Alexis Abramson, PhD is the global authority on Gen Z, Millennials, Gen X, Gen G and the Boomer consumer. She is an inspiring speaker, blogger, corporate consultant, successful author, and award-winning entrepreneur. Her commitment to multi-generations has been featured in many national publications, including TIME, Forbes, Wall Street Journal, Entrepreneur and People. Dr. Abramson is an Emmy and Gracie award-winning journalist who has appeared frequently as an on-air expert gerontologist for NBC’s Today show, CNN, CBS, FOX, MSNBC and numerous other media outlets. In addition to her own popular blog, Dr. Alexis is a featured contributor for many top tier websites. She is also highly-sought after as a keynote speaker at industry conferences. Abramson speaks to Fortune 100/500 corporations, consumers, government agencies, and non-profits bringing awareness of the intergenerational dynamic between four distinct generations. As a proven industry consultant, Dr. Abramson has worked closely with many major organizations, including L’Oreal Paris, COMCAST, Harvard, Kroger, Northwestern Mutual, Proctor & Gamble, Humana, AIG, Kimberly-Clark, Walmart, AARP and many more. She is the author of several highly-acclaimed books. Her next two books, Gen “G”: The Generation of Growth™ and Managing Your Multi-Generational Workforce will both be published in the Fall of 2019. Her dedication to multi-generations has won Dr. Abramson a number of professional accolades, including Working Woman Magazine’s General Entrepreneurial Excellence Award, Atlanta Small Business’ Person of the Year Award, 40 Under 40 Award, American Society of Aging’s Outstanding Business Award, and many others. Dr. Abramson received her Doctorate in Gerontology from the prestigious University of Southern California’s Davis School of Gerontology.
Su Bajaj, a seasoned executive in value-based healthcare, is the current Chief Technology Officer at Yuvo Health. Throughout her career, she has demonstrated leadership in steering technology solutions for MA and Medicaid health plans, ACOs, Provider Groups, and patients. At Episource LLC, she headed the development of a successful SaaS platform and a team to support it, driving significant growth. Her acumen in incorporating public healthcare policy into product features proved crucial at multiple organizations, including Family Health Network (a Medicaid Plan). She is a supporter of women-led start-ups. She lives in Houston, TX with her husband and three sons.
Ryan started consulting with Rex Wallace in July 2023. He has a Master’s degree in Public Health with a concentration in Epidemiology and Biostatistics. With 6 years of experience supporting Medicare Star Ratings, he possesses in depth knowledge of the program as a whole, as well as practical strategies that drive improvement at the measure level.
He previously worked at a multi-state 4 Star plan in both leadership and analytic roles. Ryan is passionate about leveraging data to inform decision making in support of vulnerable populations.
Julia Bietsch Chief Nursing Officer/SVP Clinical Operations Quality
Aetna
Julia Bietsch serves as the CVS Enterprise Chief Nursing Officer representing more than 16k nurses through the nurse council and various advocacy groups. She is also the Senior Vice President of Governmental Clinical Services where she is responsible for leading an organization of more than 6500 Care Management and Quality Operations colleagues delivering services to Medicare, Medicaid and Individual Family Plans populations as well as the Aetna Mental Wellbeing Strategy. In addition, Julia has been elected to the Johns Hopkins School of Nursing advisory board beginning in April 2024.
As a registered nurse, Julie spent over 40 years collaboratively building and managing innovative population health models across Aetna, Anthem, and United Health as well as Evolent Health and Common Spirit Health System. She has had the pleasure of leading Utilization Management, Case/Disease Management, Quality Assurance, Contract Negotiations and Provider Networks. She is a strong patient advocate, always working to enhance patient experience, outcomes and the ability to navigate safely through the complex health care system.
Julie received her RN Diploma from Jewish School of Nursing, Bachelor of Science in Nursing from Webster University and graduated from Johns Hopkins with a Master’s degree in Population Health Management.
Amy Blackledge Director of Clinical Quality Management
Blue Cross of Idaho
Amy Blackledge, MBA-HC, MSN, RN, CSSBB is the Director of Clinical Quality at Blue Cross of Idaho where she has oversight of HEDIS, NCQA accreditation, and quality improvement. Her previous experience includes leading quality reporting, population health, and value-based performance for large health systems. She has a passion for transformational work through collaboration, quality integration, and using data to drive improved outcomes.
Clinical Quality Manager for HEDIS at Wellmark Blue Cross & Blue Shield. Vast experience in clinical quality measurement, performance measurement, gap closure, and accreditation from both my experience at Wellmark and in the hospital/provider setting from my hospital and clinic experience. Experience coordinating HEDIS, QRS, CAHPS, and EES for three commercial and two exchange lines of business as well as monitoring results and Star ratings. Experience working closely with the HEDIS auditor and NCQA to manage the HEDIS and CAHPS portion of accreditation. Budgeting, RFP, and SOW experience with vendors required to accomplish all of the HEDIS and CAHPS work.
Excel in project management and leadership, budgeting, leading and implementing change to nursing practice and quality practice, quality improvement and patient follow up/customer satisfaction. Experience HCAHPS and Press Ganey analysis as well as staff involvement engagement in scores and creating an “Always” environment for our patients. Experience in both hospital and health plan accreditation standards and requirements. Very proficient in Microsoft Excel, data collection, and submission. Vast experience with several EMR’s and pulling data for PQRS, HEDIS, ACO, and MIPS measures.
