Su Bajaj Vice President of Product and Payer Solutions
Suhas built extensive solutions for payors, including ACOs, Medicaid, MA, and the ACA exchange. She uses technology to integrate Revenue Programs with Quality and Care Management while maintaining a dedication to adding value to the beneficiary's experience with the health plan through those solutions.Suhas aBachelors in Economicsfrom Northeastern University in Boston, MA and is a Six Sigma Yellow Belt.
Director, Strategic Initiatives and Quality Assurance
Allysceaeioun Britt Director, Strategic Initiatives and Quality Assurance
Tennessee Department of Health
Dr. Allysceaeioun D. Britt is the Director of Strategic Initiatives and Quality Assurance at the Tennessee Department of Health where she is responsible for the oversight and strategic alignment of Maternal Child Health and Chronic Disease programs to advance population health efforts. She has led innovative initiatives targeting TennCare (Medicaid) and CoverKids (SCHIP) which include the design and implementation of the TennCare (Medicaid) and CoverKids enrollment assistance program for pregnant eligible women within local rural and metropolitan health departments, the statewide expansion, integration and sustainability of an evidence-based smoking cessation program targeted for pregnant women and established an agency Maternity Collaborative to engage TennCare (Medicaid) Managed Care Organizations to improve engagement and care coordination of TennCare enrollees served through TDH public health programs.
Dr. Britt has more than 20 years of public health experience with research interest in public health and healthcare administration and policy for Medicaid populations, program development and evaluation, population health engagement with a focus on social determinants health and vaccine-preventable diseases. She also serves as an adjunct professor at Trevecca Nazarene University Skinner School of Business Education and Technology -Health Care Leadership Program.
When she is not working or teaching, she enjoys serving in her community and promoting health as an activity member of Lake Providence Missionary Baptist Church Health Ministry; member of Kappa Lambda Omega Chapter of Alpha Kappa Alpha Sorority, Incorporated Health Committee and an active member of the Music City (TN) Chapter of The Links, Incorporated Health and Human Services Facet.
She holds a Bachelor of Science in Biology from Florida State University, Masters of Public Health – Health Care Administration and Policy from University of Oklahoma Health Sciences Center and Doctorate in Public Health – Community Health from Walden University.
In her free time, she enjoys singing in her church choir, playing the piano and traveling with her family.
Executive Director, Disruptive Health Technology Institute (DHTI)
Tim has over 15 years of professional experience in health care operations and regulatory risk management. A strategic and forward-thinking business executive, Tim has a proven track record of success in risk adjustment operations, coding and documentation programs, regulatory compliance, and consulting and business advisory services. Throughout his career, Tim has demonstrated effectiveness as a leader with an ability to build and coach teams that deliver integrated and optimal results.
In his current role as National Vice President for DaVita Medical Group (DMG), Tim is responsible for the national strategy, development, and implementation of programs focused on comprehensive health assessment and quality, coding documentation improvement, and revenue accuracy. In this capacity, Tim is responsible for the oversight of six geographic markets and a growing national infrastructure, focused on DMG’s Medicare Advantage patient population.
Previously, Tim served as the Compliance Officer for DMG, Vice President of Compliance for DaVita Kidney Care, and was a management consultant with PricewaterhouseCoopers’ Health Care Practice
Stacy Coggeshall Vice President of Medicare Risk Adjustment
Stacy is the Vice President ofIoraHealth’s Medicare Risk Operations. Prior to joiningIora, she spent 5 years as the Director for Prospective Business Operations at Optum and was responsible for the Prospective Program updates, readiness and execution of products designed to assist providers in closing clinical and quality gaps in care for Medicare Advantage, Medicaid and Commercial Exchange members. Stacy has over 12 years’ experience serving in different roles within Medicare Advantage Risk Adjustment. She is also spent 4 years at the Centers for Medicare and Medicaid Services and was a registered nurse caring for liver and kidney transplant patients at Johns Hopkins Hospital. Stacy has received aBachelor’s of Sciencefrom Cornell University and a Bachelor of Science in Nursing, a Master’s of Science of Nursing and a Master’s of Business Administration from Johns Hopkins University.
