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 7 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.
Vandna Pandita, MPH is the Vice President of HEDIS® Strategy and Analytics for the AmeriHealth Caritas Family of Companies [ACFC]. In her role, Vandna is leverages her experience in quality and risk adjustment operations to support members and providers as it relates to performance reporting and the member and provider experience. Her area of influence spans analytics, plan operations and digital integration of data and processes in the transition to interoperability.
Prior to AmeriHealth, Vandna has worked for several national health plans, including Aetna, several Blue Cross Blue Shield plans, the Blue Cross Blue Shield Association and Centene. She has successfully led several health plans through NCQA Accreditation, managed HEDIS® reporting, improvement and outreach, and helped develop and implement a successful provider profiling and performance measurement program. In addition to her health plan experience, Vandna managed Risk Adjustment Client Operations for Evolent Health, is a former certified HEDIS® Compliance Auditor and led project management and client solutions for a retrieval, abstraction/coding and analytics vendor supporting health plans and provider groups in their efforts to optimize revenue and improve quality within their populations.
Vandna attended the University of California at Berkeley as an undergraduate and received her Master’s in Public Health from the University of California at Los Angeles.
Vandna has moved from coast to coast, spending the better part of the last 25 years working on her southern drawl in Atlanta, Georgia. These days you can find her running the streets of Atlanta, cooking for friends or working on her newest hobby, making wobbly pottery.
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.
Courtney Breece has served as the Product Owner for the Analytics capabilities of the Inovalon ONE® Platform for 13 years. She drives Inovalon’s integrated approach to payer related analytics for both quality measurement and risk adjustment. Ms. Breece oversees the product management, technical development, and policy oversight of Converged Quality, the industry’s leading performance measurement reporting application. Prior to joining the Inovalon team in 2012, she acted as the Assistant Director of NCQA’s Measure Validation department and managed the Certified HEDIS® Compliance Audit (CHCA) Program.
In her roles at NCQA, she worked closely with auditors, health plans, and vendors to craft measure and audit policy. She served as NCQA’s Contract Director for CMS’ HEDIS® Medicare Reporting contract for the delivery of Medicare data used in CMS’ MA 5-Star Health Plan Ratings program.
Ms. Breece received her Bachelor's of Science degree in Healthcare Administration with a concentration in Public Policy from the University of Maryland.
Keileigh is a highly dedicated Quality Analyst at Hometown Health, located in the “biggest little city” of Reno, NV. With a fervent passion for healthcare consumer education, Keileigh believes in providing healthcare services with utmost dignity, ensuring that every individual receives the care they deserve.
In her current role, Keileigh serves as an internal consultant, extending her expertise to every department within the health system. Her primary responsibilities revolve around conducting comprehensive quantitative and qualitative analyses, enabling the organization to continuously improve its services and ensure top-notch quality care.
At the heart of her work lies a deep commitment to member engagement and education. Keileigh takes pride in coordinating and implementing effective programs to educate and empower members belonging to Commercial Large Group, Small Group, Individual & Family, and Medicare Advantage populations.
Keileigh's journey at Hometown Health has been characterized by diverse experiences across the organization. Before joining the Quality team, she actively contributed to various vital functions, including plan design, performance improvement, and managing the Appeals & Grievance teams. These experiences have endowed her with a comprehensive understanding of the healthcare system.
Paige holds a Master’s degree in English and Human Development. She has over 10 years of experience in healthcare management, specializing in Medicare strategy, population health, and value-based contracting.
Previously, Paige supported Accountable Care Organizations at Collaborative Health Systems and led Quality Improvement at WellCare Health Plans. She also managed provider education at BayCare Health System, advancing healthcare outcomes and operational efficiency.
In her free time, Paige enjoys spending time with her daughters and two dogs, traveling, hiking and doing yoga.
Liz Carr VP of Product Delivery & Customer Experience
Ingenia
As VP of Product Delivery and Customer Experience at Ingenia Health, Liz directs the account management, operations and support teams for new client implementations and production clients. Liz is a trusted advisor to health plan leaders on all things related to Quality organization and analytics. She enjoys taking creative yet pragmatic approaches to problem solving in order to deliver the most value to clients.