Dave is a national leader in the healthcare industry and managed care organizations. His experience comprises a comprehensive blend of healthcare, quality, information technology and operations. He has been an executive leader at GE, GE Capital, Humana, and Anthem as well as several venture capital / private equity funded companies. While at Humana, he stood up and led their Stars Program which is widely recognized as best in class. Dave contributes to setting the national direction/policy for healthcare quality by being on NCQA's Standards Committee and a member of the Pharmacy Quality Alliance (PQA). Dave was inducted into the University of Kentucky's Hall of Distinction for his outstanding contributions in improving healthcare (given to less than 1% of alumni).
Dave currently serves as Senior Vice President - US for MedOrion Technologies, Inc.
Tim Buxton AVP - Risk Adjustment and Coding Services
Annova
Tim Buxton (MBA, CPC, CPC-I, CIC, COC, CRC, CCS, CHP) has been a certified medical coder since 2001 and a consultant and educator in the areas of Risk Adjustment, HEDIS/Quality programs, and SDOH for 15 years. He is currently the AVP for Risk Adjustment and Coding Services at Annova Solutions, a healthcare services organization focusing on medical record retrieval, review, and data extraction. Tim is a long-time RISE veteran, having spoken at over 20 conferences on a variety of subjects. He is an avid student of history and of lifelong learning.
Evelyn Chojnacki Senior 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.
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.
His background is in management and operational processes for 15 years and begun working in the Risk Adjustment arena 15+ years ago. Ryan has proven himself by helping Medical Groups and Health Plans to accurately improve their documentation with a solid track record of provider engagement. Ryan uses a unique blend of comedy, and deep risk adjustment knowledge to get buy-ins from providers to improve their documentation. His track record of results of improving documentation and thus improving revenue streams and patient care brings value to any group he works with. Having worked on the provider, payer, and now the vendor side Ryan is able to bring a unique perspective to the conversation and develop out of the box ideas to help any size group. In 2020 Ryan co-founded New Vision Healthcare Solutions to fill a niche in the market on providing provider education with data stemming from analytics, and provider chart data. Ryan is a Certified Risk Adjustment Coder (CRC) credential through the AAPC.
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.
Rhonda Farrar HEDIS & Quality Principal Program Manager
Advantmed
Rhonda is the Senior Manager of Data Analytics working with Elevate Quality Insights at Advantmed. Her clinical nursing experience includes critical care nursing in the ICU and ED, home health nursing, and Chronic Care Management. Recognizing the increasing frequency of ED and Home Health Care utilization by the same patients, Rhonda shifted to a healthcare quality focus. Rhonda has spent the last 8 years supporting patients, providers and health plans with significant experience in HEDIS and Quality Improvement. Rhonda’s health plan experience as the manager of HEDIS and Risk Adjustment departments on the payer side helps bring the clinical perspective to the technical needs of Quality. She joined the Advantmed team to use that experience to help clients balance clinical, clinical documentation, and data requirements to ultimately provide the best care possible for every patient. She is currently based in Marion County, FL and spends her free time with her husband, family, and their precious dogs Creek and River.
Jane Flaherty is the Head of Managed Care with a diverse portfolio of experience that demonstrates her HEDIS and Quality expertise and a solid track record of working with industry leaders. At two national health plans, she spearheaded quality improvement initiatives and streamlined efficiency in coordination with regional and national directors and with multiple shared services teams. Recognized for her cross-functional leadership in matrix organizations, she excels at identifying and mitigating risk factors, overcoming complex challenges, and shaping proactive organizational change. She excels at working with clients to improve HEDIS and overall quality goals. Jane’s extensive clinical background has required her to develop intimate knowledge of state and federal regulations.
Mike has spent the past 35 years studying the health care market and the health insurance industry in particular as a market researcher. As the VP of Analytics and Innovation at Press Ganey, he works directly with the Data Scientists and Research Analysts on a regular basis and consults with the Sales, Marketing and Product Development teams within PG. He also partners directly with many PG clients to address their most challenging analytical and research needs.
Mike’s expertise in questionnaire design, data collection methodologies, response rates, statistical modeling, conjoint analysis, market segmentation and other complex data analyses is put to use on a daily basis at Press Ganey. He creates special tools and insights for Press Ganey’s regulatory programs like oversampling recommendations for all CAHPS programs and the Health Outcomes Survey (HOS), helping clients interpret their Medicare Star Ratings and find improvement opportunities, participating in various presentations and webinars to communicate the latest market trends and research findings and diving into the extensive wealth of data managed by Press Ganey to develop new observations and address client concerns.
My name is Priscilla Franco, Pharmacy Supervisor at SCAN Health Plan. I graduated from NSU College of Pharmacy in South Florida, where I was first exposed to the inequities faced by the diverse (mostly senior) population there. I saw first-hand the value of bridging the gap in knowledge by educating patients in their native language and gained valuable experience working with the underserved. Years later I moved to California, where I got to continue my work with seniors, with a focus on Spanish-speakers. I currently lead a passionate team of pharmacists and care navigators who are relentless in their pursuit of equitable care for our members.
