Christpher Aguwa Executive Vice President Head of Growth and Business Development

CityBlock Health

Lisa Barrett Vice President, Member Navigation Solutions

UnitedHealthcare

Lisa Barrett is the vice president of Member Engagement for UnitedHealthcare’s My Community Connections organization. In this role, Lisa is responsible for the program management, development, advancement and implementation of an industry-leading sustainable model to standardize and use non-traditional data elements and innovative partnerships to improve health outcomes at scale. As part of this work, social barriers are addressed by “leading with help” not only to assist the member, but also as a lead generator for revenue. In 2021, the MCC “leading with help” model generated over $400M in revenue for UnitedHealthcare. In addition, Lisa is responsible for the design, development, and expansion of UnitedHealthcare’s National Veterans Program. She is also responsible for member outreach to “close the loop” on social referrals made to community- based organizations.

Lisa is well known within UnitedHealthcare for turning concepts into effective and efficient programs. In 2011, she pioneered a program for vendor management strategies that was adopted company-wide as a best practice. In addition, her work in the social determinants of health (SDoH) arena was the first of its kind with the Arizona Medicaid population. Lisa was instrumental in standing up a consumer-facing facility in 2015 serving over 15,000 under-served community residents per month with food, housing, employment and financial assistance. The community center is recognized as a model of a successful collaboration between for-profit, not-for-profit and governmental agencies.

Lisa leads the ground-breaking effort to identify and more holistically serve UnitedHealthcare’s veteran member population. The National Veterans Program strives to help veteran members get the most from their health plan. The program uses NSP’s award-winning social determinants of health (SDoH) data model to identify veterans among the UnitedHealthcare member population. Since January 2017, the program has identified more than 1M veterans and a subset of over 350,000 who receive care from the Veterans Healthcare Administration (VHA) and therefore, outside the UHC network. By identifying veteran members, we can provide better care coordination, care management, care-gap closure and social services referrals – which address SDoH barriers to good health and health care. Lisa was instrumental in the alliance agreement between UnitedHealthcare and The American Legion.

Lisa has more than 30 years of experience spanning finance, business development, operations, account management and relationship management. Lisa brings a broad range of analytical skills as well as health care operational experience to her role and has held various leadership positions in healthcare operations during the course of her career.

Prior to joining UnitedHealthcare, Lisa held executive finance positions with diverse companies outside of the healthcare industry. She has led a broad range of operations and strategic objectives including growth management, mergers and acquisitions, and financial operations.

Barrett earned a Bachelor’s of Business Administration in accounting from the University of Georgia. She is also a Certified Public Accountant and a licensed Realtor®. Lisa has been awarded several accolades while at UnitedHealthcare, including the prestigious Innovation Award. She has served on the board of several community nonprofit organizations.

Anna Basevich VP of Enterprise Partnerships

Arcadia

Kate Beck AVP, Health Information Exchange

Healthfirst

Kate Beck joined Healthfirst in 2019 as the Director of the Healthfirst Health Information Exchange (HIE). In her current role, Kate leads a team focused on growing the Healthfirst HIE by expanding the data available through the HIE as well as growing the utilization of HIE data and supporting Care Management and Clinical Quality initiatives. Kate Beck has worked in information technology for over 20 years focusing on life sciences, retail services and most recently healthcare. Prior to her role at Healthfirst, Kate held positions at the New York Care Information Gateway, The Visiting Nurse Service of New York and the NYC Department of Health & Mental Hygiene.
Healthfirst is a provider-sponsored health insurance company that serves more than 1.7 million members in downstate New York. Healthfirst offers top quality Medicaid, Medicare Advantage, Child Health Plus, Managed Long Term Care plans and commercial products.

Matt Caminiti Sr. Principal Solutions Engineer

Inovalon

Matt Caminiti, Sr. Principal Solutions Engineer, is responsible for planning, operations, design, modeling, and coordination of the Inovalon solutions across the healthcare landscape. Mr. Caminiti’s experience bringing risk adjustment, quality improvement and other solutions to health plans and health systems is essential to their effective program execution. Mr. Caminiti has focused on public policy and its impact on businesses for more than a decade, including appearances as a subject matter expert at industry-leading healthcare conferences. In addition, Mr. Caminiti previously discussed policy issues on Bloomberg Television, Bloomberg.com, Federal News Radio, and in front of the Maryland State Legislature. He has a Master of Business Administration in Finance and International Business from Loyola University, Maryland, and a Bachelor of Arts degree from Boston College.

Anna Carley Senior Director- CRM, Payer Solutions

GeBBS Healthcare Solutions

Anna Carley, RHIT, has worked in risk adjustment and quality improvement for going on 10 years. She is Senior Director, Client Relations at GeBBS Healthcare Solutions, a risk adjustment service and technology partner, and is the relationship holder between the client and GeBBS. 

Anna has worked in different aspects of risk adjustment, such as the payer side of working at UnitedHealthcare at developing the risk adjustment strategy, and by working on the provider side of building risk adjustment, quality, and pharmacy programs at Stanford Health Care. 

Anna Carley, RHIT lives in Austin, Texas with her husband and two daughters, Penelope, and Valerie. When Anna isn’t working hard at GeBBS Healthcare Solutions, you’ll find her spending time with her family and two dogs, Sampson and Dodger. 

Dawn Carter Director, Product Strategy

Centauri Health Solutions

Dawn Carter is a Director of Product Strategy at Centauri Health Solutions, LLC. Her career in healthcare spans 26 years, which most recently includes extensive experience in developing revenue integrity and quality software solutions, with a focus on encounter management and risk adjustment solutions for Medicare Advantage, Medicaid and Commercial health plans. Prior to that, her experience spans all domains of health care including health plan and provider systems administration, and healthcare applications development. Her experience also includes multiple teaching engagements in medical administration, billing and coding. Dawn holds a Bachelor’s degree in Business Administration. She is a passionate and prolific industry speaker, author, blogger and subject matter expert in claims, EDI management, and risk adjustment.

Evelyn Chojnacki MPH, Director, Health Plan Strategy

Sword Health

Evelyn Chojnacki brings an extensive health plan background to Sword Health with over 19 years’ experience serving clients and members. This includes client management, health care program development, vendor assessment and integrations, market deployment and strategy.

Evelyn joined Sword in early 2021 and remains focused on advocating for the needs of health plan partners while supporting the advancement of virtual care across the industry. This means promoting solutions positioned to deliver impactful clinical results and equitable member access to convenient care - all while tackling escalating healthcare costs. 

Outside of work, Evelyn is an active outdoor and travel enthusiast.

Jason Christ, JD Attorney

Epstein Becker Green

Health care regulatory attorney Jason Christ extends his successful defense strategies in False Claims Act (FCA) actions by the government to safeguard clients’ Medicare Part C plan risk adjustment payment programs. As one of the first and few attorneys focused on risk adjustment in Medicare Advantage (MA) plans, Jason has transformed how clients organize, monitor, and ultimately defend their programs. He creates new business opportunities and best practices for risk-bearing provider groups, plans, and vendors.

As enforcement and regulation of risk adjustment and the FCA escalates, Jason anticipates threats. He devises balanced and compliant approaches that address his clients’ greatest exposures: coding fidelity, clinical effectiveness, oversight, and consistency in best industry practices. From program assessment to testing and corrective actions, Jason shows clients how to close the compliance gap.

Deborah Coakley Ed.D., MBA, Director, Risk Adjustment Programs – Operations

Baylor Scott & White Health Plan

Blaine Collins Regional Inspector General, Office of Evaluation and Inspections  

Office of Inspector General   U.S. Department of Health and Human Services (HHS)

Debbie Conboy SVP, Risk Adjustment and Quality

Signify

Debbie is the SVP of risk adjustment and quality at Signify Health, bringing 35 years of healthcare experience to her role. With a focused expertise in Risk adjustment and Stars/quality, Debbie is widely recognized as an industry expert in these areas and an often sought after speaker at industry conferences.  Debbie has deep knowledge of multiple risk adjustment algorithms, data submission requirements, RADV/HRADV, as well as the regulatory environment that Medicare Advantage, Medicaid, and ACA operate within and around.  

Carmela Costiniuk B.Sc. OT, MHA, D. EdD (C), Vice President, Population Health and Clinical Transformation

Catholic Medical Partners

Carmela Costiniuk is Vice President of Population Health and Clinical Transformation at Catholic Medical Partners, the largest network of independent practice physicians in Buffalo, NY, with nearly 900 physician members. She develops and implements population health and operational strategies and oversees the operations team, which provides direct support to physician practices to improve quality performance and care coordination across the health continuum.

A native of Canada, Carmela earned her Bachelor of Science degree in Occupational Therapy from the University of Toronto and her Masters in Health Services Administration from D’Youville University where she is currently completing her Doctoral Degree in Health Administration.

