachelor’s degree in health care administration from Oregon State University. Wendy is a certified Healthcare Privacy Compliance (CHPC) and Healthcare Compliance (CHC) professional through the Health Care Compliance Association (HCCA).