Katie Gries is the Manager, Quality Management at Blue Cross of Idaho. Katie has been with BCI for over 4 years where her team is responsible for HEDIS for all lines of business. Katie led the efforts at BCI which moved the organization from a 3.5 Star Rating in Star Year 2023 to 4.5 Stars in SY2024. Prior to her work at BCI, she spent 7 years at a Clinically Integrated Network where she was tasked with developing a program for quality and risk adjustment improvement. This work is where she discovered a passion for quality, risk adjustment and working collaboratively with Primary Care Providers (PCP). Katie holds a bachelor’s degree in Management and Organizational Leadership and a master’s degree in Healthcare Administration. She is also Certified Medical Practice Executive through the Medical Group Management Association.
Dr. Cynthia Griffin is Florida Blue’s Vice President of Medicare Pharmacy Programs. In this role, she is responsible for managing the Medicare pharmacy operations, developing, and integrating new clinical and operational functions in order to promote innovative and compliant programs, as well as transforming pharmacy programs to support changing health care models. She also manages the Pharmacy Benefit Manager (PBM) relationship for the Medicare line of business.
Griffin has been with Florida Blue since 2006 with over 35 years’ experience in health care. Her experience includes Pharmacy Director for the Duval County Health Department, Pharmacy Director for Humana’s Jacksonville Market, Clinical Assistant Professor for Florida A&M University, Associate Professor of Clinical Pharmacy at the University of Florida College of Pharmacy, Director of Pharmacist Managed Anticoagulation Clinic, and Director of Primary Care Residency Program.
Griffin has served on numerous boards and committees including the Downtown Development Authority for the City of Jacksonville, the State Medicaid Physician Prescribing Panel; the American Society of Health Systems Pharmacist Commission on Credentialing. She served on the Florida State Board of Pharmacy from 2009-2013 (Vice Chair 2011 and Chair 2012).
Griffin completed the Executive Leadership Program sponsored by America’s Health Insurance Plans (AHIP) in 2009, Leadership Jacksonville in 2011 and Leadership Florida 2016 (Class XXXIV). She is a 2009 inductee into the Florida A&M University College of Pharmacy Gallery of Distinction. She is a 2021 Gateway Girl Scout Council Woman of Distinction. She currently serves as a Board Member of Leadership Jacksonville.
She earned a Bachelor of Science degree in pharmacy and a Doctor of Pharmacy degree from Florida A&M University. She completed an Anticoagulation Traineeship program at the Medical College of Virginia and is a Fellow of the American Society of Health Systems Pharmacist.
She is a member of Alpha Kappa Alpha, Sorority, Inc. and the Bold City Links, Inc. She leads the Women’s Ministry at her church, Wayman Temple AME. She is also active member of the Women’s Missionary Society.
Griffin has been married to Rev. Dr. Mark Griffin, Sr. Pastor or Wayman Ministries, for 40 years. They have two daughters Dr. Whitney Bunion and Crystal Griffin. One son-in-love, Tony Bunion and two grands Marcus (13) and Maya (8) Bunion.
Nick Groch, is an accomplished professional with a robust background in clinical nutrition and product development. Holding a Bachelor of Science in Nutrition and Dietetics from Northern Illinois University and completing his dietetic internship at Indiana University, he has continually demonstrated his dedication to advancing the field of nutrition. With certifications as a Registered Dietitian Nutritionist (RDN) and Licensed Dietitian Nutritionist (LDN), he has excelled in various roles, including his current position as Product Manager-Clinical Nutrition at Medline, where he oversees multiple nutrition product categories, drives business development, and spearheaded the launch of the Medline Food Benefit Solution. Prior to this, he served in numerous clinical nutrition leadership roles, most recently as Director, Nutrition Systems at UChicago Medicine. Food as Medicine is a passion that first arose while he was clinical nutrition manager at a hospital in Chicago, caring for an underserved community. During that time, he sought and received multiple federal grant to implement a hospital based farmers market to improve local consumption of fruits and vegetable for food insecure individuals, with the ultimate goal of improving long-term healthy eating habits and health outcomes. Nick’s dedication to advancing clinical nutrition practices and improving patient care exemplifies his commitment to the field and his ongoing contributions to the healthcare industry.
Bryan Hall has been involved with HEDIS as part of a major benefits consulting firm, a health plan underwriting and data manager, a HEDIS programmer, an auditor, a troubleshooter for a HEDIS vendor, a project manager, and as a consultant.
As a HEDIS programmer, he twice helped a small, non-profit health plan make the U.S. News & World Report list of America's Best 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.
Adam leads the Payer Solutions team and brings extensive management and consulting experience to his role. He is passionate about improving our experiences navigating complex health decisions to ultimately improve the quality of life for members, patients and communities. He has carried this work out leading data-driven experience improvement initiatives to identify the moments that most impact both our perception and the outcomes of care. He has worked with large national payers, state and regional non-profits, provider sponsored health plans and directly with more than 75 health systems and independent provider organizations ranging from local specialty groups to large national and academic organizations throughout the United States.