Deb joined Paramount Healthcare in May 2013 and manages the Medicare, Medicaid, and Commercial Marketplace Risk Management Program. Additionally, she is a member of Paramount’s STARS/HEDIS/Medicaid P4P and FWA strategic teams. Prior to her position with Paramount she had 19 years’ experience working with the State of Ohio workers’ compensation program, both for the government and a contracted managed care organizations. She came to Paramount with extensive knowledge in medical coding, provider billing and education, Medicare payment methodologies, quality assurance, and regulatory compliance.
Deb graduated from the University of Toledo with a Bachelors of Science in Health Information Management and will graduate with her Masters of Business in Healthcare Systems Management from the University of Toledo in December 2015. She is an active member of the American Health Information Management Association (AHIMA) and is a Registered Health Information Administrator (RHIA), Certified Coding Specialist, physician based (CCS-P), and certified ICD-10 trainer through AHIMA.
Deb is blessed with one awesome husband of 24 years, three amazing children (one son-in-law), and one adorable grandson who all fill her life with a lot of joy, a little mischief, and a whole bunch of love.
Dr. Shannon I. Decker is the Executive Director of Risk Adjustment for NAMM California, Primecare, Part of OptumCare. Dr. Decker has more than 15 years of experience in healthcare, 11 of which include working with Risk Adjustment and Medicare. Dr. Decker has a PhD. in Interdisciplinary Studies, a dual MBA, one in Finance, the other in Marketing, as well as an M.Ed. in Secondary Education and a M.Ed. in Administration and Leadership. Dr. Decker is also an Associate Professor of Higher Education and Adult Learning (HEAL) and Chief Methodologist for Walden University where she chairs and oversees the dissertations of doctoral students. An author of two books as well as 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.
MHA, Senior Vice President and Chief Operating Officer
As Managing Director of Engagys, Kathleen brings the best of consumer marketing and data-driven methodologies to healthcare to motivate better health decisions. Engagys is a healthcare consultancy lasered focused on consumer engagement and experience. Prior to founding Engagys, Kathleen led the consumer engagement consulting practice for Silverlink for 12 years leveraging Silverlink's data repository of over a billion consumer health interactions, the best of behavioral economics and the latest in clinical research to help health plans and PBMs close the last mile of consumer engagement.
Kathleen is an award-winning, high energy, engagement expert with over twenty-five years of experience. She speaks regularly on the national stage on many topics including: driving consumer health engagement, creating better consumer experience in healthcare, motivating and inspiring consumers, and using data to drive consumer behavior. She has been recently named as a consultant to the first ever FDA Patient Engagement Advisory Committee (PEAC).
Kathleen is frequently quoted in both national and trade press. Her bylines have appeared in Executive Insights, Predictive Modeling News, and AHIP Smart Brief. She recently received two Stevie awards, Maverick of the Year, Silver 2015 and Innovator of the Year, Bronze, 2016, for highlighting the greatest challenges and opportunities for improving the lives of people who are afflicted with chronic conditions.
Kathleen spent the first twenty years of her career in brand marketing at leading consumer marketing organizations, including General Mills and P&G. Additionally, Kathleen was a Vice President at Digitas, one of the leading direct marketing firms in the country. She also spent many years in marketing at various consumer, technology and media companies throughout the Boston area. Kathleen has an undergraduate degree from the University of New Hampshire and an MBA from the Kellogg School at Northwestern.
Colleen Gianatasio Risk Adjustment Quality and Education Program Manager
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.
Renee Golderman Senior Vice President of Health Care Quality
Capital Districts Physicians’ Health Plan
Renée S. Golderman, MS, RN, NE-BC joined CDPHP in 2007 and currently serves as senior vice president of health care quality. In this role, she leads the design, implementation, and management of a quality improvement program focused on providing CDPHP members with efficient, cost-effective, and timely care. Renée also oversees credentialing and appeals. With more than 30 years of progressive experience in the health care industry, Renee is also responsible for directing HEDIS, NCQA, and Medicare Stars initiatives, which includes collaboration among Medicare risk, medical management, and network providers to drive innovative initiatives to improve quality outcomes and ensure member satisfaction with their health care. She has led health care transformation initiatives, including tools for population health and clinical integration strategies, and assists in design and operational aspects of primary care incentive programs.
