Michael Adelberg Principal

Faegre Drinker Consulting

Henry Archibong Associate Vice President, Innovation Solutions

Inovalon

Mr. Archibong serves as Associate Vice President of Innovation Solutions for Inovalon, leading product development and operations for the Company’s interoperability solution suite and efforts to expand Inovalon’s connectivity infrastructure.  

Mr. Archibong has nearly two decades of experience in healthcare IT. He began his career with Johnson & Johnson (J&J), where he successfully streamlined IT project execution and resource management across all 250 J&J operating companies globally.  

Mr. Archibong transitioned into healthcare when was tapped to join Cooper University Health Care, in Camden, NJ, as their Director of Enterprise Applications. There, he successfully led the system-wide implementation and adoption of the Epic Electronic Health Record (EHR) for the health system.  

He later joined Anne Arundel Medical Center (AAMC) in Annapolis, MD, as their Executive Director and Associate Chief Information Officer (ACIO). There he led several technology advancements for the health system, including the launch of a new Enterprise Resource Planning system, a Picture Archiving and Communication System (PACS), and deployment of Epic EHR across all of their ambulatory clinics. AAMC was recognized as one of the nation’s Most Connected Hospitals by U.S. News and World Report, as well as a HealthCare's Most Wired Hospital in 2015 and 2016 during his tenure as ACIO.  

Prior to joining Inovalon, Mr. Archibong served as the Vice President and Site Executive for University of Maryland Capital Region Health in Prince Georges County, MD.  

Edward Baker Of Counsel

Constantine Cannon LLP

John Barkley VP of Risk Adjustment

Connecticare/Emblem

John Barkley is the Vice President of Enterprise Risk Adjustment and Data Integrity for Emblem
and ConnectiCare. John has been with the enterprise for ten years leading ConnectiCare and now Enterprise Risk Adjustment function.
Prior to joining Emblem John was with Aetna for twenty-one years with the last six years in the risk adjustment space. John has been an attendee and presenter at RISE events for several years now. When not executing risk adjustment activities he enjoys kayaking, biking and fishing on Cape Cod, Massachusetts where he lives.

Dawn Carter Director, Product Strategy

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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.

Jessica Columbus AVP STARs & Risk Adjustment

Apex Health Solutions

Jessica Columbus, LVN, CCS-P, CRC, CPHQ is currently the Associate Vice President of Stars and Risk Adjustment for Apex Health Solutions. Her expertise in physician performance engagement and value based care best practices are built on a foundation of more than 15 years experience in managed care focusing on end to end health plan operations related to Risk Adjustment and the CMS STAR Rating Program.

She began her healthcare career in direct patient care as a Pediatric/NICU nurse and in 2005 took an opportunity at a managed care company in their Referral/Pre Cert Department where she was first exposed to quality and risk adjustment concepts. Once promoted into a leadership role that allowed her to own and create both risk adjustment and HEDIS programs from scratch she discovered those to be her true passion.

For 10 years her career has concentrated on innovative provider engagement strategies and implementing real world solutions that positively impact provider and contract performance. Her enterprise-wide physician education programs that aim to improve understanding of clinical documentation requirements have proven successful through accuracy of HCC recapture, increased year round closure of HEDIS gaps in care and strengthened positive health plan experiences among both providers and members.

Prior to joining Apex in August of 2020, Jessica worked at Universal American/WellCare for 5 years as the Sr. Director of Quality Improvement directly overseeing all quality improvement programs, HEDIS/STARs operations and prospective risk adjustment activities for their Texas and Louisiana markets. During her tenure at WellCare she was able to consistently deliver solid Star Ratings for all contracts under her responsibility, including achieving a 4.5 STAR in 2019 for their flagship MAPD plan in Texas. Jessica’s continued career journey is centered on improving clinical outcomes for patients through advancing provider and payer partnerships that will revolutionize value based care.

Jessica enjoys spending her free time traveling or binge watching new Netflix releases with her husband Brandon and their 3 daughters (Gabriella, Alexis and Jordan) in Houston Texas.