In addition to leading a number of large-scale redesign projects requiring strategic planning, market analysis, and provider alignment, Adam has conducted assessments and overseen implementations focusing on quality, operational efficiency and growth planning; care management/coordination; and structural/governance improvement. He also has analyzed staffing, redesigned scheduling and coordinated transformational engagements for medical practice and ambulatory services; has extensive experience in vendor management and in standardization of SLAs; and has led a number of model-of-care redesign projects to improve key moments of the member/patient journey.
During his career, Adam worked for a full-service strategic health and science communications agency advising health systems, health plans, advocacy groups, and life sciences companies.
Sion Hughes has payer and provider experience with product and strategy. His experience includes building successful integrated delivery financial models, value-based payment program development, product development, and leading strategic efforts for growth of lives. Mr. Hughes has a proven track record of creating, improving, and expanding profitable Medicare Advantage products, Medicaid programs, and value-based payment models. His expertise centers around strategic thinking, increasing operating margins, and enhancing stakeholder experience. He is a subject matter expert in successful planning, contract negotiations, implementation, and growth of government products, as well as developing joint venture economic models. Mr. Hughes is the co-architect of Wakely Analytics Health Operations Optimization program, which helps to position payers and providers to be successful with managing risk.
Mr. Hughes earned his bachelor’s degree in business management from Cleary University.
Katharine is the President of Healthy People, an NCQA-licensed HEDIS audit firm and CMS Data Validation firm. She is a member of NCQA’s Audit Methodology Panel and NCQA’s HEDIS Data Collection Advisory Panel. Katharine has been a Certified HEDIS® Compliance Auditor since 1998 and has directed more than two thousand HEDIS audits.
Previously, as CEO of the company Acumetrics, Katharine provided consultancy services to NCQA which helped their initial development and eventual launch of the NCQA Measure Certification Program.
Katharine is a frequent speaker at HEDIS conferences, including NCQA’s most recent Healthcare Quality Congress. She is featured on an NCQA podcast, discussing the HEDIS Electronic Clinical Data System Measures: https://blog.ncqa.org/inside-h...
She received her BA from Columbia University and her MPH from UC Berkeley School of Public Health. She is a member of the National Association for Healthcare Quality and is published in the fields of healthcare and public health.
Ranarda Jones is a true entrepreneur with having over eight established businesses under her belt. She looks to find a need and then a solution that is implemented with consistency and exemplary customer service. Currently she is the Founder and CEO of the managed care consulting company, Pharmacy Synergistics dba PSyn, Inc. Dr. Jones has over two decades of pharmacy practice experience and is an expert in Medicare operations, compliance, and quality ratings. She graduated from the University of South Carolina earning a Doctor of Pharmacy degree in December 2003 and later pursued an MBA in Healthcare Administration from South University in 2008. Ranarda is proud of being the 2021 NASPA Excellence in Innovation Award recipient nominated through the SC Pharmacy Association and sponsored by Upsher-Smith Laboratories. She is also the 2024 University of South Carolina College of Pharmacy Outstanding Young Alumni Award. Ranarda is most proud of the work she does with mentoring pharmacy students and entrepreneurs. Dr. Jones has become a certified 10X business coach under Grant Cardone to help others scale and grow their business.
Amandeep Kaur is a distinguished healthcare leader renowned for her exceptional contributions to improving quality and revenue outcomes for health plans. Specializing in Medicare, Medicaid, and Managed Care, she is highly regarded for her expertise in leveraging data analytics to drive strategic recommendations. As a featured presenter at RISE Qualipalooza, Amandeep's insights are highly anticipated, offering unparalleled value for healthcare quality improvement. Her role as Director of Risk and Value Analytics at Health Data Decisions underscores her leadership and expertise in driving positive change. Attendees can expect an engaging presentation that delivers actionable insights for enhancing population management and provider outreach.
Jenn brings her deep understanding of the complexities and nuances within the Medicare Advantage & Value-Based Care landscape to their work at DUOS, where they lead business development, go-to-market strategy, and marketing. By leveraging data-driven insights and market intelligence, they spearhead the development of tailored products and services that cater to the unique needs of Medicare Advantage plans and deliver unparalleled value to clients and beneficiaries alike; previous leadership roles include FarmboxRx, Excelera Health, and NationsBenefits. Beyond her role at DUOS, Jenn actively contributes to the industry's progress as a thought leader leveraging expertise and advocacy for innovative healthcare practices to enhance healthcare accessibility and quality.
Mike Kester Executive Director Quality Performance Operations
Aetna
For the past 15+ years, Mike has focused on improving quality and clinical outcomes for the members he serves by seeking innovative solutions through collaborative partnerships within his organizations. He leverages rich data and insights to enable informed decision-making and create integrated, holistic care experiences to close gaps in care.
In his current role, his focus includes increasing health equity and long-term services across multiple lines of business, as well as delivering improved health outcomes across government programs. He is dedicated to achieving financial commitment by paying for value and optimizing quality programs, driving improved Star ratings, and exceeding quality performance incentives. During his leadership, Aetna achieved one of the highest HEDIS domain averages in the industry.
Mike completed a Master of Science in Organizational Leadership from Mount St. Joseph University and is certified through the Project Management Institute as a Project Management Professional (PMP).