Renee served as the director of nursing for Seton Health System, part of the Ascension Health System where she was a recipient of the NYSNA Nursing Excellence Award in Administration/Management. In addition, she held clinical management positions at New England Baptist Hospital in Boston, Mass., and New Britain General Hospital in New Britain, Conn. She also served as a clinical educator for The Eddy in Troy, N.Y. Renee earned a Bachelor of Science degree in nursing from SUNY Buffalo, and a Master of Science degree in health care management from Rensselaer Polytechnic Institute. Renée is an executive-board certified nurse by the American Nurses Credentialing Center (ANCC) and is a member of the New York Organization of Nurse Executives (NYONE).
Ms. Grossman is one of the nation’s foremost experts on Medicare Advantage, Medicaid, and Commercial physician engagement, risk adjustment, quality, HEDIS success strategies, and moving to value and risk reimbursement. She is a thought leader in healthcare business strategy and product development. Her expertise extends to provider enablement and engagement, HEDIS, STARS, QRS, analytic design, care impact, and best practices implementation. She has a wide variety of healthcare experience at organizations that include health plans, medical groups, Physician Hospital Organizations (PHOs), start-ups, integrated hospital systems, and the Institute of Health Professionals Education.
Ms. Grossman has held executive positions that encompass her areas of expertise which include: Hierarchical Condition Category (HCC) and Medicaid risk adjustment, network alignment and management, executive client relationship management, predictive and reimbursement modeling, MLR strategies and implementation, business development, strategic planning, building Centers of Excellence, acute and chronic care pathway creation, and product development and marketing for healthcare companies.
Before joining DataLink, she held executive roles with ArroHealth, Gorman Health Group, CenseoHealth, and Optum. Over the past fifteen years, Ms. Grossman has been a founding partner in three risk adjustment, quality, and cost of care reduction companies focusing on Medicare Advantage, ACA, and Medicaid. Prior to that, Ms. Grossman served as Health Net of Arizona’s Vice President of Network Strategy and Development, as well as serving in roles at Scottsdale PHO and Blue Cross Blue Shield of Arizona. She holds a Master of Science in healthcare planning from Florida State University.
Vice President of Managed Care and Commercial Risk Adjustment
Ana Handshuh Vice President of Managed Care and Commercial Risk Adjustment
Ultimate Health Plans
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.
Amy Nguyen Howell, MD, MBA FAAFP Chief Medical Officer
America’s Physician Groups
Dr. Amy Nguyen Howell is a practicing family practice physician at Cedars-Sinai Medical Network. She leads the clinical and educational programs as the Chief Medical Officer at America’s Physician Groups (APG) and supports the advocacy and leadership pillars of excellence at APG through legislative and networking events throughout the country. She serves a member of CMS’ Technical Expert Panel (TEP) for the MACRA Measurement Development Program for the Quality Payment Program (QPP) and on CMS’ TEP for the Medicare Advantage (MA) Star Ratings Program, and she is a leader on the Population Based Payment Workgroup, as part of the Healthcare Payment Learning and Action Network (LAN), recommending national guidelines for an effective population-based payment model. Dr. Nguyen actively serves on the Measures Application Partnership (MAP) Clinician Workgroup, providing input to the Coordinating Committee at the National Quality Forum (NQF) on matters related to the selection and coordination of measures for clinicians, particularly in the office setting. Additionally, she sits on the steering committee of the Core Quality Measures Collaborative and chairs the Patient Experience/ Patient Reported Outcomes (PROs) Core Measure Set Workgroup, while also participating on the ACO/PCMH and Pediatric Workgroups, setting national core measures for these specialties. Further, she contributes to the Population Health Management, Clinical Programs, and Patient-Centered Specialty Practice Advisory Committees at the National Committee for Quality Assurance (NCQA), which provides guidance on provider quality measures and requirements. By participating on these national committees, she offers guidance, structure and strategy around innovation, quality and technology to risk-based coordinated care delivery models, focusing on payment reform and integrated person-centric care. Also, Dr. Nguyen is an adjunct faculty member at University Southern California (USC) Sol Price School of Public Policy and teaches Quality of Care for the Master’s in health administration (MHA) program. She serves as member of the