Stephanie has over 14 years of experience as a health care actuary working on a diverse array of health care segments including group health, individual plan health, the Exchanges, and Medicaid. Her main focus over the last 8 years has been on Medicaid programs. She is currently a VP with Centene and leads the Medicaid actuarial team with responsibility for 29 states.

Current Responsibility Christine is an actuary with the Indianapolis office of Milliman. She joined the firm in 2005 Educational Background - Graduate, University of California, Berkeley - Undergraduate, Princeton University Professional Designation - Fellow, Society of Actuaries - Member, American Academy of Actuaries Significant Career Experience Christine has developed an expertise in analyzing and modeling healthcare expenditures. Her experience includes health insurance products, pharmaceutical products, Medicaid fee-for-service programs, and Medicaid managed care plans. She has also worked on budget and forecast modeling and managed care contracting for state Medicaid programs. Christine also has expertise working with employer groups with self-funded health insurance programs, either for active employees or retirees. She enjoys developing healthcare cost or liability estimates, brainstorming for various possible changes, then analyzing the expected impact of each. Relevant Experience and QualificationsState of Indiana, Office of Medicaid Policy and Planning Milliman has performed a full range of actuarial services for the Medicaid healthcare program since 2000. Milliman has developed and updated capitation rates for the TANF and SCHIP populations, provided Cost Effectiveness Filings, developed Medicaid budget forecasts, prepared Home and Community Based Waiver Filings, valued cost containment initiatives, and provided special reports on fiscal, legislative, and regulatory issues. The actuarial certification of capitation rates includes the TANF population, the HIP expansion population, and more recently the Aged and Disabled population. As the Project Manager for this contract, Christine provided the following recurring services: - Developed biennium budget projections. - Assisted with monthly monitoring of Medicaid expenditures, which are also reconciled to the State Appropriation. Analysis included all expenditures funded by the State Appropriation, including non-claim-based expenditures such as DSH and UPL. - Forecasted enrollment and expenditures for the Healthy Indiana Plan (HIP) expansion population. - Assisted with development of capitation rates, including risk adjustment. - Prepared cost effectiveness demonstrations for Home and Community Based Waiver filings. Ms. Mytelka also managed the following special projects: - Provided financial support for Indiana’s transition from 209(b) to 1634 status, including financial impact estimates and re-design of related eligibility program components. - Estimated the cost impact of transitioning residents of institutions into home and community-based waiver programs for various programs and populations. - Supported implementation of a Community Alternatives to Psychiatric Residential Treatment Facilities (CA-PRTF) program to treat children in the community. - Estimated financial impacts of the Mental Health Transformation initiative which involved clarifying eligibility for Mental Rehabilitation Option Services based on functional and diagnostic assessments and restructuring service types and definitions. - Worked with the state of Indiana to implement a hospital assessment fee, including planning, assisting with CMS filings, financial monitoring, and reconciliation. - Assisted with development of processes for calculation of objective needs-based annual budgets for developmentally disabled HCBS waiver enrollees, as well as adjustment of these processes for other program changes. - Prepared analyses related to Health Care Reform provisions, including projected 2014 enrollment and analysis of various program options, including the Basic Health Program option, the Family Planning Service option, Preventive Care program, and the Community First Choice option. - Supported Indiana’s 2014 MAGI conversion, including development of state data-based income standards, fiscal impact estimates, and planning for development of a resource proxy adjustment. - Analyzed the impact of managed care pharmacy carve-in/carve-out on pharmacy rebates received, and analyzed the cost impact of various program design options such as state-mandated preferred drug list and sole-sourced pharmacy benefit manager. - Developed and implemented risk adjustment processes for new or radically shifting managed care populations.