Liz began her career at MedVentive, a startup acquired by McKesson, and was on the product team for a Quality & Med Econ tool. She was a Certified Scaled Agile scrum master for the product development team and supported new client implementations. Liz made the transition to consulting, joining a boutique firm that focused on Quality and Risk Adjustment optimization for health plans. She led client accounts ranging from small Duals payers to national multi-state managed care organizations and worked with vendor partners to design new specialized software. Her projects ranged from new Quality tool implementations and multi-year HEDIS and STARS projects to organizational strategy consulting.
Liz has a BA in Neuroscience from Johns Hopkins University
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.
Tina Dueringer, BSN, RN, CCM, PCC, is the CEO and Principal Advisor at Dueringer Advisors Inc., a distinguished consulting firm dedicated to supporting health plans, vendors, and leaders in the health insurance and provider sectors. With a robust background spanning Medicare Advantage, Medicaid, Duals, ACA, and commercial markets, Tina brings extensive expertise in care management, utilization management, clinical quality, Model of Care development, Stars ratings, HEDIS measures, and accreditation standards such as NCQA and URAC.
Tina's career is marked by strategic insights into health plan operations, including strategic planning, joint ventures, partnerships, delegated relationships, and the advancement of value-based care models. She is deeply committed to advancing Health Equity, Population Health, and integrated care initiatives across the industry.
Previously, Tina served as Vice President of Clinical Quality and Stars at Rebellis Group, specializing in Medicare Advantage and government consulting. Her leadership journey includes pivotal roles at Cityblock, Blue Cross Blue Shield of Arizona, and the Wisconsin Department of Health Services, Medicaid Policy Division.
Tina earned her Bachelor of Science in Nursing and holds a post-graduate certification in Population Care Coordination from Duke University. She is also a Board-Certified Case Manager (CCM), underscoring her dedication to enhancing healthcare delivery and outcomes through comprehensive care coordination strategies.
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.
Mary Goble Director Clinical Quality and Performance Improvement
Capital Health Plan
Mary Goble, MSN, RN is the Director of Clinical Quality & Performance Improvement at Capital Health Plan (CHP) in Tallahassee, Florida. With over 30 years of experience in healthcare quality, Mary brings expertise in HEDIS, NCQA accreditation, quality improvement, and risk management. At CHP—a unique regional health plan that employs its own physicians in addition to a broad network of affiliated providers—Mary leads a cross-functional team focused on driving continuous improvement and achieving outstanding results in patient care and operational efficiency. Her commitment to excellence plays a vital role in enhancing the quality of healthcare services within the community.
Under her leadership, CHP has maintained its status as one of the highest-rated health plans in the nation, earning 4.5 out of 5 stars for both its Commercial and Medicare plans in NCQA’s 2023–2024 Health Insurance Plan Ratings. She also leads CHP’s Medicare Star ratings team, maintaining their 4.5 rating last year. She has also spearheaded provider education initiatives and data-driven campaigns that significantly improved HEDIS measure performance.
Mary regularly advises CHP’s executive leadership team on strategies that support both member satisfaction and performance improvement. She has spoken at healthcare quality forums and industry events for audiences focused on HEDIS rate improvement.
Savannah Gonsalves, RN, BSN, MHA is the Director of Quality for Hometown Health. Savannah specializes is regulatory quality programs, including MIPS, ACO, and HEDIS and has a passion for population health. She has an extensive background in clinical informatics as well and uses this to integrate quality into clinician workflows effectively and efficiently. In her role at Hometown Health, she oversees the Stars and Accreditation Programs. She enjoys hiking and camping with her family in the paradise that is Lake Tahoe.
“People who say it cannot be done should not interrupt those who are doing it” George Bernard Shaw.
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.
Sarah Hreyo Clinical Excellence Performance Manager
Novant Health Medical Group
In her role as Clinical Excellence Manager at Novant Health, Sarah designs and implements clinical quality improvement initiatives aimed at enhancing healthcare quality by reducing unwarranted clinical variations and addressing health inequities in the community. From addressing care gaps related to colorectal cancer screening to piloting novel approaches to address penicillin allergies in pediatric patients to brainstorming new and improved ways to share data with stakeholders, the work Sarah and her team takes on is diverse, engaging, and ever evolving!
Sarah holds a Bachelor of Arts in Liberal Arts with a Concentration in Public Health from Sarah Lawrence College and a Master of Applied Science in Patient Safety and Healthcare Quality from Johns Hopkins University Bloomberg School of Public Health. She is a Certified Professional in Healthcare Quality and holds several Lean certifications.