Nick is the VP of Partnerships at Sprinter Health, where he leads sales/business development, account management, and strategy. Prior to joining Sprinter Health, Nick was on the Corporate Development team at Labcorp, where he led equity investments, licensing deals, and strategic partnerships. He has an MBA from Duke University and a BS in Chemical Engineering from the University of Virginia.
Asaf is the co-founder and CEO of Medorion with over 20 years of experience in computer science, software, and leadership of diverse multidisciplinary teams. Prior to Medorion, Asaf served as VP of R&D at CloudShare, a pioneering cloud computing company. He holds an M.Sc degree in computer science from the Weizmann Institute of Science and a B.Sc. in Mathematics from Tel Aviv University.
Dr. Ifedayo Kuye is Vice President & Medical Director of Quality and Population Health at SCAN, where he develops clinical programs to improve the quality of care and health outcomes of SCAN members. He previously was Medical Director of Value Based Care in the Johns Hopkins Office of Population Health. Ifedayo is a practicing internist. He received his undergraduate degree, medical and business degree from Harvard University. He completed his residency in internal medicine at the Brigham and Women’s Hospital where he served as a fellow at Harvard Medical School. His research has been published in New England Journal of Medicine, JAMA internal medicine and Annals of Internal Medicine
Elizabeth Lacouture VP, Population Health & Quality
Presbyterian Health Plan
Liz Lacouture serves as Vice President, Population Health and Quality of Presbyterian Health Plan (PHP), a subsidiary of Presbyterian Healthcare Services, a private, not-for-profit, integrated healthcare system in New Mexico and the state’s largest provider of healthcare. PHP is the largest private employer in New Mexico and provides approximately 640,000 members with commercial, Medicare Advantage and managed Medicaid plans.
Ms. Lacouture has been with PHP since 2012 and previously served as Vice President of Behavioral Health. She brings more than 30 years of experience in healthcare, with expertise in quality, operations and government programs.
She serves as an appointed member of the NM Medicaid Advisory Committee, the Overdose Prevention and Pain Management Advisory Council, and also represents Presbyterian on the Transformation Collaborative of the NM Primary Care Council.
Ms. Lacouture earned her bachelor’s degree in Psychology from New Mexico State University, and her Masters degree in Counseling from Eastern New Mexico University.
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.
Nate Lucena is the Chief Strategy & Analytics Officer for Rex Wallace Consulting, where he specializes in helping health plans achieve their Quality Improvement performance goals through data-driven and equity-focused strategies. He began his career spending over a decade in academic research, specializing in the neural bases of schizophrenia, brain aging, Alzheimer’s Disease and human cognition. Nate has been published in the Journal of Clinical and Experimental Neuropsychology and Frontiers in Integrative Neuroscience, and regularly presented research findings at industry conferences.
Nate shifted into a managed care career at Centene Corporation, where he built and led an Enterprise Quality Analytics and Data Science team specializing in data strategy, QI initiative outcomes studies, member-level predictive modeling of experience and clinical outcomes, and performance forecasting. Additionally, he was the key analytics lead in the development of an award-winning QI Health Equity Analysis Model, incorporating stratified reporting and advanced statistical modeling to help health plans identify health disparities and drivers in HEDIS and CAHPS. He went on to lead Ratings Improvement Strategy, National Vendor Management, and Quality RFP/Business Development for Medicare, Medicaid, and Marketplace lines of business.
Core to Nate’s work across the academic and corporate sectors is a deep commitment to creating diverse workplaces rooted in equity and inclusion through measurable action. His commitment is evidenced by leadership roles in the Washington University LGBT Advisory Board, co-creator and leader of the SafeZones training program for faculty and staff departments, co-Presidency of Centene’s cPRIDE employee inclusion group, and participation in numerous equity-focused community groups. This equity focus is the primary lens through which he helps managed care organizations bring disparity reduction to the forefront of their QI strategic focus.
Nate has Master’s degrees in Experimental Psychology and Cognitive Neuroscience/Aging from the College of William & Mary and Washington University in St. Louis.
Katie Martin (she/her) received her Masters of Healthcare Informatics from the University of San Diego. She is currently Vice President, Quality and Clinical Analytics with Baylor Scott & White Health Plan. Katie is passionate about developing integrated quality programs; collaborating with population health, wellness, care management, member engagement and analytics to drive improvement. Some of her achievements involve leading plans to achieving CMS 5 Stars, improved overall quality ratings, and focused programs to guide member engagement and satisfaction.
Marie has over twenty years of experience in the healthcare industry with in-depth knowledge on risk adjustment and quality improvement programs. She is passionate about working alongside healthcare leaders supporting the implementation of diabetes eye exam solutions specifically designed for health plans that enhance patient outcomes, improve access to care, lower total cost of care, and address SDOH for both health plans and providers.