Carmela has held various administrative positions in home and community based care, acute care, long-term care, and the Local Health Integration Network (LHIN) Ontario Ministry of Health. 

Patrick Coulson Senior Vice President, Sales and Marketing 

Allymar Health Solutions

John Criswell Founder, CEO, Chairman

Porter

John has over 25 years of entrepreneurial and executive experience in the healthcare space, building relationships across major, national health plans and large regional healthcare systems. John’s newest venture, Porter, designed to reach beyond standard home interventions, is the only quality stars and risk adjustment-focused care coordination program. John previously founded Pulse8, a healthcare analytics and technology company delivering complete visibility into the efficacy of risk adjustment and quality management programs, and led them to a successful acquisition by a publicly traded health IT company. John was recently granted a patent by the United States Patent and Trademark Office for a method and apparatus for risk adjustment.

Deniese Crittenden, RN, MSN, MHA, BSW, CRC VIce President, Risk Adjustment Strategy and Solutions

Reveleer

Deniese Crittenden is the Vice President, Risk Adjustment Strategy and Solutions at Reveleer. Deniese brings more than 18 years of experience in the Medicare/Medicaid industry as well as more than 31 years of healthcare experience as a Registered Nurse and a Geriatric Social Worker.  Among many things, Deniese provides gap analysis, assessment, design, and implementation in managed care risk-adjustment activities. Deniese has extended experience across all operational areas of Risk Adjustment for Payors and Providers and provides a unique perspective having worked for both Provider and Payer organizations.

Dr. Shannon Decker, M.Ed., MBA, PhD. Principal

VBC One

Dr. Shannon Decker is principal at VBC One, a consulting firm assisting physician groups, health plans and vendors maximize the performance of their value based contracts and offerings.  Dr. Decker has more than 20 years experience in health care and most recently led teams in risk, quality, data and analytics, telehealth, COVID response and delegation compliance.  Of her more than 20 years of experience in healthcare--15 include working with risk adjustment, quality and Medicare. Dr. Decker has a PhD. in Interdisciplinary Studies, dual MBA degrees--in Finance and in Marketing, as well as an M.Ed. in Secondary Education and a M.Ed. in Administration and Leadership. Dr. Decker is on the faculty at Arizona State University and is also an associate professor of Higher Education & Adult Learning (HEAL) and chief methodologist for Walden and Capella Universities where she chairs and oversees the dissertations of doctoral students. An author of two books and several peer-reviewed articles, and a prolific national public speaker, her interests include the study of human behavior and how theories on motivation and learning may be brought to bear on population health management.

Dave DeHommel Managing Director of Risk Adjustment

BCBS Michigan

Mohamed Diab Chief Executive Officer, Accountable Care Organization

CVS Health

Julianne Eckert RN BSN, CCM, CMCN, ACMP, Senior Director, Clinical Quality Programs 

Clover Health

Julianne Eckert is the Senior Director of Clinical Quality Programs at Clover Health, a physician enablement company focused on seniors who have historically lacked access to affordable, high-quality healthcare. She is responsible for creating an innovative  data driven strategy that breaks the traditional model of healthcare to make it easier for providers and patients to deliver and receive healthcare.   

She has spent her life using her personal and clinical career experiences to help drive her mission as a patient advocate by leading health plan quality improvement strategies to prevent vulnerable populations from falling through the cracks with data stories and forward thinking programs which enable patients to easily navigate the complex matrices of healthcare and insurance. She has sweeping subject matter experience in CMS Innovation models, Stars QI programming, NCQA HEDIS/CAHPS/HOS, health equity, as well as, national and international leadership in driving laser focused strategies to improve health plan performance and member outcomes/experience.

She has held multiple Board Advisory roles and currently serves on the Board of Advisors for curriculum development for Pace University’s Design Thinking Executive Program which meets high academic standards, with a challenging interdisciplinary curriculum designed to prepare top executives to solve real-world challenges in designing innovative practices. She holds multiple certifications in Organizational Change Management, Case Management and also Managed Care.  She is an avid mentor and career coach believing it is her mission to develop our next generation of leaders.

Kathleen Faulk SVP & General Manager, Government Programs

Regence Blue Cross Blue Shield

As senior vice president and general manager of government programs, Kathleen Faulk leads the growth, operations, and finances of government programs with accountability for the overall performance of Regence’s Medicare and Federal Employee Programs (FEP) lines of business and other government contracts. She owns 2.5 billion P & L for these lines of business.
Her work includes oversight of our risk adjustment and Stars area, which supports both Medicare and the individual market and collaborates closely with our clinical and provider teams. Kathleen is an executive liaison with external agencies such as Centers for Medicare & Medicaid Services (CMS), FEP Director's Office and America's Health Insurance Plans (AHIP).
She came to Regence in 2017 with a rich career built around commercial and government program health plans with experience from finance to network to medical economics. Before Regence, Kathleen served as the central region president for Humana, where she led membership growth and revenue optimization efforts within their Medicare Advantage business and oversaw risk adjustment, Stars, medical management, and value-based provider agreements. She has also held executive roles at Excellus BlueCross BlueShield in New York managing claims, customer service, membership and provider network strategy and development. Kathleen’s experience spans 30+ years in the health plan industry.
Kathleen received her bachelor's degrees in accounting and finance at Houston Baptist University and her master's degree in strategic leadership from Roberts Wesleyan College.

Mark Filiault VP Payer Sales

Edifecs

Ellen Fink-Samnick DBH, MSW, LCSW, ACSW, CCM, CCTP, CRP

EFS Supervision Strategies, LLC

Dr. Ellen Fink-Samnick is an award-winning industry entrepreneur who empowers healthcare's interprofessional workforce. She is a subject matter expert on Ethics, Health Equity and Quality, Integrated Care, Interprofessional Teams, Professional Case Management, and Trauma-informed Leadership. Her latest books include The Essential Guide to Interprofessional Ethics for Healthcare Case Management 1^st edition, The Social Determinants of Health: Case Management's Next Frontier, End of Life Care for Case Management, and upcoming Social Determinants of Mental Health: Advancing Wholistic Practice Excellence.

Dr. Fink-Samnick has a Doctorate in Behavioral Health with specialization in Health Equity, Integrated Care, Quality, Leadership, and Trauma-Informed Practice, She is a Licensed Clinical Social Worker, Board-certified Case Manager, and Certified Clinical Trauma Professional, as well as a member of the academic honor society, Delta Epsilon Tau.

Dr. Fink-Samnick serves the industry through a variety of roles with academic appointments at Cummings Graduate Institute of Behavioral Health Studies, George Mason University’s College of Public Health, and the University of Buffalo School of Social Work. She is a clinical supervision trainer and instructor for the National Association of Social Workers of Virginia and Metro DC, lead for Rise Association’s Social Determinants of Health Community, moderator of Ellen’s Ethical Lens^TM on LinkedIn, and author of the blog, Ellen’s Interprofessional Insights. She is also a consultant for the Case Management Institute and moderator of their Case Managers Community.

Dr. Fink-Samnick is known for her fierce professional voice. Along with leadership and committee roles across credentialing entities and professional associations, she has served on the Gravity Project and the National Coalition for Social Work and Health. She is a board consultant to the American Association of Doctors of Behavioral Health, and editorial board member for the Professional Case Management Journal, and Case Management Monthly. Further information is available on her LinkedIn Profile.

Troy Garland Senior Vice President of Clinical and Quality Operations

Equality Health

Troy is the Senior Vice President of Clinical and Quality Operations for Equality Health focusing improving health and eliminating health disparities for all individuals.  Within this area, he is responsible for physical and behavioral health clinical operations, care management services, member engagement, quality improvement and risk adjustment.  

With over 28 years of nursing and healthcare experience Troy Garland has been a bedside nurse, hospital executive, Medicare, Medicaid, Marketplace, ACO executive and innovation transformation consultant.  Troy has expertise in inpatient, outpatient, and ambulatory areas within both commercial and governmental organizations.  Within these roles, Troy has expertise in leadership, operations, population health management, innovative process design, group facilitation, speaking, patient engagement, and clinical application of technology.  

Troy received his Bachelors in nursing from Gustavus Adolphus College, MN.   He received his Masters in Business Administration and Healthcare Management from University of Phoenix.

Colleen Gianatasio Clinical Documentation Integrity and Coding Compliance

Capital District Physician’s Health Plan (CDPHP)

Colleen Gianatasio CPC, CPC-P, CPMA, CPC-I, CRC has 18 years of experience in the health insurance field. She has experience in customer service, claims, quality and coding. As Risk Adjustment Quality and Education Program Manager for Capital District Physician’s Health Plan (CDPHP) Colleen’s primary responsibilities are provider engagement and clinical documentation improvement for accurate coding. Colleen specializes in developing innovative coding curriculum and instruction to support compliance with federal guidelines and appropriate reimbursement processes. She is a certified AAPC instructor and enjoys teaching a variety of coding, documentation and auditing classes. Colleen serves as President-Elect of the AAPC National Advisory Board.

