With more than 25 years of experience in health care leadership and regulatory affairs, Sheila H. Nelson serves as senior vice president, state programs and chief compliance officer at CDPHP. In this role, Sheila leads the CDPHP compliance teams, including state programs (Medicaid, HARP, Child Health Plus, and Essential Plan), Medicare, corporate compliance, and the special investigation unit. She also oversees key operations for the state programs products, including enrollment, billing, fiscal reconciliations, audits, and delegated benefit administration. Sheila’s team is additionally responsible for commercial mandate implementation and compliance. She is the regulatory liaison for all matters relating to the Office of Medicaid Inspector General, the New York State Department of Health, and the New York State Department of Financial Services.
Prior to joining CDPHP in 2010, Sheila held various health care policy positions in the Capital Region, including having served 14 years as vice president, public policy and regulatory affairs, at the New York Health Plan Association. Sheila holds a Master of Health Administration from Cornell University and a Bachelor of Science degree in psychology from Union College.