Steering Committee at the California Quality Collaborative (CQC) of the Pacific Business Group on Health (PBGH). Also, Dr. Nguyen serves as a member on the Steering Committee at the California Maternal Quality Care Collaborative (CMQCC) and is an active member of the Alternative Payment Model Infrastructure (APMI) Taskforce, part of Healthcare Information Management Systems Society (HIMSS). These national and regional committees provide structure for an innovative coordinated delivery model focused on payment reform and integrated person-centric care. She has most recently served as the Chief Medical Officer at Easy Choice Health Plan, a WellCare Company, where she oversaw clinical direction of medical services within appeals and grievances, care management, utilization management and quality improvement for 56,000 Medicare patients and 16,000 SNP members. Dr. Nguyen has extensive managed care experience overseeing revenue, quality and cost savings for over 500,000 lives in Commercial, Medicaid and Medicare lines of businesses with responsibility for profit/loss budget of over 700 million dollars. She has built strategic partnerships between medical groups, hospitals, external vendors and sales, especially in the areas of Advanced Illness Management, Care Coordination, Dual Eligibles, Quality Improvement and Practice Transformation.
Associate Vice President of Product Management & Strategy
William Kinsman Senior Manager of Product Innovations
William Kinsman, Senior Manager of Product Innovation, manages Inovalon’s Artificial Intelligence team and the implementation of their products. In his first year at Inovalon, Mr. Kinsman has made it his goal to bring clinicians and this technology together by leading the development of the advanced natural language processing algorithms presently in Inovalon’s product offerings. He collaborates with Professors and Doctorial candidates from the University of Maryland and the New Jersey Institute of Technology to bridge the gap in healthcare data extraction and develop never before seen approaches in patient-centric healthcare, with a focus on patient gap detection and intervention optimization.
Mr. Kinsman has over 6 years of experience in the construction of machine learning algorithms. Prior to joining Inovalon, he led the development of several novel language processing algorithms as a contractor at the National Security Agency, but also has previous work experience as a developer at a high frequency trading firm and as an engineer at NASA. He received his Bachelor’s degree from Clarkson University in mechanical engineering prior to years of research in electrical materials research at Penn State University.
John M. Kirk recently retired from a 16-year term as the founding CEO of Pioneer Medical Group, a multispecialty medical group in the Los Angeles area. He also served as CEO of Eagle Business Performance Services, a medical management company organized as a joint venture with the McKesson Corporation. He was a member of Board of Directors of the California Association of Physician Groups for over ten years, most recently serving as the Vice-Chair of its Public Policy Committee. After having been retired from Pioneer for fourteen months, he was called back to duty as CEO in June, 2018, due to the resignation of his successor. He “re-retired” ten months later.
His prior experience includes service as CEO of a four-hospital system in New Mexico, Medical Group CEO/COO responsibilities in San Diego and Fort Worth, Board membership in a private equity-funded hospital corporation, as the principal of a consulting firm, and in the private practice of law.
Kirk is a decorated veteran of the Vietnam War. He holds an AB from the Johns Hopkins University and a JD (cum laude) from the University of New Mexico.
Christina Lattrell Vice President of Quality Improvement
Christina has worked in the health care industry for many years teasing with different administrative functions of health care, allowing herself to make a modest but forceful impact. It all started in a small clinic in rural Minnesota. As the oldest daughter of a health system administrator and nurse she had the privilege of serving the small community in many ways, not realizing then that it was what she was destined to do.
She learned clinical process early on by pretending to check patients in after hours and adding postage to patient billings with the mail machine. She played in the secret racquetball rooms underneath the clinic and was forced annually to get her well‐child check‐ups and dental exams. She was not only an observer of health care policy and process but it was ingrained into her daily life.
She continues to mold herself into an accomplished strategic leader with the ability to transform the US healthcare delivery system through application of population based metrics; driving advanced quality outcomes while decreasing medical cost.