Greg Gierer Vice President of Policy and Research

Better Medicare Alliance

Greg Gierer, MPP, joined the Better Medicare Alliance as Vice President of Policy and Research in September 2021, bringing nearly 25 years of policy and advocacy experience to the role.
His post at Better Medicare Alliance follows leadership roles with some of the nation’s leading health care associations including the Pharmaceutical Research (PhRMA) and Manufacturers of America and the Blue Cross and Blue Shield Association (BCBSA). Greg most recently served as Senior Vice President for Policy at America’s Health Insurance Plans (AHIP). He began his career on Capitol Hill as an aide to U.S. Senator Christopher J. Dodd (D-CT).
Greg is a graduate of Providence College and earned his master's degree in public policy (MPP) from Georgetown University. He also served on the Cancer Support Community’s Cancer Policy Institute Advisory Board.
A Connecticut native, Greg resides in Leesburg, Virginia with his wife and three children.

Garth Graham Director and Global Head of Healthcare and Public Health

Google/YouTube at Alphabet, Inc.

Christi A. Grimm Inspector General

Office of Inspector General, Department of Health and Human Services

The Honorable Christi A. Grimm was sworn in as the sixth Inspector General of the U.S. Department of Health and Human Services (HHS) on February 22, 2022, following her nomination by the President and confirmation by the U.S. Senate. As the head of the HHS Office of Inspector General (OIG), she leads an independent and objective organization of more than 1,600 auditors, evaluators, investigators, data analysts, attorneys, and management professionals who carry out OIG’s mission to protect the integrity of HHS programs as well as the health and welfare of the people they serve. Ms. Grimm is responsible for the oversight of more than 100 programs administered by HHS agencies such as the Centers for Medicare & Medicaid Services, Administration for Children and Families, Centers for Disease Control and Prevention, Food and Drug Administration, and National Institutes of Health. Collectively, taxpayers usually devote approximately $1.5 trillion a year to these programs. In 2021, including COVID-19 relief funding, HHS was responsible for a total of $2.4 trillion in spending. Since the onset of the COVID-19 pandemic, HHS-OIG is responsible for oversight of the HHS-COVID-19 response and relief efforts. Ms. Grimm represents HHS-OIG on the Pandemic Response Accountability Committee (PRAC) and leads PRAC’s Health Care Subgroup.

Beginning in January 2020 until her appointment as Inspector General, Ms. Grimm served as Principal Deputy Inspector General Performing Duties of the Inspector General.

Ms. Grimm brings two decades of leadership and expertise in providing oversight of health and human services programs. She is a leading expert in program integrity issues related to HHS programs, with particular emphasis on health and safety in care provided in home and community-based settings, in hospitals and nursing homes, and in facilities serving unaccompanied children under HHS’s Office of Refugee Resettlement. Ms. Grimm regularly engages with Government partners, national professional associations, and the private sector. She elevates accessibility and understanding of OIG work through articles on a range of topics, including medical identity theft, deleterious effects of elevated risk scores in Medicare managed care, and commercial influences on electronic health records. Ms. Grimm is a frequent speaker at educational programs and before Congress and the media.

Ms. Grimm began her career with OIG in 1999 as an evaluator in OIG’s Office of Evaluation and Inspections and later served in a variety of management roles, including Chief of Staff and Deputy Inspector General for the Immediate Office. As an evaluator, she designed and conducted groundbreaking work to improve quality and safety in hospitals, stop unqualified providers from enrolling in Medicare and Medicaid, and improve the process for appealing Medicare payment decisions.

Ms. Grimm holds a Master of Public Administration from New York University and a Bachelor of Arts from the University of Colorado, Denver. She is a graduate of Harvard University’s Kennedy School of Senior Managers in Government. Ms. Grimm has received the Secretary’s Award for Excellence in Management and the Council of the Inspectors General on Integrity and Efficiency Award for Excellence in Management
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RaeAnn Grossman EVP, Operations - Risk Adjustment, Population Health Management, and Quality

Cotiviti, Inc.

As Executive Vice President of Operations for Population Health Management, Risk Adjustment, and Quality, RaeAnn is responsible for leadership and management oversight of financial performance and operations, as well as innovation, vision, strategic and business planning. In this capacity, she is reframing and accelerating the success and impact of Cotiviti’s industry-leading Risk Adjustment, Quality Network and Clinical, plus Consumer (Eliza) solutions focused on health plan success, health equity and outcomes, and provider performance. With her extensive track record of customer focus, value creation, along with government program and industry experience, Grossman drives the Cotiviti portfolio to improve financial and clinical metrics, reduce the cost of care, and create a landscape for health equity.

Grossman is a renowned industry expert in healthcare innovation and transformation, product strategy, partnership development, and risk adjustment and quality. She has more than 25 years of experience in executive roles at an array of organizations, including commercial and government health plans as well as medical groups, integrated hospital systems, startups, and physician hospital organizations. Most recently, she was President of Medicare Advantage/COO of Bright Health Plan, managing a multi-state Medicare Advantage plan. Prior to that she held C-suite roles at various healthcare technology and consulting firms for nearly two decades, including extensive time with Gorman Health Group, which the premier consulting firm for government-sponsored healthcare programs.

RaeAnn earned an MS in urban and regional planning from Florida State University, and a bachelor’s degree in environmental policy from University of Minnesota.

Ana Handshuh Principal

CAT5 Strategies

Ana Handshuh, Principal at CAT5 Strategies, is a government programs executive with expertise in creating and implementing corporate programs for the healthcare industry. Her background includes Quality, Core Measures, Care Management, Benefit Design and Bid Submission, Accreditation, Regulatory Compliance, Revenue Management, Communications, Community-based Care Management Programs and Technology Integration. Ms. Handshuh currently serves on the Board of the Resource Initiative and Society for Education (RISE), the preeminent national professional association dedicated to managed and accountable care financing and delivery. She is a sought after speaker on the national healthcare circuit in the areas of Quality, Star Ratings, Care Management, Member and Provider Engagement, and Revenue Management. Her recent consultancy roles have included assisting organizations create programs to address the unmet care management needs in the highest risk strata of membership, document their processes and procedures, achieve accreditation status, design and submit government program bids, institute corporate-wide programs and create communications strategies and materials. She possesses sophisticated business acumen with the ability to build consensus with cross-functional groups to accomplish corporate goals. Ms. Handshuh served as the Vice President of Managed Care Services at Central Florida Inpatient Medicine (CFIM). In this role, she provided leadership and strategy on CFIM projects and collaborations with physicians, risk entities, hospital health care systems, and health plans. CFIM is the largest Hospitalist group in Central Florida, with 70 providers discharging over 50,000 patients annually from multiple hospitals across two health care delivery systems and 24 skilled nursing facilities. At CFIM Ms. Handshuh previously served as the Vice President of Operations. Prior to those assignments, she worked with Precision Healthcare Systems as their Vice President of Quality Improvement. In that capacity, she led the IPA’s Quality efforts and collaborated with payers on implementing programs to move the needle on Quality and Star Rating initiatives. Ms. Handshuh also served as the Director of Corporate Program Development at Physicians United Plan. In this role, she led the Quality Management and Corporate Communications departments and spearheaded the development of innovative integrated technology solutions to drive business excellence and Star Rating achievement initiatives. For the past fifteen years Ms. Handshuh has taken an active role in redefining and implementing changes that have led to improvements and greater efficiency within Government programs and healthcare delivery. Prior to joining Physicians United Plan Ms. Handshuh was the founder of I-Six Creative. Under Ms. Handshuh’s vision and leadership, I-Six Creative provided expertise in the areas of managed Medicare benefit design, MSO/IPA operations, provider network strategy, new market launches, technology integration, corporate communications and quality improvement.

Michael Hasbany EVP of Sales and Commercialization

Inovalon

Liz Haynes DVP, Risk Adjustment & Stars- Government Programs

Blue Cross and Blue Shield of Kansas City

Kevin Healy CEO

Allymar Health Solutions

Kevin is the CEO of Allymar Health Solutions, a leading single platform, core administrative services organization built to assist health plans and risk bearing provider groups become more effective and efficient. Services include claims administration services such as claims adjudication, claims payment, members services, provider services, membership and billing as well as risk adjustment and Hedis services. Prior to taking on his current role Kevin has held several executive level positions at such organizations as Optum, Inspiris, Warm Health, Social Service Coordinators and The SilverSneakers Fitness Program. 

This is the 14th year that Kevin has chaired the Rise Nashville event and is glad to be back. 

