Dr. Douglas Allen, MD., MMM
Wynda Clayton, MS, RHIT
Julia Friedman, FSA, MAAA
Kimberly L. Geidel, BS, MPM, CPC
Kevin M. Healy
Nikki Hungate, MS, MHA
Eric C. Makhni, MD, MBA
Henry W. Osowski
Ellen Rudy, PhD
Adele Towers, MD MPH FACP CRC
Mary Yeh, FSA, MAAA
Ivan Yen, ASA, CERA, MAAA
Dr. Douglas Allen, MD., MMM
Beginning is career as an internist, after five years of clinical work he transitioned to administration. He now has over 24 years experience in healthcare administration. He has held CMO, VP and SVP positions with medical groups and IPAs as well as four health plans. Some of the organizations he has work with include CareMore, HealthCare Partners, Heritage Provider Network, Greater Newport Physicians and as the first national CMO for Optum’s medical group. He has also work with the health plans, including Molina, PacifiCare and Blue Shield of California.
Dr. Allen has developed a broad skillset over his career, but has particularly deep subject matter expertise in the areas of the California delegated model, Medicare Advantage, risk adjustment, STAR quality improvement, utilization management and information technology.
Prior to joining ATRIO Health Plans, Jessica served as the Senior Director over the Star Ratings consulting divisions for Gorman Health Group and HealthScape Advisors. Jessica is an accomplished nurse with over twenty years of diverse experience and achievement in managed care, quality improvement and clinical operations. She has strong Medicare, Medicaid, Marketplace, and dual eligible programs knowledge. Jessica is also an experienced national conference presenter on the topics of heath care quality improvement and Medicare Star Ratings. She brings over ten years of managed care experience including delegated case management oversight and quality ratings program leadership, in addition to her years of nursing experience in the states of MN, IN and NY, primarily focused on geriatric, disabled and dual-eligible populations.
Founded in 1982, Network Health offers customized commercial and Medicare health insurance services to employers, individuals and families in more than 23 counties throughout Wisconsin. Through its strong reputation for quality health care coverage and superior customer service, Network Health has grown to serve more than 120,000 members. Learn more at networkhealth.com.
Wynda Clayton, MS, RHIT
Wynda Clayton is a Risk Adjustment Manager at Providence Health Plans in Beaverton, OR. She received her Health Information Degree from College of Saint Mary’s, her BS in Health Care Management from Bellevue University and her MS from Clarkson College. Wynda has been in the health care field for over 25 years with experience on all phases from compliance to billing and reimbursement to coding to Quality Assurance to being a RADV Auditor to risk adjustment and providing physician education. Wynda is very enthusiastic and loves basketball, traveling and helping those unfortunate. To help is not always meaning to give, but it also means to teach others how to make a difference in their lives. Currently Wynda resides in Portland, OR with her husband Kevin. She can be contacted at [email protected]
For over a decade, Lauren Easton, LICSW, has served as a Behavioral Health leader for Commonwealth Care Alliance (CCA). Over the years and in various roles, Lauren has been largely responsible for developing CCA's behavioral health integration across its care models, for creating a responsive network, and for creating many innovative programs, including CCA’s Crisis Stabilization Units. Lauren embraced the integration of behavioral health and medical care long before the concept became "trendy." She has made behavioral health integration a hallmark of program development throughout her professional life.
In her current role, Lauren is responsible for the oversight of CCA's behavioral health services, delivered through its network of behavioral health providers and internal behavioral health specialists to CCA's 22,000+ members. She is responsible for assisting clinical leadership in improving the level of integration of Primary Care and behavioral health services for CCA members and for guiding network development, cost management, and quality improvement activities. She oversees the Behavioral Health development and expansion of the One Care program and Senior Care Option Program, paying particular attention to the significant mental health needs of this population.
Lauren holds a master's degree from Simmons College School of Social Work. She also attended Boston University and the University of Massachusetts, where she completed a double Major in psychology and education.
