Mark Shaffer is Vice President of Medicaid Operations at BlueCross BlueShield of South Carolina
Check out his LinkedIn profile HERE.
Which segment of the industry are you currently involved?
I work in BCBSSC’s Celerian Group, where I am responsible for the Medicaid Operations Division. The Celerian Group is a collection of companies that primarily provide services to Government Programs. My team currently delivers Medicaid related services including Claims Processing, Provider Enrollment, Provider Call Center services, Eligibility application processing, and Third Party Liability functions.
How many years have you been in the Medicaid industry?
I started in Medicaid back in 1988, I like to think those of us with this length of service have a genetic predisposition rather than a defect, but only history will decide that. I have been fortunate to work in a wide variety of market segments over my career and the breadth of this experience has certainly kept things interesting over the years.
What is your focus/passion? (Industry related or not)
Meeting new people and helping them if I can. My father, a retired Marine, recently recounted that when I was in Kindergarten living in Korea when they met new people, they would say “oh, you are Mark’s parents”. Growing up I lived in 11 houses before the age of 13 and my wife of 30 years and I have just completed our 11th move to our 6th State! No matter the different backgrounds and perspectives over the years it is amazing how much we are alike and share the same needs. By the way, everyone also thinks their traffic is terrible!
What is the top item on your “bucket list?”
My wife and I have discussed creating a behavioral health charity to help working families that are struggling with children with behavioral health needs. Unfortunately for working parents, the current system does not provide the support necessary to help children when needed.
What do you enjoy doing most with your personal time?
I love motorcycles and the camaraderie of riding with friends. It really doesn’t matter where we go it is about getting away from the day to day and enjoying the ride and the shared experience.
Who is your favorite historical figure and why?
If you asked which historic figure I would want to meet, it would be Jesus. Just too many answers that could be cleared up in a single meeting! But since that isn’t the question, my favorite other historic figure is Peter the Great. While he is known for conquering additional territory and expanding his empire he also lead a cultural renaissance to modernize his country based on his experiences with Western Europe leaving a lasting legacy on the world.
What is your favorite junk food?
Bacon. Although bacon should never be referred to as junk food.
Of what accomplishment are you most proud?
Helping to raise my three adult children and having them all out of my house!
For what one thing do you wish you could get a mulligan?
In the early 90’s when I was with Electronic Data Systems (EDS), we implemented the FLORIDA system (integrated eligibility). The system served Florida well for decades (all systems end up being legacy systems at some point), unfortunately EDS and the State ended up in a protracted legal dispute. The dispute negatively affected the company, reduced competition in the market, and disrupted service to the citizens. I think I would have made different recommendations to my leadership if we had a mulligan.
What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?
Expanded use of social determinants of health
Disruption from early adopters using AI and related technologies in the health insurance space
The impacts continuing industry consolidation
Know someone in the space who’s doing great work and is an all around interesting person?
Send a note to firstname.lastname@example.org to nominate them for the next round of Medicaid Industry Who’s Who Interviews