Eric Hedrick Vice President, Analytics

Advantmed

Eric oversees data analytics and reporting across all Advantmed solutions. He brings over 10 years of experience in healthcare that includes actuarial work, provider engagement, and risk adjustment leadership. Through his extensive experience at both health plans and vendors, Eric understands the value of providing data that is actionable, nuanced, and trustworthy. He is focused on building these qualities into all solutions at Advantmed. His experience includes roles at Priority Health and Cigna health plans as well as Pulse8 where he directed the provider-facing solutions and played key roles across all analytics.  

James Hereford Chief Executive Officer

M Health Fairview

James Hereford is President and Chief Executive Officer of Fairview Health Services. Based in Minneapolis, Minnesota, Fairview is a $6.5+ billion non-profit integrated health system affiliated with the University of Minnesota through our joint clinical enterprise, M Health Fairview. Fairview’s 34,000+ employees and 5,000+ system providers provide exceptional clinical care, from prevention of illness and injury to caring for the most complex medical conditions. Fairview has proudly served its communities for more than 150 years, and is the fourth largest employer in the State of Minnesota.

James provides strategic direction and ensures operational effectiveness for Fairview’s entire continuum of services, which is unmatched in the region. Following the integration of the HealthEast system in June 2017, Fairview is now one of the most comprehensive and geographically accessible systems in the state, with 10 hospitals—including an academic medical center—serving the greater Twin Cities metro area and north-central Minnesota. Its broad continuum of care also includes 40+ primary care clinics, specialty clinics, senior living communities, retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, counseling and home health care services, medical transportation, and an integrated provider network. Fairview also is a founding member of specialty pharmacy network Excelera and many other unique partnerships that advance our vision of driving a healthier future. In 2022, Fairview will open the Community Health and Wellness Hub in St. Paul, a first-of-its-kind center bringing together comprehensive services focused on addressing social risks.

Prior to joining Fairview, James served as chief operations officer at Stanford Health Care. Previous roles included chief operations officer at the Palo Alto Medical Foundation and a series of leadership roles with the Group Health Cooperative in Seattle.

James holds bachelor's and master's degrees in mathematics from Montana State University. He has taught courses with Stanford University’s Graduate School of Business, University of Washington’s Master of Health Administration program and The Ohio State University’s Masters of Business Operations Excellence program. He is a frequent writer and presenter on the topic of lean management systems and transformation.

Josh Hetler Executive Vice President, Business Intelligence

DataLink Software

Josh is a customer-focused, healthcare technology leader with over ten years of experience in building software products to improve the workflows for healthcare professionals in value-based arrangements. At DataLink, he has held management, director and vice president positions, successfully building strategies that impact customer adoption and engagement. He has been instrumental in the growth of the Evoke360 platform development and the innovation of new products and solutions to support value-based care.

Previously he served in Sales with a medical device start-up and he began his career in education. Josh earned a bachelor’s degree from the University of Florida.

Brett Hickman Chief Commercial Officer

Modivcare

Craig Hittle SVP Health Plans

Kaia Health

Craig leads Kaia’s growth and sales initiatives in the US for the national and regional payer/provider channel, focused on driving visibility and adoption of Kaia’s world class digital therapies. He is passionate about practical and transformational solutions and democratizing accessible, affordable, quality health care. Craig brings 22 years of diverse health care experience and expertise in business development, market/product growth and innovation, transactions and valuation, performance improvement and executive leadership. Prior to joining Kaia, Craig was SVP and Market Head for Lumeris and Essence Healthcare, a national leader in population health enablement and Medicare Advantage, responsible for revenue growth, strategic partnerships with leading health systems, providers and payers, and growth of its MA business unit. He earned a BS from Purdue University, an MBA from Indiana University Kelley School of Business and is a Certified Valuation Analyst (CVA). Craig is an avid sports fan, enjoys traveling, reading, and outdoor adventures, and resides in Indianapolis, Indiana with his wife and three children.

Nikki Hungate MS, MHA Director, Medicare & Gov't Programs Product Strategy

MVP Health Care

Nikki Hungate, a long-time resident of the Western New York region, currently serves as the Senior Leader of Medicare & Government Programs Product Strategy at MVP Health Care. Utilizing the 17 years of experience in the health plan industry she is accountable for leading a team of product innovators that create and deliver a suite of high-quality government products that address the needs of the community in a customer-centric fashion, placing emphasis on those populations that are most vulnerable and underserved. Nikki holds a Bachelor and Master of Science in Health Administration from Roberts Wesleyan College. She is currently an Executive Leadership doctoral candidate at the University of Charleston. Nikki has a passion for sharing knowledge, and also serves as an adjunct professor in the health sciences degree programs at Monroe Community College and Roberts Wesleyan College. In her free time, she volunteers as fundraising coordinator for the local Vietnam Veterans of America chapter in Rochester, NY.

Leo Janze Head of Data Engineering, NLP

Change Healthcare

Troy Jelinek Chief Commercial Officer

Icario

Ashish Kachru CEO

DataLink Software

Ashish is an industry visionary with more than 20 years of healthcare technology and executive leadership experience. As the Chief Executive Officer of DataLink, he leads the strategic direction of the organization and drives future innovation to enable high-quality, cost-effective, value-based care. Previously, Ashish was the Chief Executive Officer of Altruista Health, a leading healthcare technology company he founded to provide care management solutions to payers impacting better health outcomes for millions of members. 

Ashish has been widely recognized for his entrepreneurship and leadership in healthcare and most recently was voted Best Tech Leader in Washington, DC in the 2021 Timmy Awards. He was named a Top 25 CEO by the Northern Virginia Technology Council two years in a row (2020 and 2019) and one of the Top 10 Emerging Healthcare Leaders in 2018 by Managed Healthcare Executive magazine. He also received the prestigious EY Entrepreneur of The Year® Award in the health category in the Mid-Atlantic region in 2017. 

Ashish serves on the board of the Department of Medical Assistance Services, the agency that administers Medicaid programs in the Commonwealth of Virginia. He is also a member of the Young Presidents’ Organization. Ashish earned a bachelor’s degree in engineering from NIT Bhopal in India, a master’s degree in nanotechnology from the University of North Carolina and an MBA from the University of Chicago Booth School of Business.

Jenn Kerfoot Chief Experience Officer

FarmboxRx

As Chief Experience Officer at FarmboxRx, Jenn Kerfoot is the head of Client and Member Experience Operations. In this role, Jenn leads the strategic planning, design, and implementation of initiatives that drive Member Satisfaction & Retention. Additionally, Jenn spearheads the Member Insights function using qualitative and advanced analytic approaches to understand the gaps in care and unmet needs of populations. Jenn has helped companies articulate and achieve success across several aspects of the healthcare space. As a military veteran, Jenn brings leadership and vision to diverse audiences, and offers a unique perspective within start-ups and high-growth stage companies. With a passion for organizational mission and values, as well as the unique competitive advantage of establishing a strong culture, Jenn works with all departments to streamline processes and programs that integrate the member experience into every aspect of the business.

Autumn Kerr AVP, Clinical Quality

Healthfirst

Autumn Kerr has been with Healthfirst since 2007, most recently as AVP, Clinical Quality. In this role she serves as the subject matter expert for HEDIS and provider engagement for quality activities. She leverages these areas of expertise exploring new and innovative ways to close care gaps both within her organization and with provider partners. In her tenure, Healthfirst has been awarded 4 Stars from CMS multiple times and routinely in the top performing Medicaid plans in New York State. Autumn has worked in healthcare for 20 years on both the payor and payee side.

Healthfirst is a provider-sponsored health insurance company that serves more than 1.7 million members in downstate New York. Healthfirst offers top quality Medicaid, Medicare Advantage, Child Health Plus, Managed Long Term Care plans and commercial products.

Gregg Kimmer CEO

ATRIO

Effective August 1, 2022, ATRIO’s new President and CEO is Gregg Kimmer.  All of Gregg’s experience in healthcare has been in Medicare Advantage, and until ATRIO, it has all been in the Midwest, with Chicago serving as the anchor geography.  After nearly 7 years at Humana, where he was 1 of 5 Divisional CFOs and oversaw $1.4 billion in revenue, he became Chief Medicare Officer over the Great Lakes market at Aetna / CVS Health.  During his 4 years in this role, he had full P&L responsibility and oversaw organic growth of 20k to 133k members.  

Gregg is originally from Nashville, TN.  Without a doubt, what he enjoys most is spending time with his family.   

Daphne Klausner Plan President

Honest Medical Group

I have been privileged to serve the senior population for over 25 years, and most recently within the largest city in America with the highest amount of poverty. While it was home to some of the world’s best hospitals and doctors, the people who needed us most were struggling. Despite everyone’s best intentions and hard work, the state of the system was highly fragmented. When we decided to test a new model of care, where a health plan collaborated with doctors, we saw great things happen.

David Larsen Senior Advisor Payor Solutions

Press Ganey

David L. Larsen has been the Director of Quality Improvement for SelectHealth in Salt La¬ke City, Utah for the past 31 years and has worked for Intermountain Healthcare for 38 years. SelectHealth is a mixed model HMO with more than 900,000 members in Utah, Idaho and Nevada. Intermountain Healthcare is an integrated health care delivery system with 23 hospitals and over 1500 employed physicians.