Laura Cooley, PhD Senior Director of Education and Outreach

Academy of Communication in Healthcare

Laura Cooley, PhD, humanizes healthcare through her contributions to education and outreach for The Academy of Communication in Healthcare. She serves as Editor-in-Chief for The Journal of Patient Experience, an open-access, indexed, SAGE publication, dedicated to presenting advances and applications that impact the patient and provider experience. Additionally, she holds a faculty appointment at Vanderbilt University School of Medicine where she contributes to the Center for Effective Health Communication. In her primary role with  ACH, Dr. Cooley leads strategic efforts to develop and deliver customized communication skills training programs designed to enhance patient experience in partnership with organizations such as: Stanford Healthcare, Yale New Haven Hospital, Northwell Health, Adventist Health, Texas Children's Hospital, Baylor Scott & White, & many more.  As a leader for The Academy of Communication in Healthcare for the past 8 years and recent editor of a book on the topic (Communication Rx: Transforming Healthcare Through Relationship-Centered Communication) Dr. Cooley is uniquely positioned to discuss the impact of technology on communication and relationships among patients and providers.  

Patrick Coulson Chief Growth Officer

Advantasure

Patrick Coulson has more than 25 years of experience leading healthcare sales, specializing in early-stage companies, new product launches and C-level new business sales. With expertise in Medicare Advantage, risk adjustment, technology services and member engagement, he has a record of enhancing start-up organizations – doubling revenue year-over-year, in many cases.

Prior to joining Emerging Markets as Advantasure’s Chief Growth Officer, Coulson served as Senior Vice President of Business Development for engagement services company Integra ServiceConnect. Within two years, Coulson helped triple the client base and double the annual revenue. He was previously Vice President of Sales for medical cost management company MedSolutions, where he was responsible for Medicare Advantage sales nationwide.

Sean Creighton Member

RISE Policy Committee

Shahyan Currimbhoy Senior Vice President of Products

Talix

Mr. Currimbhoy is an experienced healthcare executive and has led teams to create innovative product and services to drive growth. Mr. Currimbhoy is a seasoned product leader with experience in conceptualizing and launching new products to market and enhancing existing products. Prior to joining the Company, he was VP, Product Management at Healthline. Prior to that, Mr. Currimbhoy worked for Caradigm USA,LLC, Microsoft Corporation and Siemens Healthcare. He holds a master’s degree in Software Engineering from Carnegie Mellon and a bachelor’s degree in Computer Science from Cornell University.

Katy Davis, MBA, CPC, CPMA Director, Risk Adjustment Coding Quality and Compliance

Medical Mutual of Ohio

Dr. Shannon Decker, M.Ed., MBA, PhD. Vice President of Clinical Performance

Brown and Toland

Dr. Shannon Decker is Vice President of Clinical Performance at Brown and Toland where she leads a department responsible for Clinical Quality Documentation (Risk Adjustment); Clinical Quality, Patient Experience & Population Health; Clinical Compliance, including Appeals & Grievance; and Clinical Data Management, including Encounter Data Management. She also serves as Brown & Toland's COVID-19 Taskforce leader. Dr. Decker has more than 20 years of experience in healthcare--15 of which include working with risk adjustment 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, she consults in both the fields of healthcare and education. Her interests include the study of human behavior and how theories on motivation and learning may be brought to bear on population health management.

Eden Encarnacion, MHA Director of Quality and Star Programs

Clever Care Health Plan

Eden Encarnacion, MHA is the Director of Quality and Star Programs at Clever Care Health Plan. Prior to joining Clever Care HP, her work primarily focused on quality improvement for Commercial, Medi-Cal and Medicare lines of businesses for 2 MSO’s in CA. A few achievements include year-over-year awards from Integrated Health Association (IHA) AMP Program for Most Improved Medical Group (for 4 IPAs) and improving an IPA from a 3 star to a 4.5 Star Performance. Her experience spans not only in quality but also in the areas of risk adjustment, claims, encounter data submission and overall improvement focused on strategic development and implementation of Value Based Performance Programs. 