Outside of work, Sarah is passionate about fitness – if she looks familiar, you’ve probably seen her on screen at your local infrared fitness studio. She also loves to read and is on track to read over 100 books in 2025. If you have any book recommendations, let her know!
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.
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.
Dr. Ekaette Joseph-Isang is a subject matter expert in population health and value-based care with over 20 years combined experience in payor-provider strategy.
Her expertise cuts across population health, risk adjustment, healthcare quality, and healthcare innovation. Her specialty is in serving as a bridge between payers and providers and supporting organizations in getting their providers the tools, resources, and education that they need to stay competitive and efficient in the value based care space.
She is certified across multiple professional organizations in the risk adjustment, CDI, coding, and healthcare quality and is highly sought after for healthcare strategy and operations consulting.
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 Leiper Director, Performance & Risk Management, Government Quality
Highmark
Mike has been working at Highmark Blue Cross Blue Shield since 2003 in various technical, operational, and strategic roles. He has spent the last 5+ years with Highmark’s Government Quality department where he originally led a team of Medicare Advantage Star quality program managers but now oversees a small strategy team whose mission is to create remarkable health care experiences and outcomes in alignment with quality performance standards established by federal and state regulators for Medicare Advantage, ACA, and CHIP members. He and his team establish targets, manage performance, and partner with cross-functional program teams to influence Highmark’s Medicare Advantage Star & ACA Quality Rating System results across PA, NY, WV, and DE…leading to (1) high quality health care for our members, (2) satisfaction of gov’t regulator quality expectations, and (3) achievement of Highmark’s financial objectives.
He has a BS in Mathematics & Computer Science from Westminster College and MBA from University of Pittsburgh Katz School of Business…a non-traditional background for his current role. However, he has found his position aligns with his passion for applying use of data to solve problems via practical strategies that benefit vulnerable insurance member/patient populations while generating financial value that can be reinvested into those populations.
Outside of work he is actively involved in coaching and/or running recreational sports teams for his 3 boys, enjoying walks/campfires with his wife, or watching his favorite college/professional sports teams.
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.
Misty is an experienced Registered Nurse, licensed in all 50 states plus DC, with a robust background in nurse management, clinical operations, clinical strategy, telehealth, and clinical business development. As the Vice President of Clinical Business Development, she leads clinical service expansion for health plans and employers, working closely with cross-functional teams to translate client needs into measurable outcomes.
In this role, Misty is a key driver in strategic initiatives, overseeing new and expanded services, improving processes, and providing critical support for clinical activities and audits. Passionate about patient care and access to healthcare, Misty is dedicated to developing innovative solutions that empower individuals to achieve positive health outcomes and drive meaningful change in the healthcare industry.
Beau Muñoz, MD is a former Navy combat physician, battalion surgeon, published scientist, and patent holder in machine learning applications for ICU clinical decision support tools. He is a California native and a graduate of the University of Southern California with a degree in Economics. Upon completing his undergraduate degree, he was a recipient of the congressionally awarded Fulbright Fellowship which funded 2 years of full-time graduate work overseas. He graduated from Duke School of Medicine in 2010 and attended Harvard Medical School’s Massachusetts General Hospital General Surgery residency. In addition to multiple combat deployments and extensive international service, in 2018, Dr. Muñoz was the recipient of the Department of Defense Exchange of Scientists and Engineers Program (ESEP) award which supported a 1-year trauma surgery research fellowship at Queens Elizabeth Hospital in England. Prior to venturing out into the health-tech startup field, Dr. Muñoz was the Director of Operational Medicine for the US Naval Special Warfare Command (Navy Seal Teams) in Coronado, Ca. Dr. Muñoz has both a professional and academic interest in the application of machine learning technologies to clinical and population-based medicine. His works have been published in The Lancet and the journal Surgery.
Hallie Noecker is a partner at Whistleblower Partners. She brings cases in federal and state courts and before various agencies on behalf of clients reporting fraud spanning various industries, including healthcare, technology, and financial services.
Crystal Redfern Senior Director of Clinical Improvement
Novant Health Medical Group
In her role as Senior Director of Clinical Excellence at Novant Health, Crystal designs and implements clinical quality improvement initiatives aimed at enhancing healthcare quality by reducing unwarranted clinical variations and addressing health inequities in the community. She has led efforts to increase breast, colorectal, and cancer screening rates across all populations within the Novant Health footprint. Additionally, her team is responsible for developing organizational quality metrics and implementing process improvement plans across the Novant Health Medical Group.