As the Director of Quality Improvement, David has responsibilities for oversight of the Medicare Advantage Stars program for which SelectHealth received a 4.5 Star rating in 2020 and 4 Star rating in 2021, maintaining NCQA accreditation; HEDIS performance measurement; CAHPS measurement and reporting, public reporting (transparency) and population health.

David has also been responsible for the oversight and development of chronic disease registries, performance measurement and web based reporting systems, quality improvement pay for performance incentives for providers, and direct patient improvement interventions related to chronic illnesses including patient adherence monitoring, reminders and incentive programs.

Sean Libby President

BeneLynk

Sean has worked at the intersection of managed care and government benefit programs for the past 20 years. He is responsible for BeneLynk’s product development, new business acquisition, and strategic growth initiatives. Prior to BeneLynk, Sean served as the President of Freedom Disability and Alpha Disability, one of the nation’s largest Social Security Disability and Veterans Advocacy companies. Before that, Sean served as Vice President, Sales for SSC Disability, providing government program benefit services for Managed Care Organizations. 

He is recognized by the Social Security Administration as a non-attorney representative (EDPNA) and has personally represented claimants in hearings for Social Security Disability Insurance and Supplemental Security Income throughout the country. 

Sean is an expert on a wide variety of government benefit programs and has been quoted in Bloomberg, Business Week, and other national publications. He regularly publishes articles on managed care and government benefits for BeneLynk’s blog. 

Sean is a graduate of Middlebury College and has a master’s degree from Yale University. 

Paul G. Linder, MD

Paul G. Linder and Associates PC

Paul G. Linder, MD, is a primary care physician, internist and small business owner in Pittsburgh, Pa. He has operated a solo practice since 1991. He also serves as clinical director at Biolife Plasmapheresis Center in Braddock and was a visiting professor and clinical lecturer at Washington and Jefferson College in Washington, Pa. He earned a bachelor’s degree in biology from Brandeis University and a doctorate in medicine from Milton S. Hershey Medical Center. Dr. Linder completed his residency in internal medicine at West Penn Hospital in Pittsburgh and is board certified in internal medicine. He and his wife, Mary Anne, have three children.

Robert London Medical Director

Semler Scientific, Inc.

Belinda Marcel VP, Member Engagement

Matrix Medical Network

Lisa Marshall Manager, Alternative Payment Strategies

Driscoll Health Plan

Lisa has a bachelor’s degree in Business Administration with a minor in Contract Management in Acquisitions from University of Maryland and an MBA from Texas A&M with emphasis in business analytics. She is currently working on obtaining her Project Management Professional (PMP) certification.

Lisa has had the unique opportunity of following her husband through his 28-year naval career living all over the country and overseas. That nomadic lifestyle allowed her the opportunity to work in healthcare in a variety of capacities. Her 25 years of healthcare experience includes national commercial carriers, managed care organizations, physician offices, hospitals (including Department of Defense (DoD) military treatment facilities) and in a variety of capacities. She ran my own business for many years consulting for physicians working closely with family practice, therapy, and behavioral health. Lisa has a significant understanding of the impact that business decisions have on these organizations.

Driscoll Health System (DHS) is a non-profit health system in south Texas.  DHS supports a predominantly pediatric population of 270,000 members across 24 counties with communities that can be significantly remote. Driscoll Health System has multiple clinics across their service delivery area with more than 30 medical and surgical specialties. Driscoll has the only free-standing children’s hospital in South Texas and is building a second free standing hospital in McAllen, Texas scheduled to open in the fall of 2023.

Currently, Lisa’s team runs a 113M dollar Alternative Payment Program for Driscoll Health Plan which impacts approximately 71% of their contract business.

Melissa McVaugh, MSN-LM, RN, CPC Director Clinical Programs

Mountain Health CO-OP

Gabriel Medley Vice President, Risk Adjustment & Analytics

Blue Cross Blue Shield of Michigan

Gabe Medley brings over 22 years of progressive healthcare experience leading diverse multidisciplinary teams and projects to successful outcomes. Gabe’s background includes a combination of healthcare, business, and data analytic leadership roles with his most recent role serving as VP, Risk Adjustment and Analytics at BCBSM. In his current role, Gabe manages risk adjustment, HEDIS/quality improvement, and analytic reporting programs for the Medicare product line.

Prior to Emblem Health, Gabe’s previous experience included roles as Vice President of Provider Network and Population Health at Emblem Health headquartered in NYC, NY; start-up health plan (Iowa Total Care) for Centene Corporation as VP - Quality Improvement; progressive leadership roles at Highmark Wholecare (fka. Gateway Health) culminating as VP - Quality and Risk Adjustment, Manager - Risk Adjustment Programs (Horizon Blue Cross Blue Shield of NJ), Manager of Healthcare Data Analytics (Inovalon Inc.); Senior Manager of Patient Access (Military Health System, National Capital Region); and active-duty service as a Captain in the U.S. Army (Medical Service Corps).

Gabe’s education includes the following: Master of Science in Healthcare Administration (MHA) and a Master of Business Administration (MBA) from the University of Maryland Global Campus in Adelphi, Maryland; Bachelor of Science in Psychology with a minor in Military Science from Grambling State University in Grambling, Louisiana. In his spare time, Gabe enjoys working out, traveling, and spending time with family and friends.

David Meyer Chief Customer Officer, Applied Research Works

COZEVA

David Meyer is a nationally recognized thought leader and change agent, with over 20 years of experience in healthcare commercial and government programs operations, data science, clinical outcomes, revenue and quality. He currently serves as the Senior Vice President of Health Outcomes and Informatics at NationsBenefits, where he is building-out the Research and Data Services unit of the company. In pervious roles, he has run revenue, quality and healthcare informatics for both regional and national health plans, spanning both Medicare Advantage and Commercial products. He has been a RISE Advisory Executive Board Member 12+ years, and is a frequently invited speaker at conferences and summits.

Lyle Mioduszewski Vice President of Population Health

Ciox Health

Lyle Mioduszewski is Vice President of Population Health for Ciox Health, where he works with risk-bearing entities to understand the utility of social determinants of health factors, with the goal of improved and equitable outcomes for all individuals. With twenty years of experience throughout the health care continuum, Lyle has clinical expertise in emergency and trauma nursing of adults and pediatric populations, as well as cardiac catheterization and electrophysiology nursing. Lyle has been a leader in the health information technology and medical device industries with previous companies, including McKesson Corporation, PointClickCare (Collective Medical), and Zoll Medical. He is passionate about advancing value based care modalities, augmenting process relative to varying health literacies, care collaboration, interoperability, and influencing an end to the opioid epidemic through the use of innovative technologies.  

Shontelle Mixon

Blue Cross Blue Shield of Illinois

Erin Montgomery

Advantmed

P.J. Morris MHA, Manager, Risk Adjustment Operations & Analytics

Fallon Health

P.J. Morris, MHA, has worked in risk adjustment for almost 6 years. Currently, he is the Manager of Risk Adjustment Operations & Analytics at Fallon Health, a health insurance plan in central Massachusetts. 

P.J. has previously worked at Tufts Health Plan in different areas of health insurance for over 10 years. This experience includes Membership Operations, Provider Network Contracting, and Finance. He also has worked on the provider side at UMass Memorial Healthcare in the Finance department.  

A former college athlete, P.J. Morris, MHA, lives in Massachusetts with his wife Susannah and daughter, Sydney. When P.J. isn’t working hard at Fallon Health, you’ll find him watching sports, mentoring youth from his church, or enjoying a local craft brewery.

James Murray VP, Clinical Informatics and Interoperability

CVS Health/Aetna

Lynne Newson Vice-President, Medicare Strategy

BCBSMA

Lynne is currently Vice-President, Medicare Strategy, responsible for the Medicare Stars program, Revenue Management, Medicare Compliance, and the Overall Medicare Segment Strategy.  Prior to this position, Lynne was the Medicare Compliance Officer at BCBSMA, responsible for the Medicare Compliance Program for BCBSMA’s Medicare Advantage and Prescription Drug Plan Contracts.

Prior to her work at BCBSMA, she worked at Blue Cross Blue Shield of Rhode Island (BCBSRI) as the Director of Government Programs. Lynne started her career in Washington, DC at the Department of Health and Human Service’s Budget office, where she was lead analyst on Medicare Physician Payment Policy and Medicare Risk Plan Policies and Regulations.  Her career also included a period as a Senior Policy Analyst in the Washington, DC based Office of Policy and Representation at the Blue Cross Blue Shield Association.