Emma Ericksen Emma Ericksen VP of Product

Signify Health

Emma Ericksen, VP of Product, leads strategy and product development for Signify Health’s Social Determinants of Health products including the Care Advocate Model, Specialized Home and Community Solutions and Community Networks. She joined Signify Health with 13 years of healthcare payer experience, first joining UnitedHealthcare where she spent a majority of her time focused within Community & State’s Medicaid population, in a variety of roles from member engagement, new business implementation, clinical technology and lastly within the Social Determinants of Health program myConnections, leading community engagement, program operations, and data and technology strategy. Following that, Emma joined WellCare in 2018, leading the enterprise wide SDoH program Community Connections, including a social care coordination team, local community engagement teams, pilot innovation leaders and a data and technology team. This role focused on both Medicaid and Medicare populations, with a goal of developing, executing, measuring, and scaling innovation programs to support enterprise priorities and quantitatively measure the impact of social interventions. 

Emma has a Master of Science in Applied Psychology, with a concentration in Industrial/Organizational Psychology and Program Evaluation. Emma resides in Minneapolis, Minnesota and in her free time enjoys traveling, spending time at her family cabin and trying new foods and restaurants. 

Dave Etling Senior Vice President & General Manager

InComm

Dave is a recognized visionary within the prepaid industry, having established first to market multi-billion dollar categories in retail, including InComm’s digital content and gaming vertical. He was InComm’s fortieth employee and has held various positions, including executive management, business development, sales, product development and merchant services. Dave uses his broad knowledge of InComm’s technologies and services to establish deep and mutually beneficial business relationships with our customers. He has been a key asset to InComm’s growth over the past 20 years in improving product partner acquisition and successful retail launches of products for major industry leaders such as Apple, Google, Facebook, Microsoft, and Sony. Dave was previously the general manager of the InComm InCentives division and now InComm Healthcare.  

Jonas Foit Senior Vice President, RQNC Analytics & Reporting

Cotiviti, Inc.

Jonas Foit has been developing and leading risk adjustment and quality analytics platforms and programs for over 15 years. He co-developed the first risk adjustment analytics platform to serve Payers and Providers and has since went on to lead industry-first programs in prospective risk adjustment, CMS 5-Star analytics, member and patient behavior data science, and value-based care. Jonas has worked for payers like Molina Healthcare and premiere vendors such as Inovalon, Ciox, and Pulse8. Jonas has a BS in computer information systems and a BA in management from Marietta College. 

Colleen Gianatasio

Mount Sinai Health Partners

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.

Wayne Gibson Senior Managing Director, Health Solutions

FTI Consulting

Wayne Gibson is a Senior Managing Director at FTI Consulting and is based in Washington, DC. He is part
pf the Health Solutions segment. He has 20 years of experience applying economic and financial
modeling, data‐intensive analysis, and complex claims analyses across numerous industries and in a
variety of operational, dispute and compliance matters.

He has assisted health plans, providers, pharmaceutical manufacturers and PBMs with in a variety of
matter types including operational improvement and compliance consulting, nationwide class‐action
litigation, Medicare and Medicaid false claims and sales and marketing investigations, investigations by
other government agencies, and arbitration matters. Significant types of matters Mr. Gibson has worked
on include:

Risk Adjustment Operational Improvement and Compliance Assessments – assisted Medicare Advantage
plans, ACA exchange‐based plans, trading partners/vendors, and providers under risk contracts in an
end to end assessment and redesign of work flows and data flows, policies and procedures, controls,
reporting and forecasting related to their Medicare Advantage and risk adjusted populations. Has also
performed reviews of systems and programming logic used to filter encounters to assess compliance
with Medicare Advantage and Managed Medicaid requirements. Has worked with clients to develop and
implement interim and ‘bridge’ applications that provided added functionality in managing populations
subject to risk adjustment. Has supported plans in RADV and other regulatory reviews. Has assisted in
contractual disputes regarding payments from health plans to provider groups under shared risk
agreements.

