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Sarai McDowell

Enterprise Project Manager

As enterprise project manager, Sarai ensures all client projects are executed with excellence.


Utilizing key objectives, milestones and our project management solution, Sarai oversees delivery of all projects. She maintains overall enterprise project performance while also paying attention to the details of the project.

Working alongside the consultants and partners, she verifies and implements the timeline of the project, has an open line of communication with our project POC and our consultants.

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Charlyn Shepherd

Advising Government Clients

Ms. Shepherd is a Certified Public Accountant and Certified Fraud Examiner.  She has devoted her career to accountability in state and federal government programs as an auditor, consultant, forensic auditor, innovator, and leader.  She has more than 25 years of experience performing and leading state and federal program financial, cost report, and compliance audits for health care and social programs under Medicaid, Medicare, and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).  She has been a project manager providing professional services to state clients for programs such including Skilled Nursing Facilities, Intermediate Care Facilities, Promoting Interoperability, Certified Community Behavioral Health Clinics, State Innovation Model Grants, Recovery Audit Contractor, Long Term Services and Supports, Durable Medical Equipment, Physician Services, Pharmacy Program, Non-Emergency Transportation, and Home and Community-Based Services. She has performed audits in accordance with Generally Accepted Government Audit [Yellow Book] Standards (GAGAS), Generally Accepted Audit Standards GAGAS), and OMB Uniform Guidance. Having an understanding of the claim payment process and underlying data, she has developed analyses to identify data trends and anomalies in both Fee for Services claims and Managed Care encounters.  She was Georgia’s first Chief Auditor of the Medicaid Fraud Control Unit at its inception in 1995 and performed investigative audits and provided expert testimony in high profile Skilled Nursing Facility and Home Health Agency cost report fraud trails, resulting in over $30 million in recoveries for the Medicare and Medicaid programs.

Focus Areas
  • HHS program evaluation
  • Provider audits and reviews
  • Claims payment analysis

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Erica Sahm

Advising Government and Technology Clients

Erica provides research and optimization for complex issues in the public health world. Her background in patient advocacy, medical sales, and clinical research inform her mindful and patient-centered approach. Erica is fueled by her passion to understand and provide better avenues for preventive care. She considers herself a ‘forever student’, eager to build on her academic foundations in biology and public health and stay current with the latest policies and healthcare programs through continued professional development.

She believes the most important tool we can use is past experience; therefore, companies and healthcare organizations should always be looking in the past to make a plan for the future. With Erica, you know the work will be autonomous when necessary, but without fail, always involves the greater goals of those she works with. You can count on her to look beyond what is immediately in sight.

Focus Areas
  • HHS technology (various)
  • Integrated care
  • Data analysis and systems
Other Affiliations
  • Glacier Healthcare Consulting (President)

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Lauretta Converse

Advising Government and Technology Clients

Lauretta Converse is a healthcare consultant, providing informed, timely and cost-effective solutions that help states, payors, providers, and investors improve their services to Medicaid and other publicly funded programs.  Combining policy expertise with analytical skills, her previous roles include directing Rhode Island’s payment reform efforts and serving as the Senate’s primary resource on healthcare finance.  She lives in New England, where she teaches graduate courses in healthcare management and loves waking up to freshly fallen snow.

Focus Areas
  • Strategy
  • Data analysis

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Kip Piper

Advising Government and Pharmaceutical Clients

Kip Piper is a leading expert on Medicaid, Medicare, and health reform – is a prominent consultant, speaker, and author.  A skilled business and policy strategist, Kip Piper advises health plans, hospitals and health systems, states, and pharmaceutical, biotechnology, medical device, information technology, and investment firms.  Kip Piper’s 30 years’ experience includes senior advisor to the Centers for Medicare and Medicaid Services (CMS) administrator, director of the Wisconsin Medicaid program, Wisconsin state health administrator, a senior Medicare budget officer at the White House Office of Management and Budget (OMB), and director of national, foundation-sponsored projects on payment reform and quality improvement.