Jessica Muratore has a master’s degree in public administration and bachelor’s degrees in political science and psychology. She spent the first half of her career in the legal field focused on civil litigation where she became skilled in the interpretation of federal and state laws before entering managed care. Currently, she is the Chief Operating Officer with Rex Wallace Consulting, LLC (RWC) focusing on quality improvement across all lines of business with both health plan and vendor clients. Before joining RWC, Jessica spent 10 years on the payer side. Jessica worked for MVP Health Care and Centene Corporation in executive leadership positions. She was responsible for national market performance and execution, governance, quality improvement organizational structure, NCQA health plan accreditation, delegation oversight, quality compliance and program operations, federal and state audits, quality improvement strategy, and quality Medicaid RFPs and new health plan implementations. She has extensive experience working with the Medicare, Medicaid, Marketplace, Commercial and the Basic Health Program populations. In 2014, she also started as an adjunct professor at SUNY Brockport’s Public Administration Master’s Program teaching classes on healthcare focusing on government programs, global health care systems and the Patient Protection and the Affordable Care Act. Jessica enjoys serving her community through board leadership positions and spending time with her husband and daughter, traveling, reading and being outdoors.
I am a dedicated and accomplished healthcare leader with a passion for driving quality of care and population health initiatives to new heights. I have a deep commitment to data driven decision making processes leading to impactful, accessible, equitable and high quality healthcare service to all. Driven by a passion for improving healthcare and innovation with a belief that healthcare is a fundamental right for all human beings.
Dr. Edo Paz attended medical school at Columbia University and completed his internal residency and cardiology fellowship at Columbia-New York Presbyterian Hospital. He later founded Heartbeat Health, a virtual-first cardiology care startup, and went on to work at K Health, an app-based primary care solution. Dr. Paz joined Hello Heart in early 2023, serving as Senior Vice President of Medical Affairs. In addition to his work at Hello Heart, Dr. Paz practices cardiology part-time at White Plains Hospital in White Plains, New York.
Amanda Rees is co-founder and CEO of Bold, a digital health company focused on disease prevention and healthy aging. Bold partners with Medicare plans and provider groups to offer older adults personalized and science-based exercise programs that prevent falls, reduce musculoskeletal pain and disability, and increase physical activity levels. Before Bold, Amanda worked in energy and environmental justice, managing the renewable energy portfolio at The 11th Hour Project, a program of The Schmidt Family Foundation. Prior to that, she was a Dalai Lama Fellow, and she has conducted research at Stanford, Princeton and UCLA. Amanda has a BSE in Chemical & Biological Engineering from Princeton University. She has been a fitness instructor for over a decade, teaching dance, yoga, indoor cycling, and community tai chi for fall prevention.
Josh is the President of Hyperlift, where he has been an integral part of the team since 2017. In his role, he oversees product development and implementation, while also managing customer relationships. With over 15 years of experience in technology leadership roles, Josh brings a developer's expertise to the company's strategic vision.
Heidi has deep expertise in helping health plans improve their Member Experience. Prior to joining RWC, she led the CAHPS and HOS national strategy for Cigna.
Amy Schuler is the HEDIS Process Manager at Devoted Health, Inc., working to build a lean, system-approach to the maturing HEDIS function in a fast-growing organization. Prior to Devoted Health, Inc. she was a proven leader in a hospital system both in Illinois and Missouri, leading quality, regulatory, patient experience and performance improvement teams. She has provided consulting services to Penn State Health to establish a foundation for a daily Operating System. Amy is a 1998 graduate of St. Louis University, where she earned a degree in Physical Therapy. Since then, she has obtained her MBA from Webster University and prides herself in using her Six Sigma and Lean mindset and skills to establish sustainable and standardized processes in complex work-streams, such as HEDIS.
Purvi Shah is an accomplished managed care leader with a diverse background in healthcare, blending clinical expertise with strategic management acumen. With a strong focus on enhancing Medicare Stars, Purvi excels in driving operational excellence and delivering well-rounded solutions across clinical, operational, and management program aspects.
As a physician by training, Purvi brings a unique perspective to her leadership role, allowing her to bridge the gap between clinical knowledge and administrative functions. Her ability to oversee multi-million-dollar portfolios with a keen eye on synergies in improving HEDIS, customer experience, provider engagement, and member engagement sets her apart in the industry.
Purvi Shah's expertise lies in her ability to leverage her clinical background, strategic vision, and leadership capabilities, to drive organizational success in the dynamic and evolving landscape of Medicare Stars. She is known for her proficiency in managing complex initiatives, building high-performing teams, and delivering measurable results that positively impact business performance and patient outcomes.
Purvi Shah holds a Master's in Health Administration from the Johns Hopkins Bloomberg School of Public Health.
Adam Simmen is the Vice President of Strategic Accounts at Everly Health Solutions, where he plays a pivotal role in shaping the future of healthcare quality. At Everly Health, Adam is responsible for the comprehensive management of client relationships, strategic planning, and ensuring customer success for the company's payer clientele. His leadership and vision are instrumental in driving innovation and delivering value-added solutions, tailored to meet the unique needs of each client.
With over 15 years of experience in the healthcare industry, Adam has consistently demonstrated his commitment to enhancing patient experiences and outcomes. He has successfully led teams to achieve significant growth and scalability, always prioritizing patients and his client's best interest. Adam's expertise and dedication make him a key contributor to advancing healthcare quality and fostering partnerships that benefit both clients and patients alike.
Jason Sloan
Vice President, Medicare Advantage Stars and Risk Programs
Jason Sloan Vice President, Medicare Advantage Stars and Risk Programs
BlueCross BlueShield of South Carolina
At BlueCross BlueShield of South Carolina Jason leads the strategic vision and implementation for Medicare Advantage quality improvement activities, risk adjustment procedures and value-based provider partnerships. Under Jason’s leadership the MA program has markedly increased quality outcomes by helping beneficiaries navigate the healthcare system and by establishing strong partnerships with local healthcare providers.