Medicare and Medicaid Investigations ‐ assisted a variety of clients including health plans,
pharmaceutical manufacturers, institutional providers, diagnostic lab testing companies, and their
outside counsel in responding to governmental investigations and in conducting internal investigations
related to Medicaid and Medicare false claims and fraud and abuse issues as well as how these issues
may impact statutory and SEC reporting. These investigations encompass issues such as reimbursement,
pricing, Medical Loss Ratios and cost reporting, and sales and marketing. As part of these investigations
has assisted clients and their counsel in discussions with the DOJ, OIG, state Medicaid and regulatory
agencies, and the SEC.

Compliance and Operational Reviews – assisted a variety of clients with compliance reviews related to
Medicare Advantage, Fee for Service Medicare and Medicaid programs. He has also performed other
contractually‐mandated reviews, and operational assessments of controls, data and information
systems, and relationships with third parties/sub‐contractors.

Litigation and Commercial Disputes (Healthcare and Other Industries) – assisted a variety of clients and
their outside counsel in defense of nationwide class‐action matters, federal and state court litigation,
international arbitration, and arbitration and mediation matters. Has developed and submitted expert
reports on damages in a number of forums and has testified in arbitrations.

Steve Goldberg, MD, MBA VP, Chief Health Officer, Medical Affairs & Diagnostic Services

Quest Diagnostics

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.

Erin Hatzikostas Founder

b Authentic Inc

Erin is an internationally-recognized leader on the impact of authenticity in the workplace. She is the founder of b Authentic inc, where she’s leading a movement to eradicate the workplace of its BS and make it a fundamentally more authentic place.
Erin is the best-selling author of You Do You(ish), a TEDx speaker, coach-sultant, and the co-host of an offbeat career and leadership podcast, b Cause with Erin & Nicole. 

Her talks have reached hundreds of thousands of people and her thought leadership has been featured on ABC, CBS and published in Business Insider, Fast Company, Well+Good, among several others.

Erin spent her career “first half” working in the corporate world, where at the age of 42, she became the CEO of a large healthcare financial institution. In just three years, she took a struggling company and led a massive turnaround, tripling earnings and sending employee engagement skyrocketing. Her secret? Radical authenticity.

Erin holds a BBA in Statistics from Western Michigan University and an MBA in Finance and Marketing from the University of Connecticut. She is married to her husband, Manny, who she met while stumbling through (and failing) an early career in the Actuarial field. They have two children - Ella (13) and Mick (10). In Erin's free time you can find her coaching basketball, running, skiing, drinking wine in her fat pants, or dancing wherever you're not supposed to dance.

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

Mike Jones Vice President & General Manager, Clinical Quality and Revenue Integrity

Nuance Communications

Paige Kilian, M.D. Chief Medical Officer

Inovalon

Dr. Kilian serves as the Chief Medical Officer (CMO) for Inovalon. In this role, Dr. Kilian is responsible for the oversight of the medical directors of the Company, the clinical content and design of the Company’s software and analytics, and the clinical training, quality, policies, oversight and compliance of associated operations. For more than a decade, Dr. Kilian has led a team of clinical personnel who bring the latest best practices and evidence-based clinical standards to Inovalon’s products and services. Dr. Kilian is well known throughout the healthcare community as an expert on the application of data, software, and analytics to the benefit of clinical protocols, care guidelines, real-world healthcare clinical workflow, and regulatory policy guidelines adherence. Most recently, Dr. Kilian has been recognized with the Healthcare Business Women’s Association 2020 Luminary award.

Prior to joining Inovalon in 2007, Dr. Kilian was in clinical practice with Johns Hopkins Community Physicians, where she served as Medical Director with responsibilities including patient care, clinical training of medical students and residents, and clinical oversight of a multispecialty practice.

Dr. Kilian graduated summa cum laude from Washington and Lee University and earned her doctorate in medicine from Tufts University School of Medicine. She completed her residency in Internal Medicine at The Johns Hopkins Hospital in Baltimore, Maryland.

John Linnehan Practice Director, Health Economics & Advanced Analytics

Avalere Health

John E. Linnehan leads a team of consultants, strategists, and data scientists focused on driving healthcare improvement through value demonstration, stakeholder engagement, predictive and applied analytics, and data innovations. 