Focus Areas
  • Policy development
  • Medicaid financing
Career Highlights
  • Wisconsin state Medicaid Director
  • President of Piper Results Group

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Clay Farris

Founder and Practice Lead, Client Solutions

Clay has advised CMS administrators, state Medicaid Directors, health plan CEOs, technology COOs and a wide range of other clients in the healthcare industry.  His unique blend of management consulting, project management, policy making and analytics help deliver on-time, actionable results for a wide array of business challenges. His Weekly Medicaid Roundup is read and loved by more than 10,000 professionals in the Medicaid industry.

His experience includes policy making at both the federal (CMS) and state levels (State of Georgia), management consulting for large organizational change initiatives, big data solution sales and implementation and cutting-edge analytics.

He currently leads key project components related to consultation design, Medicaid subject matter expertise and project management. He has a masters in Health Policy from the Johns Hopkins Bloomberg of School of Public Health and is a Certified Internal Auditor.

Focus Areas
  • HHS technology (various)
  • Integrated care
  • Data analysis and systems

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Pamela Tyranski

Advising Health Plan and Government Clients

Pam has over 30 years of experience in executive leadership roles in healthcare operations, program development and support in the public and private sectors. Her accomplishments include restructuring and establishing clinical and non-clinical programs, writing and evaluating proposals, strategic planning, compliance and program integrity. For clients and former employers, she has developed strategic partnerships in various arenas. Specializing in clinical and government compliance, individual case and situational analysis, her expertise has contributed to the operational success of many government, for-profit, and not-for-profit entities nationwide.

Pam currently serves on the Delaware Board of Nursing as a Board member, formerly as President and chairs the Limited Lay Administration of Medications Committee (formerly AWSAM). She served on the National Council of State Boards of Nursing (NCSBN) Committee on Long Term Care, and as the Delaware Delegate and on the Delegate Assembly Resolutions Committee. Pam donates her knowledge and time to various community and charitable agencies, and served as a healthcare advisor to Delaware Legislators.

Focus Areas
  • Clinical quality program development and evaluation
  • Provider network development
  • Medicaid policy development

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Cindy Becker

Advising Government and Health Plan Clients

Cindy Becker is a health professional with more than 25 years of progressive leadership experience in Medicaid funding and delivery systems.  She has a demonstrated record of achieving results with a strong focus on collaboration, communications, and customer service.

Cindy has significant experience in health systems in both the public and private sectors.  She is well versed in health transformation – as a founding member of Oregon’s largest Coordinated Care Organization (CCO) now serving more than 230,000 members and a senior executive at the second largest CCO serving 125,000 members.  She has also held executive positions with state and local governments, serving as deputy director of the state’s health and human services agency and director of health for one of the large metropolitan counties.

Cindy is adept at bringing groups together to plan and accomplish strategic priorities.  Her passion is getting systems, policies, and resources aligned to achieve positive outcomes for individuals, families, and communities. Her experience in the private and government sectors, combined with her consulting work, uniquely positions her as a go-to person with the skills, abilities, and insights to provide exceptional services to clients.

Focus Areas
  • Coordinated Care Organizations
  • HHS policy development
  • Process improvement and measurement

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Kris Vilamaa

Partner & Chief Growth Officer

Kris has twenty years of behavioral health, health information technology and health policy experience.  Clients include information technology and pharmaceutical companies, state health and behavioral health departments, state Medicaid agencies, managed care organizations, federally qualified health centers, safety net hospitals, large health systems and community health providers to enact meaningful initiatives. 

His past governmental experience includes state system transformation projects, planning for Medicaid Transformation, development of new behavioral health treatment standards, service definitions and leading large information technology system implementations. Prior to joining Mostly Medicaid, he was Director of Behavioral Health for Germane Solutions and the first Chief Information Officer for the Alabama Department of Mental Health.

Currently, as Partner and Chief Growth Officer for Mostly Medicaid, Kris leads the consulting and product sales team, serves as a senior project manager for key client engagements and a thought leader for behavioral health and health policy in the Medicaid space.

Focus Areas
  • HHS technology (various)
  • Integrated care
  • Data analysis and systems
Career Highlights
  • State Mental Health CIO
  • Consulting practice leadership