Lynne received a Master's degree in Public Policy from Duke University and a Bachelor of Arts degree from Bowdoin College

Khanh Nguyen Chief Executive Office

Cozeva

• Khanh has a Doctorate from the University of California San Francisco, School of Pharmacy, and has over 15 years of experience in creative 
•  payer-provider collaborations. Her leadership around care innovations, social determinants of health and health disparities, patient engagement, system integrations for enhanced point-of-care solutions, and provider incentive programs broke new ground in California’s 
•  sophisticated managed-care environment.  

Roy Oaks Senior Director, Data Analytics

Driscoll Health Plan

Nigel Ohrenstein President

Kaia Health

Nigel is passionate about transformational solutions that improve cost and quality of care. Most recently, he was the co-founder of Lumeris, helping to build Lumeris into the leading Value Based Care Company and operator of Essence Healthcare, the Five Star rated Medicare Advantage plan. Prior to Lumeris, Nigel led the Medicare business at Express Scripts. He has a BA and MA from the University of Cambridge.

Nationally recognized as a thought leader in healthcare, Nigel is excited to democratize healthcare and through Kaia Health make clinically proven digital therapies available to patients anywhere and at any time.

When not working, Nigel can be found running, traveling, spending time with family and watching Liverpool FC.

Lynne Padilla Vice President of Risk Adjustment Solutions

Change Healthcare

Lynne is a Risk Adjustment coding healthcare leader with over 30 years’ experience in coding and quality solutions. Lynne’s focus over the past 10-years has been on leading Risk Adjustment coding operations and quality improvement where she led a large international team of coders and clinicians. Lynne’s subject matter expertise includes ICD-10, Medicare Advantage, HHS-HCC , CDPS and other state Medicaid Risk Adjustment models. In Lynne’s current role as VP of Risk Adjustment Solutions, Lynne is leading a team of clinicians and data science experts at Change Healthcare building and enhancing our products with AI-driven technology solutions.  

Wayne Pan Medical Director

Banner Health

Vandna Pandita Vice President, HEDIS Strategy & Analytics

AmeriHealth Caritas

Vandna Pandita, MPH is the Vice President of HEDIS® Strategy and Analytics for the AmeriHealth Caritas Family of Companies [ACFC].  In her role, Vandna is leverages her experience in quality and risk adjustment operations to support members and providers as it relates to performance reporting and the member and provider experience.  Her area of influence spans analytics, plan operations and digital integration of data and processes in the transition to interoperability. 

Prior to AmeriHealth, Vandna has worked for several national health plans, including Aetna, several Blue Cross Blue Shield plans, the Blue Cross Blue Shield Association and Centene.  She has successfully led several health plans through NCQA Accreditation, managed HEDIS® reporting, improvement and outreach, and helped develop and implement a successful provider profiling and performance measurement program.  In addition to her health plan experience, Vandna managed Risk Adjustment Client Operations for Evolent Health, is a former certified HEDIS® Compliance Auditor and led project management and client solutions for a retrieval, abstraction/coding and analytics vendor supporting health plans and provider groups in their efforts to optimize revenue and improve quality within their populations.

Vandna attended the University of California at Berkeley as an undergraduate and received her Master’s in Public Health from the University of California at Los Angeles.

Vandna has moved from coast to coast, spending the better part of the last 25 years working on her southern drawl in Atlanta, Georgia.  These days you can find her running the streets of Atlanta, cooking for friends or working on her newest hobby, making wobbly pottery. 

Margaret Paroski MD, MMM, President & CEO and Chief Medical Officer

Catholic Medical Partners

Dr. Paroski is the is the President & CEO and Chief Medical Officer of Catholic Medical Partners, an independent practice association with 900 physician members. A board certified neurologist, Dr. Paroski has held various administrative positions including Medical Director at Erie County Medical Center; Senior Associate Dean of Academic Affairs & Admissions and Interim Vice President of Health Affairs and Interim Dean at the Jacobs School of Medicine and Biomedical Sciences, University at Buffalo; and Executive Vice President and Chief Medical Officer at Kaleida Health.

She began her medical career at the Buffalo VA Medical Center and held hospital appointments at the Buffalo Psychiatric Center, Roswell Park Cancer Institute, Kaleida Health, and Erie County Medical Center. In addition to her clinical and leadership roles, Dr. Paroski has been a faculty member in the Neurology department at the Jacobs School of Medicine and Biomedical Sciences for the past 37 years.

As President & CEO and Chief Medical Officer of Catholic Medical Partners, Dr. Paroski leads clinical integration and standardization efforts and physician relations among the organization’s medical and specialty practices. She is also responsible for engaging physician members in population health initiatives and value based payment model adaptation. 

Manoj Pawar Chief Medical Officer

Mutual of Omaha

I'm a senior physician executive and primary care physician with a solid track record of improving health outcomes and affordability. I love what I do because it allows me to help patients on a large scale. And yes, I still provide clinical care too - I find it keeps me grounded, reminded of what's important, and in touch with the challenges of today.

By serving in executive leadership roles for medical groups, hospitals, health systems, population health organizations (IPAs, ACOs, CINs), and health plans, I've had the opportunity to make an impact on a regional and national level...in all parts of our healthcare ecosystem, to really understand how they work.

I've also helped individuals and organizations in healthcare (including startups) in solving tough problems as a strategic advisor, consultant, and coach. Helping others on the same journey is extremely rewarding work, in that I learn from them as much as they learn from me.

I'm passionate believer that public health and primary care must serve as the foundation for improving the health of populations and communities, and I'm always looking for ways to help in these efforts, as well as ways to get the various parts of our systems to work together more effectively.

Right now, I'm working on improving health outcomes & affordability for seniors by innovating in the Medicare space and helping physician leaders make a big impact via leadership development, training, and coaching.

Matt Plack VP for Innovation and New Solution Strategy

Apixio

As VP for Innovation and New Solution Strategy at Apixio, Matt Plack utilizes his 25 years of healthcare IT expertise to solve critical business problems for payers and providers through Apixio's machine learning (ML) platform. Beginning with McKesson (now Change Healthcare) and Siemens Medical Solutions (now Cerner/Oracle), Matt's career arc has taken him from Product Management and Marketing roles with large healthcare IT organizations to customer-focused sales roles with mid-to-late stage startups like MEDecision and Apixio. His specific areas of domain expertise include revenue cycle, population health, utilization management, and the use of ML to improve risk adjustment coding and quality measure abstracting for improved business outcomes.

Lisa Pouncey Director Product Management, Data Transformation and Submissions

Veradigm

Melanie Prince MSN, BSN, NE-BC, CCM, FCM, FAAN, President/CEO

MAPyourWAY, LLC

Melanie A. Prince, is the President of Case Management Society of America (CMSA).  She served 30 years in the armed services, retiring in the rank of Colonel assigned to Headquarters Air Force where she was responsible for developing strategies to eliminate interpersonal violence in the military and advanced the Air Force Surgeon General’s global health care strategy. 

Vinitha Ramnathan Senior Vice President, Product

Episource

Seth Ravine Senior Vice President

Modivcare

Jacqualine Reid Social Science Research Analyst , Office of Evaluation and Inspections

Office of Inspector General   U.S. Department of Health and Human Services (HHS)

Jacqualine Reid is a Social Science Research Analyst in the Office of Inspector General, U.S. Department of Health and Human Services (HHS). She conducts national program evaluations on a range of issues effecting various HHS programs, including the Medicare Advantage program. She received her Ph.D. in Anthropology from American University.

Hassan Rifaat Chief Executive Officer

Vatica Health

Hassan Rifaat, MD, is chief executive officer at Vatica Health and has more than 25 years of experience in the healthcare industry. Dr. Rifaat was previously chief executive officer of Windsor Health Group, a Medicare Advantage and supplemental insurance carrier based in Nashville, Tenn., with over 300,000 covered members. He served as chief operating officer at Outcomes Health Information Solutions and was senior vice president, eastern region, for Coventry Health Care. At Coventry, he managed seven health plans serving more than 1.5 million commercial, Medicare and Medicaid members in 11 states. He held senior executive positions at Humana, Inc., including regional CEO for Illinois and the southeast region and market president for Louisiana. Dr. Rifaat is a graduate of the University of Virginia School of Medicine and Harvard University, where he was an All-American player on the national rugby team.  

Francesca Rinaldo SVP, Clinical Product & Innovation

Sharecare

Within her role, Jessica works in close partnership with leaders throughout Providence Health Plan to support and lead key initiatives that enhance operational efficiency, manage medical expense, improve quality for members, shepherd process improvement, and coordination of data analysis and evaluation. Jessica has been in health care for nearly 10 years and is an expert in implementing and managing programs focused on improving health care delivery and quality. Jessica received both her Bachelor's of Science and her Master's of Business Administration from Oregon State University. 