His team of experts, extracting knowledge and insights from one of the largest US patient data sources, supports a diverse array of healthcare stakeholders including commercial, HEOR, medical, and public policy professionals at biopharmaceutical companies, device manufacturers, health plans, delivery networks, patient advocacy groups, and medical societies. 

John’s technical expertise is grounded in HEOR and using evidence-based medicine to achieve commercial aims and long-term strategic planning. He has a strong background in sales and new business development, and regularly advises healthcare executives on maximizing commercial and medical potential within a dynamic and complex healthcare ecosystem. An accomplished public speaker, he presents regularly at conferences, national meetings, and academic environments. 

Prior to joining Avalere, John served as a health economist at Oxford Outcomes (now part of ICON) and a research associate within the Health Economics practice at United BioSource Corporation (now Evidera). 

John holds an MPH from the Johns Hopkins Bloomberg School of Public Health, an MBA from the Johns Hopkins Carey Business School, and a BA in biology from the University of Pennsylvania. His research has been published in numerous peer-reviewed journals. 

Donna Malone, CPC, CRC, CRC-I, AHCCA, RAP Director Clinical Documentation and Quality Improvement (CDQI),

Mount Sinai Hospital System

Donna Malone, CPC, CRC, CRC-I, AHCCA, RAP: Director Ambulatory Clinical Documentation Quality Improvement (CDQI) with Mount Sinai Health System, Adjunct Professor with MassBay Community College, Chair of the RISE Risk Adjustment Academy HCC Coding Faculty Advisory Group and President of the Watertown AAPC Chapter

Previously, she worked for Tufts Health Plan in their enterprise risk adjustment division for seven years with as Director Enterprise Risk Adjustment Coding and Provider Education, and was responsible for audit and coding review management, development and implementation of department and vendor policies and procedures, development of provider and coding training materials, implementation of provider system education and process review, government audits (CMS RADV, HHS RADV, OIG), coding team performance management.

Additionally, Donna serves at the MassBay Community College in Framingham, where she has been an advisor and adjunct professor currently in her 17^th year. Her specialty area is the Medical Coding and Medical Office Administration Programs. Prior to Tufts Health Plan, Donna worked for ENJOIN as the Director of Ambulatory CDI – Risk Adjustment, Blue Cross Blue Shield of Massachusetts as an HCC Professional Audit III for four years. Earlier, she worked for AM B Care for 9 years and other healthcare settings previously. Donna also has served as Education Officer (2016) and President (2017 – current) for the AAPC chapter in Watertown, MA.

Donna speaks nationally for RISE, AAPC and AHIMA

Gabriel McGlamery Senior Health Care Policy Consultant 

Florida Blue Center for Health Policy

Gabriel McGlamery is in charge of Federal regulatory policy for Florida Blue’s individual market business. This means analyzing, influencing, and general problemsolving for the insurer covering roughly 10% of Marketplace enrollment. Prior to joining
Florida Blue in 2012, Gabriel helped develop the rules for the ACA at HHS and graduated with honors from the University of Connecticut School of Law.

David Meyer Member

RISE Policy Committee

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.

Frank Micciche Vice President, Public Policy and External Relations

NCQA

Frank Micciche is NCQA’s vice president of Public Policy and External Relations. In this position, he directs NCQA’s relations with Congress, federal agencies and the states, as well as NCQA’s work with employers, associations, corporate sponsors and the media.Micciche was formerly the Vice President for Partnerships and Coalitions at the Campaign to Fix the Debt, a nonpartisan collaboration of prominent public and private sector leaders and more than 350,000 grassroots supporters working to address the nation’s fiscal imbalance. Prior to this position, he was a Senior Advisor on health reform at McKenna, Long & Aldridge, LLP and worked for the New America Foundation think tank.Micciche’s service in the public sector includes his time as a legislative director for the House Minority Leader in Massachusetts and as a federal liaison for Governor John Engler of Michigan. He served for four years as the Director of State-Federal Relations for Governor Mitt Romney (R-MA), where he led the Commonwealth’s Washington, DC, office and advised the governor on federal policy issues, with a focus on health care reform.Micciche holds a master’s degree in public policy from the John F. Kennedy School of Government at Harvard University, and a bachelor’s degree in political science from Tufts University.