She has demonstrated much success in developing and implementing clinical quality metrics, achieving cost reductions, and improving satisfaction with both internal and external customers. Through her current education and practical experiences, she has acquired exceptional problem solving skills and a keen ability to aggressively identify opportunities, develop focus, and provide tactical business solutions.
The experience she has gained has provided her the needed skills to shape the health care delivery system of tomorrow, a delivery system that will be more cost effective while increasing the quality of care and transparency provided.
Her background and expertise is vast and includes experience in many areas from Claims, Configuration, and Payment Policy, Electronic Data Interchange (EDI) management, Call Center oversight, CMS Medicare Star Measure program development, Medicare Risk Adjustment program management and oversight to NCQA accreditation programs.
Donna Malone CPC, CRC, Senior Manager of Enterprise Risk Adjustment, HCC Coding and Quality Assurance
Tufts Health Plan
Donna has been on the job with the Tufts Health Plan in their senior products division since August 2014, and is responsible for audit and coding review management, development and implementation of department and vendor policies and procedures, simulation RADV Audits for preparedness, coding team performance management and provider education development and management. Additionally, Donna serves at the MassBay Community College in Framingham, where she has been an advisor / professor for nearly 10 years. Her specialty area is the Medical Coding Certificate and Medical Office Administration Program.
Prior to Tufts Health Plan, Donna worked for 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 Maine Medical Center.
Ms. Marta has been with Inovalon since 2008 and serves as the Senior Director of Quality.In this role, she is responsible for coding and abstraction oversight for all clinical review staff, and also oversees the Quality Clinical Review Team, which is responsible for performing client audits and monitoring quality oversight.
Ms. Marta began her career in the early 1990s in patient care and later hospital management in both Maternal/Child Health and Adult Critical Care.She has also held positions with Spacelabs Medical/General Electric as a Clinical Application Specialist and later as a Project Manager, and has provided utilization management training and coding education in the role of Corporate Clinical Trainer for a national health plan.
Ms. Marta maintains an active RN license from the state of Maryland and received her BSN from Georgetown University in Washington, DC.
J. Gabriel McGlamery J.D. Senior HCR 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.
Dave is a strong leader with 14+ years of experience in Revenue and Clinical Outcomes Program Development and Management in various healthcare environments (Plans, MG/IPA, Academic, and Consulting). Proven record of success in optimizing Operations, PE / Investor Meetings, Maintaining Compliance, Recovering / Maximizing Revenue, Enhancing Clinical Quality and Developing Software and Custom Analytics.
Specialties: RA / HCC, Pay for Performance (P4P), CMS Stars Program, NCQA HEDIS, Off‐shore Software Product Development, HOS, CAS, NCQA Accreditation, Physician Profiling, Encounter Programs, Contract and Claims Analytics.
Previously, Dave served as an independent consultant to healthplans, was Corporate VP, Operations (Revenue and Quality) at InnovaCare Health. He has also performed as Sr. Consultant, Risk Adjustment and Health Plan Operations for Dynamic Healthcare Systems, and in other roles with healthplans.
Creagh Milford, DO MPH, FACOI is a physician executive who serves as the Chief Medical Officer for Healthcare Highways, a healthcare innovation company based in Dallas, Texas. He has a passion for improving healthcare, specializing in population health management, healthcare informatics, analytics, and innovation.
Dr. Milford has held several C-suite positions. Recently, he served as the Chief Executive Officer of FullWell, a population health management services company, which was sold in 2017. Previously, Dr. Milford served as the system-wide division president of population health services of Mercy Health. He served as Assistant Chief Medical Information Officer for Massachusetts General Physician Organization (MGPO) and Massachusetts General Hospital (MGH), a Harvard teaching hospital. He also served as Associate Medical Director for Population Health Management at Partners Healthcare, a Boston-based health system founded by MGH and Brigham and Women’s Hospital.
Dr. Milford remains engaged in national health policy. He was nominated as a Fellow of the National Academies of Medicine, where he participated on the Board on Population Health. He has also held positions within the Centers for Medicare and Medicaid Services and the Department of Health and Human Services Office of the National Coordinator for Health IT, focusing on federal policy for value-based purchasing and health IT.