Jennie Roberts Senior VP, Quality and Clinical Modernization

UnitedHealthcare

Jennie Roberts is Senior Vice President of Quality & Clinical Modernization for UnitedHealthcare. As a leading insurer serving more than 54 million people across the full spectrum of health benefit programs for individuals, employers and Medicare and Medicaid beneficiaries, UnitedHealthcare is dedicated to helping people nationwide live healthier lives by simplifying the health care experience, meeting health and wellness needs, and sustaining trusted relationships with care providers. 

As Senior Vice President of Quality & Clinical Modernization, Jennie Roberts leads end-to-end strategy and drives effectiveness for programs impacting HEDIS and STARs results. This includes aligning the right program, the right population and the right resources for each market and health plan to help achieve targeted HEDIS and population outcomes. 

Since joining UnitedHealth Group in 2006, Ms. Roberts has held executive roles throughout the organization, including leading hospice and long-term care delivery teams, national clinical call centers and Medicaid program oversight. 

Ms. Roberts has retained a focus on patient care outcomes during her clinical practice and throughout her business career. Prior to joining UnitedHealth Group, she served in leadership positions including Director of Business Development with Independent Care Health Plan, Director of Health Operations for Assurant Health and Assistant Vice President of Managed care for United Heartland Inc. 

A graduate of Alverno College, Ms. Roberts holds a bachelor’s degree in Nursing and Biology and received her Master of Business Administration degree from the University of Phoenix.

Steve Romary MBA, PMP – Director, Risk Revenue and Strategy

Highmark

Steve Romary serves as Director of Risk Revenue and Strategy for Highmark, which proudly offers Medicare Advantage and ACA health insurance coverage to 600,000 members across PA, DE, WV, and NY.  Steve oversees the strategic vision, implementation, and execution of Risk Adjustment clinical gap closure programs.  Before devoting his work to Highmark, Steve provided technology delivery services as a consultant for an information technology firm.  Steve’s technology and health care experiences align to support innovative solutions that meet payer and provider needs.  In his free time, Steve enjoys travel, golf, and spending time with his family.

Lynda Rowe Senior Advisor, Value-based Markets

Intersystems

Ms. Lynda Rowe, Senior Advisor for Value-Based Markets at InterSystems is a subject matter expert around the shift to value-based payment models. She shares her expertise with customers and the industry through speaking engagements and published pieces. For the past two decades, Lynda has held senior-level positions in health information technology. She’s worked for payers, health systems, start-ups, vendors and the federal government. Prior to her role at InterSystems she was an executive in the health market at Booz Allen Hamilton, where she led a number of consulting projects for the Centers for Medicare and Medicaid and the Office of the National Coordinator within HHS. She provided leadership for quality measurement, health information technology use and adoption, health information exchange, interoperability and standards. She continues to be active in a number of national efforts including the HL7 Da Vinci project.

Aria Sameni Vice President of Growth and Strategy

Optum

Aria Sameni leads the growth and strategy team responsible for interoperability and workflow optimization in Optum’s risk adjustment and quality solutions vertical.  He holds a bachelor’s degree in Economics from the university of Minnesota and a master’s degree in Business Administration from the University of Florida.  Aria brings over a decade of health care experience focused on risk adjustment and quality performance, including payer risk or gainshare modeling, care delivery collaborations, provider interoperability, prospective and retrospective program ideation and execution, and facilitating amongst payers, providers and vendors to drive informed care and better patient outcomes.  This experience motivates his commitment to supporting payers in their goals to deliver improved health care solutions to their beneficiaries.

In his current role, Aria is honored to lead a team dedicated to helping providers succeed in risk and quality programs.  Optum Risk & Quality Programs serve payers representing more than 6M members and engages with more than 13,000 providers nationwide.

Kelley Scott, MSN, FNP-c Nurse Practitioner

Providence St Joes

Kelley has been a board-certified Nurse Practitioner for over 20 years with experience in internal medicine, pulmonology, and healthcare administration. She has extensive knowledge about risk adjustment programs: MA, MSSP and ACOs. She has spent that last 9 years working with physicians, as well as NPs and PAs on proper coding, documentation, and best practices. She has led large HCC training initiatives across our teams in CA, Texas, Oregon, Montana, and Alaska. Kelley has worked closely with our vendors on the clinical application of HCCs from the coding and provider standpoints to ensure all workflows are seamless and effective. Kelley currently serves in a leadership role at Providence in the Risk Adjustment Programs division and has played a key role in the success of the department.

Eric Segal Sr. Director of Platform Strategy and Solutions

Episource

As Director of Platform Strategy and Solutions, Eric is at the intersection of Product, Operations, and Client Services with a focus on the development and execution of innovative healthcare solutions. He has a background in mobile technology and served as an Emergency Medical Technician in South Los Angeles. Eric holds a BA from Lehigh University and an MBA from the USC Marshall School of Business.

Laura Sheriff, RN, MSN Vice President Operations, Risk Adjustment

Southwestern Health Resources (SWHR) 

Laura Sheriff, RN, MSN, is currently working as Vice President Operations, Risk Adjustment for Southwestern Health Resources (SWHR).  She also works as a consultant with physician groups and health plans to capitalize on risk adjustment performance and operations.  Laura is an MSN with >13 years’ experience in Medicare, Medicaid, and Marketplace Managed Care and has led teams in risk, quality, telehealth, and population health analytics.  Laura demonstrates effective leadership, innovative problem-solving techniques, and goal-oriented focus to execute business objectives and meet performance metrics.  Laura has designed and coordinated activities including provider education, training, auditing, data mining, and data analysis to direct program success.  Laura has a Master’s in Nursing Education and is also a certified professional coder and a certified risk coder.   Laura is also a frequent speaker for RISE, a best-in-class organization for all things related to accountable care and government healthcare reform.

Dr. David Shulkin Ninth Secretary, US Department of Veteran Affairs-Shulkin

Solutions, LLC

The Honorable Dr. David J. Shulkin was the ninth Secretary of the US Department of Veterans Affairs in the Trump Administration and VA’s Under Secretary of Health in the Obama Administration.  As such, Secretary Shulkin was the only member of the Cabinet to have served both Presidents and to have been confirmed by the US Senate by a vote of 100-0.  

As Secretary, Dr. Shulkin represented the 21 million American veterans and was responsible for the nation’s largest integrated health care system with over 1,200 sites of care, serving over 9 million Veterans. VA is also the nation’s largest provider of graduate medical education and major contributor of medical research and provides veterans with disability payments, education through the GI bill, home loans, and runs a national cemetery system.

Secretary Shulkin is a widely respected healthcare executive having served as chief executive of leading hospitals and health systems including Beth Israel in New York City, Morristown Medical Center in Northern NJ, and currently advises leading health systems.  Secretary Shulkin has held numerous physician leadership roles including the Chief Medical Officer of the University of Pennsylvania Health System, the Hospital of the University of Pennsylvania, Temple University Hospital, and the Medical College of Pennsylvania Hospital. Secretary Shulkin has held academic positions including the Chairman of Medicine and Vice Dean at Drexel University School of Medicine.  As an entrepreneur, he founded and served as the Chairman and CEO of DoctorQuality one of the first consumer orientated sources of information for quality and safety in healthcare.  Secretary Shulkin has served on boards of managed care companies, technology companies, and health care organizations.  He now works with healthcare organizations that are leading the transformation of medicine around the world. 

Secretary Shulkin is a board-certified internist. He received his medical degree from the Medical College of Pennsylvania, his internship at Yale University School of Medicine, and a residency and Fellowship in General Medicine at the University of Pittsburgh Presbyterian Medical Center. He received advanced training in outcomes research and economics as a Robert Wood Johnson Foundation Clinical Scholar at the University of Pennsylvania.

Over his career Secretary Shulkin has been named  “One Hundred Most Influential People in American Healthcare” by Modern Healthcare.  He continues to advocate on behalf of the country’s veterans by serving on the board of numerous nonprofits that serve veterans, is the host of the popular Policy Vets Podscast,  and is the author of the recent book, “It Shouldn’t Be This Hard to Serve Your Country: Our Broken Government and the Plight of Veterans”.

Follow @DavidShulkin

Melissa Smith EVP, Consulting & Professional Services

Healthmine

Melissa Smith is the Executive Vice President of Consulting and Professional Services at HealthMine, bringing over 25 years of experience in Star Ratings, strategy, sales, and marketing for health plans, providers, pharmacy benefit managers, and industry vendors. Melissa has extensive experience developing strategic and tactical solutions to meet client needs and a strong background of building productive partnerships across internal teams and with external vendors to improve performance on clinical, medication, patient survey, and administrative quality measures.

Most recently, Melissa was Senior Vice President of Sales, Marketing, Strategy and Stars at Gorman Health Group. She is a well-known thought leader and healthcare strategist with proven success developing enterprise-wide solutions to improve Star Ratings, quality performance, health outcomes, and the member experience. Melissa’s team helps clients improve performance within quality ratings systems, evaluate market dynamics and opportunities, optimize distribution channels, and support our clients’ strategic planning needs.