Donna Page Senior Director, Risk Adjustment Operations

Cigna

Donna Page has an extensive background and over two decades in healthcare consulting and management experience specifically related to government health plan programs such as Medicare Advantage, the Affordable Care Act and Medicaid.  Before joining Cigna as Senior Director of Risk Adjustment Operations, Donna served as Vice President of Product Delivery & Engagement with Pulse8, an advanced risk-adjustment revenue and quality analytics company.  Donna has over 10 years consulting experience serving in various capacities and spent more than 8 combined years with BlueCross BlueShield plans serving in such roles as Medicare Director of one of the largest employer group state health benefit plans and Executive of Enterprise Quality and Risk Management teams. 

 
Donna holds a bachelor’s in finance from the Terry College of Business at The University of Georgia.  She is certified in Emergency Management Training, holds a CRC certification, and is currently enrolled in the University of Pennsylvania, Wharton Business School’s Leadership Management program.

Beth Roberts President, Commercial Business

Point32Health

Beth-Ann Roberts takes a vision and makes it a reality through sound market-based strategy, with a focus on profitable growth.  Respected as a passionate, no-nonsense leader with a credible voice in decision making, she sees opportunities and works cross-functionally within the organization to develop and implement strategies that drive business advantage. She has a reputation for building a teamwork approach, breaking down barriers and eliminating silos.

As President of Commercial Business at Harvard Pilgrim Health Care/Tufts Health Plan — a $9.0 billion, non-profit health services company serving over two million members — Ms. Roberts oversees the five commercial markets.  With more than 30 years’ experience in the health care market, she specializes in identifying synergies, establishing internal partnerships, leveraging talent and leading a team of over 350 staff to identify the most promising opportunities within Massachusetts, New Hampshire, Connecticut, Rhode Island and Maine. The careful balance of understanding the external market—including the products and services that drive successful business growth—and, optimizing the company’s strengths delivers winning solutions to the market.

Previously, as Senior Vice President for Harvard Pilgrim Regional Markets, Ms. Roberts led market-based strategy for New England, with direct responsibility for growing New Hampshire.  Under her leadership, Harvard Pilgrim became the second-largest health plan in that state by entering new lines of business, forming unique partnerships and implementing a strategic approach to business development.

Ms. Roberts serves as Chair of the Board of Trustees for the RiverWoods Group and is a Board member of Benevera.  In addition, the New Hampshire Business Review recognized her as an Outstanding Woman in Business in 2008, and in 2015 Business New Hampshire named her one of the top intriguing women of NH.

Ms. Roberts graduated in 1991 from Southern NH University with a bachelor’s degree in Business Administration and in 2010 received her MBA from Boston University. 

Ms. Roberts and her husband Michael have two children, Branden and Bryanna.  She raised her family in Londonderry, New Hampshire, and now resides in Waltham, Massachusetts, where she enjoys spending time outdoors with her family, and an active lifestyle that includes cycling, running, hiking and boating.

Aria Sameni Vice President of Growth and Strategy

Optum

Laura Sheriff, RN, MSN, CPC, CRC

MSN with 10 years’ experience in Medicare, Medicaid, and Marketplace Managed Care with proven success in Risk Adjustment. Confirmed track record in operations, program management and process improvement. Demonstrates effective leadership, innovative problem solving techniques, and goal oriented focus to execute business objectives and meet performance expectations. Designed and coordinated all team activities including provider education, training, auditing, data mining, and data analysis to steer program success and achieve performance metrics.

Lisa Slattery Chief Strategy and Compliance Officer

Allymar Health Solution

Lisa Slattery serves as Chief Strategy and Compliance Officer for Allymar Health Solutions. With more than 25 years of executive leadership experience in health care operations, quality and compliance in hospitals, managed care plans and integrated delivery systems, she is excited to leverage her passion and expertise to support health plans and physician groups in driving optimal health and financial outcomes through data driven solutions.  