He earned his bachelor’s degree from the University of Colorado at Boulder and his D.O. degree from the Chicago College of Osteopathic Medicine at Midwestern University. Following a residency at the University of Chicago-North Shore and a fellowship in Health Management and Policy at Massachusetts General Hospital, he earned a master’s degree in Health Management and Policy from the Harvard School of Public Health, where he continues to serve as a guest lecturer.
Greg Pastor Managing Director of Risk Adjustment Operations
Greg Pastor is Managing Director of Risk Adjustment Operations for Advantasure. Under his leadership, 200+ risk adjustment professionals drive client execution, customer value, and optimize plan revenue through a suite of risk adjustment services such as retrospective medical record retrieval and review, the industry leading prospective Provider Engagement Coordination (PEC) program, in home assessment services, as well as analytic insights for clients.
Mr. Pastor had previous served as Advantasure’s Regional General Manager for the New York market where his team was responsible for driving value for three health plan clients via 41 field operations staff delivering prospective and retrospective Medicare Advantage solutions on behalf of 120,000 lives under management.
Prior to joining Advantasure in 2016, Mr. Pastor spent 19 years supporting value creation in a variety of roles at Aetna, Inc. As Director of Revenue Strategy for Aetna’s Medicare Business Segment Mr. Pastor’s team optimized program interventions that improved condition documentation generating $450M of incremental revenue and managing risk adjustment vendor model with $55M in annual spending. Mr. Pastor also held a variety of market and client facing roles in the US and UK driving advancements in the management of populations, resulting in improvements in the cost and quality of care.
Mr. Pastor has his Master of Public Policy Degree from The College of William & Mary as well as BA Degrees in Economics and Politic Science from the University of Colorado – Boulder.
FDNY Chief and Highest-Ranking Firefighter to Survive the World Trade Center Collapse
Richard Picciotto FDNY Chief and Highest-Ranking Firefighter to Survive the World Trade Center Collapse
Author of “Last Man Down”
The highest-ranking firefighter to survive the World Trade Center collapse, and the last fireman to escape the devastation, Richard "Pitch" Picciotto was on a stairwell between the sixth and seventh floors of the North Tower when it collapsed on September 11, 2001. An FDNY battalion commander, his is the harrowing true story of an American hero who thought nothing of himself and gave nearly everything for others during one of our nation's darkest hours.
Janine has been with UnitedHealthcare-Nevada since 2010 and has more than 15 years of experience in Quality and Performance Improvement. Currently Janine oversees the HEDIS Operations team for the UnitedHealthcare Nevada market. Her HEDIS tenure and subject matter expertise has helped grow a successful internal operations team that is directly responsible for improving HEDIS ratings in all lines of business. Janine has a strong background in analytics, technical specifications, MRRV activities and all aspects of NCQA submission requirements.
Janine is a strong-willed success driven professional, who possesses an exceptional determination to get the job done. When she is not at work, Janine enjoys spending time with her family, working out and running. She prides herself in her philanthropic work with the Leukemia & Lymphoma Society. Janine welcomes you to reach out to her via email@example.com or on LinkedIn.
Laura Sheriff, RN, MSN, CPC, CRC Regional Director, Risk Adjustment
Molina Healthcare, Inc.
Laura leads a dynamic Risk Adjustment Team, managing the day to day operations for Medicare and Marketplace members. She has a proven track record of maximizing risk scores. Laura designs and coordinates all team activities which focus on provider education, training, auditing, data mining, and data analysis to steer program success and achieve performance metrics. Laura is familiar with developing strategies for seeing high risk members utilizing technical dashboards, auditing processes, and working 1:1 with local vendors. Additionally she identifies end-to-end processes and prioritizes interventions to correct known weaknesses. Laura also provides support to corporate compliance efforts for RADV audits for both lines of business. She collaborates with business partners and develops best practices, and shares them with other health plans.
She has over 20 years of varied clinical nursing practice experience including more than ten years of Clinical Coding Certification practice. Laura is a Master’s prepared nurse, who also maintains her CPC and CRC through the AAPC.
Kathleen Stillo, MBA
President and Chief Operations Officer, Clinical Redesign Community & State,
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 ACA Risk Adjustment, brought all chart review activity in‐house saving 500K per year in vendor coding fees, and partnered with the hospital CDI/Quality Physicians to create an Outpatient CDI Department focused on documentation quality, Risk Adjustment activities and clinic training for 1,200 providers.