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 accreditation, 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 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.
Mark is the Vice President of Service Innovation at SCAN Health Plan, one of the nation's largest and fastest growing not-for-profit Medicare Advantage plans. SCAN has earned a 4.5-star rating from the Centers for Medicare and Medicaid Services (CMS) for the six consecutive years.
Mark lead’s SCAN’s efforts to improve and innovate on SCAN’s industry leading service model with a focus on service experience, scalability, and retention. Mark has been at SCAN for 6+ years and has a passion for keeping older adults healthy and independent. Prior to SCAN, Mark was a Director at PwC’s healthcare practice and spent 8 years in consulting. Mark is a double Bruin receiving his MBA from the UCLA Anderson School of Management and his undergraduate economics degree from UCLA.
Andy provides strategic focus to healthAlign, ensuring that the work of the team is properly aligned with the goals of payers, patients and caregivers. He brings over 20 years of healthcare experience to the job. As Senior Vice President of Strategic Solutions at Maxim Healthcare Services, Andy oversaw the company’s nationwide Business Development across strategic accounts as well as program implementation and management for large-scale strategic engagements. His work driving the Product Development function there brought about a Community Based Care Management offering that has been shown to reduce readmissions by over 65% while also driving a 35% reduction in in-patient spending.
Andy came to Maxim from Medco Health Solutions where he worked on the development of the Medicare Part D drug benefit, the early launch of the internet pharmacy marketplace and the regulatory environment for mail service pharmacies. Andy began his career as an aide to former New Jersey Governor Christine Todd Whitman.
Julia Friedman, FSA, MAAA
Julia Friedman is a senior consulting actuary with the Milwaukee
office of Milliman. She joined the firm in 2010.
Julia’s primary area of expertise is consulting with organizations who operate in the Medicare Advantage program by assisting her clients in better understanding the financial and strategic impacts of the ever- changing Medicare Advantage landscape. Julia has served many types of organizations in her time with Milliman, including health plans, provider systems, union groups, and integrated delivery systems. She has assisted organizations with capitation rate development, feasibility studies, benefit analysis, premium rate development, and estimation of the impact of legislation reform, among others. Specifically, she has developed nearly 300 Part C and D bids for a number of Medicare Advantage health plans, ranging from small to midsize mature Medicare Advantage organizations. In addition, she is a leader in competitive analysis in the Medicare Advantage market, and leads the development of the Milliman MACVAT tool suite.
Kimberly L. Geidel, BS, MPM, CPC
Kim Geidel is the AVP of Government Revenue for UPMC Health Plan and leads HCC Risk Adjustment operations for Medicare, Special Needs Plans and ACA programs. She defines strategy for revenue optimization while ensuring accuracy and compliance through the use of integrated technology. Kim also possesses extensive experience in Data Analytics, Provider Network, Provider Contracting & Reimbursement as well as Quality Improvement. Kim earned an undergraduate degree in Health Services Administration from Slippery Rock University and holds a Masters of Public Management from Carnegie Mellon University.
Colleen Gianatasio CPC, CPCO, CRC, CDEO, CPC-P, CPMA, CPPM, CCS, CCDS-O, and AAPC Approved Instructor has over 20 years of experience in the health insurance field. She has experience in customer service, claims, quality, and coding. As Director, Clinical Documentation Integrity and Coding Compliance, Colleen’s primary responsibilities are provider engagement and clinical documentation improvement for accurate coding and reimbursement. Colleen specializes in developing innovative coding curriculum and instruction to support compliance with federal guidelines and appropriate reimbursement processes. She is a certified AAPC instructor and enjoys teaching a variety of coding, documentation, and auditing classes. Colleen serves as President of the AAPC National Advisory Board.