Before joining Allymar, she served as Vice President of Operations at National Committee for Quality Assurance (NCQA) focused on the growth and delivery of all NCQA Accreditation and Recognition programs. Her experience also includes her role as Vice President of Enterprise Quality at Blue Cross Blue Shield of Tennessee, directing corporate clinical strategy and improving star ratings across the commercial, Medicare, and Medicaid lines of business.  She has served as Chief Quality Officer of an integrated health system, Chief Quality and Compliance officer for a tech start up, and VP of Population Health and Quality for a community based 4.5 star plan.  

A clinician at heart, Slattery began her career as a physical therapist, and is a graduate of the University of Florida and North Carolina State University 

Jennifer Spear Associate Director of Population Health

Humana

Josh Stern Chief Revenue Officer

Vatica

Josh Stern has a successful track record of leading sales teams and driving consistent growth in healthcare organizations. As an executive with HMS Holdings for nearly a decade, he led client relationships, new business development and go-to-market strategies for all commercial business line product suites. He started his career in investment banking in New York. 

Anne Stowell Vice President Product Consumer Experience

Signify Health

Scott Stratton Chief Data Scientist, Business Development

Pulse8

Scott Stratton is an industry leader in the design and development of analytic products and technologies that demonstrably improve health care quality and financial results. Scott joined Pulse8 in 2013 and is the chief architect of Pulse8’s predictive models, clinical inferencing logic, and Dynamic Intervention Planning, for which two patents are pending.

Prior to Pulse8, Scott co-founded a company supporting pay-for-performance in invasive cardiology and one of the first global fee/bundled payment companies.  Before those, Scott had a key role with the first company to integrate all of a hospital’s quality-related functions (UM, QM, DRGs, Infection Control, Surgical Case Review, Credentialing).  ComputerWorld tapped his RationalIQTM Fortune 100 product at Medco as one of two finalists in Global Best Practice in Business Intelligence and Analytics.  His work on diabetes medication management won a URAC Six-Sigma award.  He co-designed/deployed Pfizer’s global system for managing Phase II-IV clinical trials that is still in use after 15 years.  The medical analytics function he built at Oxford was profiled by CIO magazine.  He is proudest, however, of building the first urban-focused Child Health Plus program for 2,000 disadvantaged children in the Bronx, a model for the federal SCHIP program, which also received the Creative Excellence Award from the International Foundation of Employee Benefit Plans.

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. 

Dr. Ian Tong Chief Medical Officer

Included Health

Ashley Tyrner Founder and CEO

Farmbox Brands

Ashley Tyrner is the founder and CEO of Farmbox Direct, FarmboxRx, and Harlow’s Harvest. Ashley has gone from being a single mom on food stamps to the CEO of a national brand that aims to reinvent the way the American healthcare system addresses the overwhelming number of chronic diet related diseases that plague our population today. With a clear conviction that all people should have access to healthy food, Ashley works tirelessly to disrupt the health and food policy space by making food as medicine accessible to all. 

Since 2019 FarmboxRx has been disrupting the healthcare industry. As an extension of the Farmbox Direct mission, FarmboxRx focuses on proactive wellness by delivering Food as Medicine (FaM) nationwide in partnership with Medicaid and Medicare programs. This division of Farmbox was created to partner with health insurance plans by offering members a box of fresh fruits and vegetables as a means to help combat the most prominent Social Determinant of Health (SDOH) –food. FarmboxRx is a first-of-its-kind nutrition program that makes healthy eating accessible to members and includes curated educational content with wellness tips from experts and easy recipes in every box! 

FarmboxRx is now available through participating Medicaid or Medicare programs as an Advantage Benefit, through Over the Counter (OTC) Network card benefits, or as a part of a plan's Healthy Food card benefit. Farmbox is dedicated to changing the way the healthcare system approaches member wellness and disease prevention by pioneering the food as medicine initiative across the country. 

Ashley’s third company Harlow’s Harvest, which was recently acquired by Farmbox Brands, is re-inventing nutrition and food education for young, curious chefs. Harlow’s Harvest is developing a series of educational cooking kits as hands-on learning tools for families, children, teens, and young adults to teach critical life skills and promote a lifelong love of nutrition and healthy eating for those eligible under the Children’s Health Insurance Program (CHIP) and Medicaid.  