Prior to Gorman Health Group, Melissa served in a leadership capacity at Cigna-HealthSpring. Before working in Medicare Advantage and quality ratings systems, Melissa was an Associate Director at Vanderbilt University Medical Center. Melissa received her degree from Purdue University and began her career at KPMG, LLP. Melissa’s unique background of business process, regulatory compliance, and healthcare quality offers our clients unique access to healthcare strategy, quality performance, revenue optimization, and more.

Alyson Spencer Sr. Director, Clinical Quality

Blue Shield of California

Will Stabler Executive Vice President, Payer Solutions 

GeBBS Healthcare Solutions

Will Stabler has led Risk Adjustment, Quality and Payment Integrity revenue growth with companies such as Change Healthcare, Advantasure (BCBSM) and most recently at Discovery Health Partners (MultiPlan). Leading Sales, Marketing, Accountant Management and Product Management teams.

He was raised in a family of physicians; he grew up coding procedures and learning the business of medicine-and was formerly a certified coder. He was also part of the first wave of electronic claim processing and built a medical billing & consulting firm that assisted practices with building new facilities, CMS audits, billing, claims. human resource administration and general practice management.

Will has been laser focused on technology-enabled information/business/healthcare services and software with deep experience with providers, health plans and other risk-bearing entities. And is a sought after thought leader and as such delivers Key Notes, crafts commentary and often participates in industry panels and roundtables.

In prior roles, Will has been responsible for multinational new business development across an array of industries. He has extensive experience partnering with C-Suite peers and boards of directors across the entire range of the corporate life cycle from start-ups to middle market companies to billion-dollar multinationals. He has been responsible for P&L, market strategy development, and client solution planning for various regional, national and multinational markets and served as President, CEO and other CXO roles.

Scott Stratton MPH, Chief Data Scientist & VP Industry Development

Veradigm

Mikal Sutton Managing Director, Medicaid

Blue Cross Blue Shield Association

Elaine Taverna Senior Vice President for Risk Adjustment and Quality

Advantasure

With  over 25 years’ experience,  Elaine Taverna has spent the last 10 years improving revenue trend and lowering medical expense for healthcare providers and payers  within the United States and throughout Michigan.  

A career of success in health care 

Elaine has overseen medical management, risk adjustment and quality programs, primarily within the government funded product sector.   

As senior vice president of risk adjustment and quality for Advantasure, she is responsible for performance in revenue stream areas such as risk adjustment and quality five-star programs.   

As the vice president of revenue management and risk adjustment at Health Alliance Plan of Michigan (HAP), a subsidiary of the Henry Ford Health System. Elaine led the evaluation, design and implementation of HAP and Henry Ford risk adjustment and provider performance programs for all government-funded revenue streams. She also designed and implemented a chronic care outpatient ambulatory program for Henry Ford Medical Group and, as director of government programs, developed a strategic plan to integrate physical and behavior health for members. 

At Concerto Health in Detroit, a physician organization, Elaine served as the national director of care management - with responsibility for provider performance for risk adjustment, quality and cost containment - designing and overseeing care management programs, quality assurance initiatives and contract compliance. 

Elaine also served as Meridian Health Plan’s national director of long-term care supports and services, administrating lines of business in three states with over 500k of membership; at Community Living Services (CLS) as the division director of long-term care services and business development; and, earlier, as CLS director of operations for its Personal Supports and Services Department. 

Education in social work and health administration 

A licensed registered social worker in Michigan, with 12 years of national consulting experience, Elaine earned a Master of Science degree in health administration from Central Michigan University and a Bachelor of Science in social work from Eastern Michigan University. 

Ally Thomas Ph.D., AVP, Quality Improvement

UPMC Health Plan

Megan Tinker Chief of Staff

Office of Inspector General   U.S. Department of Health and Human Services (HHS)

Megan Tinker is Senior Advisor for Legal Affairs for the Office of Counsel to the Inspector General, U.S. Department of Health and Human Services. She advises the OIG on jurisdiction and oversight issues under the IG Act, and health care fraud and compliance matters, including Medicaid, Medicare and grant programs. Ms. Tinker is responsible for executive level direction and oversight on highly complex and sensitive matters for which the Office of Counsel provides legal advice and representation to OIG officials. This includes a wide range of issues dealing with fraud, waste, and abuse in HHS programs and grants.

Ms. Tinker has testified before Congress, and spoken to the Health Care Compliance Association, Association of Government Accountants, Association of Healthcare Internal Auditors, and American Health Lawyers Association. Ms. Tinker provides training on multiple topics including OIG jurisdiction and authorities. Ms. Tinker is also a guest lecturer at the American University, Washington College of Law, Health Law Program. Ms. Tinker graduated cum laude from American University, Washington College of Law and with honors from University of Richmond.

Elissa Toder VP, Quality Improvement Strategy & Solutions

Reveleer

Elissa Toder, Vice President of Quality Improvement Strategy and Solutions has worked in managed care for over 16 years as a former Staff Vice President of Quality Improvement.

Jessica Wack-Alexander MBA, Program Manager, Health Care Services

Providence Health Plan

Within her role, Jessica works in close partnership with leaders throughout Providence Health Plan to support and lead key initiatives that enhance operational efficiency, manage medical expense, improve quality for members, shepherd process improvement, and coordination of data analysis and evaluation. Jessica has been in health care for nearly 10 years and is an expert in implementing and managing programs focused on improving health care delivery and quality. Jessica received both her Bachelor's of Science and her Master's of Business Administration from Oregon State University.

Susan Waterman Trainer, Director, Risk Adjustment

Baylor Scott & White

As Director of Risk Adjustment, Susan Waterman has been empowered to plan, design, and oversee business and strategic coding and education objectives to optimize the Risk Adjustment Department . Responsible for ensuring the accuracy of risk adjustment payment, while successfully managing activities related to Medicare Advantage, DSNP, ACA, and HIX Risk Adjusted lines of Business.

In that capacity Susan directed department changes that resulted in multi-million dollar gains in Risk Adjustment, brought all chart review activity in-house, and partnered with the hospital CDI/Quality Physicians to create an Outpatient CDI Department focused on documentation quality, Risk Adjustment activities and clinic training.

A proven leader in her field, Susan’s professional experience includes coding and compliance management, auditing and provider training, system management, and consulting services.

Bruce Waugaman Risk Adjustment Leader

EmblemHealth

Scott Weiner Director, Government Programs

Sentara

Scott is the Director of Government Programs at Sentara Health Plans. Prior to joining Sentara, Scott was the founder of Quadralytics, a data analytic, software, and finance consulting company. Previously, he was the Senior Vice President, Analytics and Strategy, EMSI HEALTH where he was focused on expanding the company’s HEDIS, Medicare Stars, Medicaid Risk Adjustment and data analytics offerings to better meet the needs of health plans and other clients. He has extensive executive-level and health-plan consulting experience, having held managed care, risk adjustment and data analytics positions for more than 20 years. He has a Master of Business Administration (MBA) from Seattle University and a bachelor’s degree in accounting from Central Washington University. He holds the Certified Risk Adjustment Coder (CRC) designation from AAPC and CMA and CFM from the Institute of Management Accountants. Scott served on the RISE Advisory Board and has been involved with RISE for many years.

Meghan West Sr. Manager Product Management, Clinical Data Exchange

Veradigm

Meghan West is an experienced Director of Financial Planning and Analysis with a demonstrated history of working in the Healthcare industry, specializing in Medicare Advantage and Quality Performance. She is highly skilled in Microsoft Excel, Customer Service, Managerial Finance, Strategic Planning, and Business Process Improvement.

George Witwer CEO

Cavo Health

George Witwer is the founder, Chairman, and Chief Executive Officer of Humanizing Technologies, Inc.  He launched the company in 2000, with the goal to bring new technologies for structuring unstructured data to market. In 2017, Witwer led the team that developed Cavo Health for auto-coding electronic medical records.  Today, Witwer continues to work closely with the company’s search science, search platform, and web interface teams to design new technologies and features for Cavo Health and other company products.

Michelle Zilisch Director, Product Management

Ciox Health

Michelle Zilisch serves as Director, Product Management at Ciox Health/Datavant. With more than 20 years in adult education training experience and 16 years healthcare, Michelle has led the training and implementations for provider and facility EMR/EHR systems, Health Information Exchanges, hospital time and attendance systems, capital purchasing/budgeting software, and Medicare Advantage, Medicaid and ACA Risk Adjustment and Quality software and services solutions for health plans. Her career in Risk Adjustment and Quality has focused on intervention identification, coding, submissions, and clinical documentation improvements through knowledge management, improving efficiencies, customer engagement, and compliance management. Michelle has a Master of Arts in Curriculum and Instruction: Educational Technology from University of Northern Iowa and enjoys spending her free time in the kitchen cooking and baking for family, friends, and colleagues.