Jason has spent his career managing local and national Medicare Advantage quality programs along with experience in medical research and physical therapy health programs. He earned an MBA from the University of Notre Dame and a Masters in Biomedical Science from Midwestern University in Chicago. To stay well rounded Jason enjoys fishing with his kids and playing golf as often as possible.
For more than a decade, Melissa Smith has been at the forefront of leading Medicare Advantage and Star Ratings teams. As the founder of Newton Smith Group and a Senior Advisor to Oliver Wyman, Melissa is a widely recognized thought leader and healthcare strategist. Her proven track record of success lies in developing comprehensive enterprise-wide solutions that enhance Star Ratings, quality performance, health outcomes, and the overall member experience.
Melissa excels in crafting strategic and tactical solutions to meet client needs, forging productive partnerships across internal teams and external vendors, and improving performance on various quality measures. Her unique background in business, finance, regulatory compliance, and healthcare quality provides clients unparalleled access to healthcare strategy, quality performance, and revenue optimization.
As the former Chief Consulting Officer at Healthmine and Senior Vice President at Gorman Health Group, Melissa's leadership spans across prestigious organizations like Cigna-HealthSpring and Vanderbilt University Medical Center. Graduating from Purdue University, Melissa began her career at KPMG, LLP and is a Certified Public Accountant.
I started my career in healthcare in 2007, working in the mental health field, cardiothoracic intensive care then in the emergency department of a level 1 trauma center. In 2017 I left bedside nursing to work for Martins Point Health Care as a CDI nurse/HEDIS reviewer, then as the HEDIS Administrator in 2018. I live in Gorham Maine with my husband, two children, and dogs that keep me busy.
Elizabeth Strachota Benz Vice President of Quality and Clinical Integration
Network Health
Respected, results oriented senior executive with nearly 20 years industry experience. An employee and customer-centric leader who collaboratively executes strategic tactics.
Prior to Network Health, Elizabeth on Molina Healthcare of Wisconsin’s senior leadership team and as vice president of sales at Universal American.
Elizabeth has a B.S. in marketing and B.S. in international relations from Syracuse University. An avid runner and has a passion for health equity.
Derrick is a highly accomplished healthcare executive with a track record of over 20 years in entrepreneurship, specializing in developing top-tier risk adjustment, quality, SDoH (Social Determinants of Health), and eligibility and enrollment programs for health plans and hospital systems. Currently serving as the Senior Vice President of Business Development at Ingenia Health, he leads the company’s sales and business development efforts nationwide.
Prior to his role at Ingenia Health, Derrick held the position of Senior Vice President of Business Development at Centauri Health Solutions. During his tenure, he played a pivotal role in the creation and success of Centauri Advance, the company’s flagship SaaS platform. This achievement stemmed from Centauri Health Solutions’ acquisition of Tactical Management, Inc. (TMI), a risk adjustment firm that Derrick founded in 2005.
Derrick’s educational background comprises an undergraduate degree in Finance and Management Information Systems from Alfred University, followed by an MBA from the Crummer Graduate School of Business at Rollins College. His wealth of experience and expertise continue to drive innovation and growth in the healthcare industry.
Elissa Toder
VP Quality Improvement Strategy & Solutions, Product Development
Elissa Toder VP Quality Improvement Strategy & Solutions, Product Development
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.
Mick Twomey is the founding Chief Operating Officer (COO) and current Chief Executive Officer, (CEO) of Hyperlift Logic, Inc. Coming from a management consulting background, Mick set his vision on redefining how plans approach Stars optimization. Out of that was bornStars Monitor, Hyperlift's SaaS technology platform.
Crafted by Stars professionals for their peers,Stars Monitoris the industry's leading Stars analytics solution that gives Stars teams time back while redefining how plans approach Stars optimization. Mick's dedication to creating a scalable and universally applicable model has helped establish Hyperlift's innovation-driven approach into a trusted partner in the healthcare sector.
Through a combination of leading-edge technology, Stars experts, and a year-round engagement framework, Hyperlift propels healthcare plans of all magnitudes to elevate their Stars performance management. Mick's leadership catalyzes these solutions, enabling healthcare plans to embark on a transformative Stars management journey that outperforms conventional performance management.
Rex Wallace is the founder and principal of Rex Wallace Consulting, LLC, a firm that specializes in improving Star Ratings for Medicare Advantage health plans. Rex assesses plans and guides them in the development and implementation of-leading strategies to drive material Quality Improvement. Since its inception in 2017, RWC has helped multiple Medicare Advantage contracts achieve significant improvements in Star Ratings, including single-year full-Star improvements. Prior to launching RWC, Rex spent twenty-three years in strategic healthcare roles, with a strong focus on Medicare Advantage. Most recently, he led Stars for a large, multi-state plan that consistently achieved 4 and 4.5 Stars across its multiple contracts.