Kristopher Volrath Vice President, Field Products and Solutions

Inovalon

Mr. Volrath serves as the Vice President, Field Products and Solutions, and is responsible for product revenue, design, strategy, and product execution across multiple product portfolios, including Quality Spectrum^®, Data Visualization and Reporting, and the Inovalon ONE^® Platform. In this role, Mr. Volrath and his team partner with clients to provide deep insights into quality measurement, drive quality improvement strategy and execution, deliver integrated member and provider engagement solutions, analyze and visualize information for rapid consumption, and achieve meaningful quality outcomes for Medicare Advantage, state-based Medicaid, and Commercial Health Insurance Exchange plans.

Mr. Volrath has more than 16 years of experience in fields of healthcare technology, commodities, financial services, software engineering, data analytics, enterprise architecture, and portfolio management, holding a variety of leadership positions responsible for product and technology strategy. Prior to joining Inovalon, Mr. Volrath worked for Constellation Energy, a leading national supplier of energy products and services, where he was responsible for multiple delivery groups leading complex program initiatives, executing upon mergers and acquisitions, and driving innovation. Mr. Volrath previously held positions focused on financial services and software engineering at Accenture and Legg Mason.

Mr. Volrath received his bachelor’s degree in Management Information Systems with a concentration in Finance from Salisbury University’s Perdue School of Business in Salisbury, Maryland.

Susan Waterman Trainer, Director, Risk Adjustment

Scott & White Health Plan

As Director of Risk Adjustment, Susan Waterman has been empowered to plan, design and oversee business and strategic objectives in creating and optimizing a Risk Adjustment Department responsible for ensuring the accuracy of risk adjustment payments while successfully managing all activities related to Medicare Advantage, ACA and Exchange 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.

Lesley Weir Chief Risk Adjustment and Quality Officer

ATRIO Health Plans

Lesley Weir, Chief Risk Adjustment and Quality Officer, has over 30 years’ experience in the Medicare Managed Care industry, with specific expertise in operations, risk adjustment and quality improvement. Lesley joined ATRIO in April 2021. She has a demonstrated track record of assisting health plans in meeting operational and revenue goals, as well as developing innovative strategies to improve member’s health and experience.  Prior to her leadership role at ATRIO, she held various leadership positions at multiple provider-owned Medicare Managed Care Health Plans and a large national plan.  She also spent six years working in the vendor space supporting Medicare Advantage plans across the country with their risk adjustment and quality programs.

Rebecca Welling AVP, Risk Adjustment and Coding

SelectHealth

Meghan West Sr. Solutions Manager, Collabor8

Pulse8

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.

Jay Wohlgemuth, MD CMO & Physician Executive

Quest Diagnostics

Jay G. Wohlgemuth, MD. is the Chief Medical Officer Senior Vice President,  that includes Research & Development and Medical Population Health 

Dr Wohlgemuth oversees research and development, medical, and employee health and wellness for Quest Diagnostics. He rejoined Quest in 2016 from HealthTap, a health information start-up, where he served as senior vice president and chief healthcare officer. Prior to that, he was senior vice president, R&D, medical and chief scientific officer with Quest. Dr Wohlgemuth originally joined Quest in 2009 from Genentech, where he was director, clinical diagnostics, ITGR (immunology, tissue growth and repair) and global development team leader for ocrelizumab. Dr Wohlgemuth was co-founder and chief medical officer for the molecular diagnostics company XDx. He earned a bachelor’s degree in biology from Harvard College and a medical degree from Stanford Medical School, where he also served a fellowship in cardiovascular medicine. 

Megan Zakrewsky Director of Product, Clinical Data Exchange

Pulse8

Megan Zakrewsky is a dedicated and driven product director with nearly 15 years of diversified healthcare technology experience. As a certified project manager (PMP), she has a proven record of execution from concept to completion while maintaining distinguished client relationships. Megan is passionate about clinical data exchange and has a wide array of experience with EHRs, clinical workflows, and the complexities facing health information exchange. Her most recent roles have given her experience in health plan and payer workflow to support risk adjustment, quality measures, and HEDIS initiatives.