Crystal began her career as a clinical laboratory scientist in a microbiology laboratory and has extensive experience in molecular genetics and bacteriology research. She holds a Bachelor of Science in Clinical Laboratory Science and Psychology from the University of North Carolina at Chapel Hill, a Master of Business Administration from Wake Forest University, and a Master of Science in Biomedical Sciences from Wake Forest University School of Medicine.
Outside of work, Crystal coaches a high school club volleyball team and regularly plays indoor and beach volleyball. She has also recently taken up gardening—outcomes to be determined.
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.
Dr. Jim Schultz has served as the Chief Medical Officer for Neighborhood Healthcare since 2001. Neighborhood Healthcare is an 30-site, 110,000 patient Federally Qualified Community Health Center providing comprehensive primary care, dental, behavioral health and PACE services to indigent patients of all ages in San Diego and Riverside Counties. Dr. Schultz is a Family Medicine specialist who splits time between active patient care and administrative duties. He sees patients in the office at Neighborhood Healthcare and until recently as a very part time hospitalist at Palomar Medical Center Escondido.
Dr. Schultz has been instrumental in growing clinic operations and improving patient access to specialty services. He led the move to an electronic health record and has led and helped implement robust quality and population health improvement systems.
Dr. Schultz also serves as the Medical Director for Project Access San Diego. He is Volunteer Clinical Professor for the UCSD Department of Family Medicine and Public Health and is the lead faculty for the Family Medicine Residency Outpatient Gynecology Rotation., and is a Volunteer Clinical Professor of Medicine f for the Western University of Health Sciences.
Dr. Schultz completed his family practice residency as Chief Resident at Tallahassee Memorial Regional Medical Center a very long time ago. He received his MD from the University of California, Los Angeles, and his MBA from California State University, San Marcos. He has been awarded the Diploma in Mountain Medicine and a Fellowship in the Academy of Wilderness Medicine. In his free time he can usually be found trail running, biking, or off somewhere teaching or doing wilderness and global medicine.
Reva Sheehan is the Senior Director of Customer Insights at mPulse, a company specializing in digital solutions for the healthcare industry.
With over 15 years of experience in health plan operations, Medicare quality, long-term care, and compound pharmacy management, Reva is dedicated to enhancing member experiences and outcomes.
In her role at mPulse, Reva focuses on leveraging data-driven insights to improve healthcare consumer experiences. She has been instrumental in developing strategies to navigate changes in Medicare Star Ratings and has shared her expertise through webinars and industry events.
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.
Kristine Sitson is a Sr. Data Healthcare Analyst at IHP, where she manages quality data and network initiative analysis and reporting. She is dedicated to improving healthcare quality by transforming data into decisions for actionable insight and optimization.
Kristine earned her BS in Psychobiology from the University of California, Los Angeles, and MPH with a concentration in Health Management and Policy from San Diego State University.
Jamee Sunga is a seasoned sales operations professional with more than a decade of Medicare experience. As Director of Product Operations, she leads the strategy, implementation, and operations of all Bloom onboarding products, helping to produce a better onboarding experience for Medicare health plan stakeholders and their members. Prior to joining Bloom, Jamee served as National Integration Manager for Centene Corporation, where she helped lead large-scale, nationwide initiatives for their Medicare Solutions business.
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.
He is part of the legal team pursuing a qui tam case against UnitedHealth Group alleging the nation’s largest Medicare Advantage Organization submitted false claims for payment to the Medicare Program by improperly inflating its members’ risk scores. Max also has experience analyzing complex data sets, developing damages models, and assisting with statistical analyses. He has also published numerous articles on issues of healthcare law, whistleblower programs, and environmental issues.
Max received his J.D. from Georgetown University Law Center. During law school, Max served as a research assistant on taxation to Professor John Brooks and as the Symposium Editor for the Journal of Law and Public Policy. Prior to law school, Max completed his undergraduate studies at the University of Illinois, where he was a member of the Mathematics Honors Society and graduated with a degree in Actuarial Science and a Minor in Business.
Max worked in State Farm’s actuarial science department and coached the debate team for a high school in Illinois, including one team that won the State Championship. He is fluent in Russian.
In his spare time, Max enjoys hiking, tennis, and is, unfortunately, a devoted fan of the Chicago Bears.
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.
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.
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.