Mary Walter
Principal, Quality and Accreditation Practice Group
Mary Walter Principal, Quality and Accreditation Practice Group
HMA
Mary Walter is a senior executive consultant with over 30+years in the healthcare industry. Specializing in quality and optimization, she provides high performing clinical, business, and financial strategies to support growth and profitability across all levels of health plan operations and its organization.
Ms. Walter currently serves in a Principal role who advise clients on quality improvement and business performance in operations, profitability, structure, and strategy. She aids in the advancement of project management and business development initiatives, collaborating closely with other executive and senior leaders as well as peers and colleagues in her current role.
Before joining HMA, Ms. Walter founded and served as president of Healthcare & Integration Solutions, LLC. with 25 years in the Managed Care Space responsible for all lines of business in Medicaid, Medicare, Marketplace and Commercial. Her extensive expertise in quality strategy and execution including successfully passing state Medicaid audits and attaining top scores in Performance Improvement Projects, winning state-wide RFPs, optimizing clinical and HEDIS measures that include Adult/Child Core/Universal set, including favorable outcomes via value based purchasing program results, achieving near perfect or perfect NCQA Accreditation scores, including 4-5 CMS Medicare Star rating performance, exceeding goals in risk adjustment scores and revenue. In addition, she has ensured state and regulatory requirements with compliance, including safe-guarding membership via patient safety and quality initiatives by promoting provider and community-based partnerships with adhering to gold standards of care and best practices. She supplied insight on strengthening key performance indicators and fiscal operations via profit and loss margins as well as improving marketing and sales, product development and market expansion efforts.
Prior to this, she served as the vice president of clinical quality at Cigna Medicare. She oversaw the US Enterprise Quality Program. She led the strategy, execution, and growth of the clinical quality team, where she elevated person-centered population health management strategy, innovation, and quality compliance oversight. Her leadership resulted in a CMS All Star nomination for her achievement of contributing to fully passing the CMS audit. She and her enterprise quality team supported the improvement of Star rating ranging from 4-5 Stars, moved the risk management program to fully passing the State audit and raised the NCQA accreditation scores from 86 percent to 98 percent. She has served the Utah market for well over 12 years and has prior legacy experience with the key Managed Care Organization across the State of Utah. She deeply understands the health care delivery systems across the state regarding the challenges, opportunities, and successes of the current health care delivery systems, including the community base organizations and State agencies as well.
Ms. Walter earned her bachelor’s degree in physical education with an emphasis of exercise physiology and minor in health from Iowa State University. She earned three-year diploma practical nursing degree from the Iowa Methodist School of Nursing. he is a registered nurse with a critical care and cardiology background. She earned her Improvement Advisor certification via Kaiser Permanente Process Improvement Institute that included training in lean six sigma/process improvement.
Daniel Weaver recently became the Senior Vice President of Stars and Quality at Zing Health. With over 25 years of experience in Operations and Star Ratings strategy, Daniel has previously served as VP, Government Quality Programs at Gateway Health and Director of Stars Programs at Highmark Health, helping both organizations achieve and maintain their first 4.5 Star Ratings. In his career, Dan has overseen the development and implementation of many analytics-driven and customer-focused programs, and he advocates for continuous improvement and operational excellence philosophies for sustained success. In his new role with Zing Health, Daniel will focus on implementing a high-performing Stars infrastructure to support the organization’s rapid growth with a focus on servicing special needs members in several states.
Andy received his Doctor of Pharmacy from the University of Minnesota School of Pharmacy-Twin Cities College of Pharmacy and his MBA from Lakeland University. After graduation, he was a retail pharmacy manager at a national chain for 11 years. During this time, he also worked with various companies in workers’ compensation case reviews/consultations, long-term care and Medication Therapy Management (MTM).
Andy is a licensed pharmacist with 22+ years of experience in the pharmacy industry, with nearly 8 years at Network Health. His current role focuses on Medicare BID, Medicare compliance, custom formulary management, Medicare Part C and Part D Stars/Quality Initiatives and medical drug management programs.
Stephen Winn is the Senior Director for Quality at the Mid-Atlantic Permanente Medical Group, a large multi-specialty medical group based in the Mid-Atlantic, and oversees Quality Program reporting, including HEDIS. With more than a decade of experience, he focuses on building programs, systems, and workflows that promote the delivery of high-quality care and accurate reporting.
Prior to working in Healthcare, he was an International Economist at the U.S. Department of Treasury.
Kate Wormington, Director Solutions Management, joined Veradigm in January of 2023 leading the Quality Analytics solutions. For the past 20 years, Kate has focused on HEDIS and quality reporting for both payers and providers. Kate spent close to 10 years managing complex operations of a quality analytics program supporting HEDIS, CMS Star, IHA AMP, QARR, QRS, and Medicaid State measurement sets for innovative healthcare organizations. She joins us with deep experience as a result of leading a multi-state Client Success Support and Implementation team, supporting 27 clients across 3 products. Additionally, Kate has led an NCQA Data Aggregator Validation (DAV) project team through Cohort 2, and was in the middle of Cohort 4, providing targeted HEDIS standard supplemental data using C-CDA files. Kate began as a software engineer specializing in software quality, with a Masters degree in IT. She embraced the business side, utilizing product, project and client management skills. Kate lives in Denver, Colorado, originally from the UK, starting her career in healthcare working for the National Health Service.
