Michelle Juhanson, CHC, CHPC
Director of Government Programs
Michelle has received industry recognition for helping plans and PBMs build exceptional Medicare reputations. She applies regulatory knowledge, innovation, and strategic thinking to every project. Michelle most recently served as Vice President and Chief of Staff II, Government Programs at Prime Therapeutics and Magellan Rx Management. She led Magellan Health, Inc. to one of only three “perfect” CMS Program Audits in 2021.[1]
Michelle previously served as the Compliance Officer and Quality Director at PerformRx, part of the AmeriHealth Caritas Family of Companies. There she was accountable for the audit, compliance and quality functions for the pharmacy benefit manager and specialty pharmacy divisions. This included achieving and maintaining multiple accreditations with NCQA, URAC, and ACHC for specialty pharmacy, pharmacy benefit management, drug therapy management, and utilization management. Michelle’s 19 -year Medicare journey began at MAXIMUS Federal Services, where she reviewed reconsiderations and reopenings at the beginning of the Part D benefit.
Michelle is a breast cancer survivor, polyglot, and public speaker. She is certified in Health Care Compliance and Health Care Privacy Compliance by the Health Care Compliance Association. With 15 + years Medicare and Medicaid compliance and quality experience, Michelle advises industry coalitions and councils on health equity (AHIP, PCMA), pharmacy quality (PQA), compliance (HCCA), and accreditation (NCQA). The National Academy of Social Insurance elected Michelle to membership in its 2024 cohort. She is serving a two-year term on the Pharmacy Quality Alliance Health Equity Technical Expert Panel. In 2022 Michelle was named a Health Care Businesswomen’s Association (HCBA) Luminary and is a member of the HCBA.
[1] https://www.cms.gov/files/document/2021-program-audit-enforcement-report.pdf