A proven leader in her field, Susan’s professional experience includes coding and compliance management, auditing and provider training, system management, and consulting services.
Josh Weisbrod currently serves as the Vice President – Risk Adjustment at Network Health in Menasha, WI. He brings over 20 years of health insurance, healthcare analytic and human service experience to Network Health. Josh specializes in government programs, health plan operations, risk adjustment and data analytics. Prior to his work at Network Health, he served as Director of Government Programs for a regional Wisconsin health plan serving the state’s Medicare, Medicaid and Marketplace participants. Josh previously served as the Director of Operations for the Wisconsin Health Insurance Risk-Sharing Plan (HIRSP), the state’s high-risk insurance plan. HIRSP also administered the federal high-risk insurance plan in Wisconsin prior to the implementation of the Affordable Care act. Josh has taught part-time at the college level for over 11 years and has extensive experience training health insurance and human service professionals.
For over ten years, MattWallaerthas been applying behavioral science to practical problems, from startup exits to the Fortune 500. and is currently the healthcare industry’s first Chief Behavioral Officer at Clover Health, a Medicare Advantage plan changing the model of insurance by changing behavior. He’s given hundreds of talks on the science of behavior change and is the author of Start at the End, which details how anyone can become a behavioral scientist by making behavior their outcome and science their process. His side projects consistently focus on the unrepresented, like GetRaised.com, which has helped underpaid women ask for and earn over $2.3B in salary increases.
Terry Ward is SVP of Solutions, where he leads the development of new payer-facing products. Prior toApixio, he served as VP of Product Management, Reporting and Analytics at Change Healthcare, and worked at UnitedHealth Group for 14 years, most recently as Vice President of Network Data Strategies
Senior Director of Quality & Value Based Care
University of Maryland Medical System & UM Quality Care Network
Karen Wilding Senior Director of Quality & Value Based Care
University of Maryland Medical System & UM Quality Care Network
Karen Marie Wilding is the corporate Senior Director of Quality & Value-based Care with the University of Maryland Medical System (UMMS).
Karen is responsible for driving value based care efforts across acute and ambulatory care settings from revenue cycle optimization thru integrated care coordination. She works with commercial and government payers; facilitating work streams that are a growing 100M+ in annual quality / payment portfolio for the system.
In addition to her system-wide responsibilities, she leads major operating divisions for both the University of Maryland Quality Care Network (UMQCN) and UM Transform Health MD (Care Transformation Organization), within the organization’s clinically integrated network. Karen’s team provides state-wide support to clinicians and healthcare entities in the areas of quality, practice transformation, risk adjustment, health IT, data & analytics and federal policy/programs. Collectively, they are supporting over 1B in care for the state of Maryland and over 100,000 patients. Karen serves as an affiliate compliance officer, ensuring the emerging population health programs have a robust compliance program wrapped around them.
She was previously the Director of Operations for the enterprise Information & Technology Department at UMMS and has worked in Health IT for over fourteen years for both small and large organizations. She has completed hundreds of implementations, adding to her experience within all aspects of healthcare technology.
Karen is soon ending her two-year term as President of Maryland Chapter of HIMSS. With over 2000 members, the current board has advanced programming beyond traditional educational sessions and now specializes in executive engagement as well as diversity in health IT. Over the last two years, vendor partnerships have doubled, allowing expansion of programming for one of the largest chapters in the country. She has been an active member since 2011.
In fall 2017, she achieved board certification as a Certified Healthcare Chief Information Officer (CHCIO) with the College of Healthcare Information Management Executives (CHIME). In spring 2018, she was inducted as a Fellow of the Health Information Management Systems Society (FHIMSS) for her continued leadership and dedication to the industry and community at large. Karen has held an adjunct faculty appointment with the Community College of Baltimore County (CCBC) in the Health Information Technology Program since 2010.
She attended The George Washington University in Washington D.C and holds a Master’s certificate in Value-based Care from The Johns Hopkins University and Normandale CC. She resides near Annapolis, with her husband and three children.