Bryan Gregory currently serves as the Senior Manager of Practice Performance for Prominence Health Plan. Prior to Prominence, he was at Vera Whole Health, and has served as Clinical Director for over 12 years across multiple organizations. Bryan’s deep experience in practice management as well as leadership in optimizing and implementing new systems and strategies have resulted in greater operational efficiencies and superior quality patient care for his plan’s members.
Emily Griese is responsible for providing leadership and oversight for all operational areas at the health plan, focusing on financial strength and operational efficiencies while ensuring the highest quality member experience and outcomes. She further leads Sanford Health Plan towards advancing its mission in value-based care integration, working closely with the Sanford Health system.
Dr. Griese has 10 years of experience in community-based work and population health. Before joining Sanford Health Plan in January of 2020, she worked with Sanford Health as a leader in population health, working closely with the enterprise CMO in building the system strategy around the transition to value-based care. Prior to that role, she worked in research as a community-based evaluator focused in rural and tribal health and data and analytics, leading Sanford’s work in social determinants of health data efforts.
Allison Hess is the Associate Vice President of Health and Wellness Programs for Geisinger. In this role, she is responsible for the oversight of health and wellness programs for commercial, Medicare and Medicaid populations, community based programming and programming for the Geisinger employee population. Ms. Hess earned her bachelor of science in Health Education with a concentration in Psychology from Bloomsburg University and is currently pursuing her MBA. She is a Certified Wellness Practitioner (CWP) and has additional certifications in the wellness and health education field. Ms. Hess has worked for over 15 years in the specialty of community health and worksite wellness. Her most recent work involves community based strategies impacting food insecurity and focusing on social determinants of health and the impact on condition management.
Kevin M. Healy
Kevin M. Healy is the CEO for Allymar Health Solutions and has held the position since the company’s inception in 2021. Kevin has been in the healthcare business for more than 22 years. Prior to joining Allymar Kevin was the Senior Vice President for Optum for 12+ years. At Optum Kevin was one of very few leaders that worked within the Optum Insight, Optum Health and Optum Rx lines of business. Kevin was brought into Optum when they acquired Inspiris, an in-home assessment care/care management and Hospice organization, where he was Chief Development Officer. Kevin also served as the SVP of Sales for Warm Health (sold to Altegra, now Change Health), the Managing Director of Social Service Coordinators (Sold to Altegra, now Change Health) and the VP of Sales for Healthcare Dimensions (SilverSneakers Fitness Program) which was acquired by Axia Healthcare and then Healthways (Now Tivity). Prior to healthcare, Kevin spent 14 years in the sports marketing/communications and golf business in various sales, product and marketing roles.
Nikki Hungate, MS, MHA
Nikki Hungate, a long-time resident of the Western New York region, currently serves as the Senior Leader of Medicare & Government Programs Product Strategy at MVP Health Care. Utilizing the 17 years of experience in the health plan industry she is accountable for leading a team of product innovators that create and deliver a suite of high-quality government products that address the needs of the community in a customer-centric fashion, placing emphasis on those populations that are most vulnerable and underserved.
Nikki holds a Bachelor and Master of Science in Health Administration from Roberts Wesleyan College. She is currently a doctoral candidate at the University of Charleston in the Executive Leadership program. Nikki has a passion for sharing knowledge, and also serves as an adjunct professor in the health sciences degree programs at Monroe Community College and Roberts Wesleyan College. In her free time, she volunteers as fundraising coordinator for the local Vietnam Veterans of America chapter in Rochester, NY
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 Healthcare Quality Congress and RISE 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.
Angi is the VP of Operations at ArchWell Health, a venture-backed value-based care provider. At ArchWell, she is responsible for developing a best-in-class senior-based primary care delivery model with their physician leadership, driving achievements in both member experience and clinical outcomes. Prior to ArchWell, Angi was Associate Director of Clinical Strategy and Operations at Humana, managing operations for Conviva Care Solutions, Humana's wholly owned primary care solution. Angi has more than 20 years of hospital and primary care experience, and has developed deep expertise in strategic planning, project management, cost reduction, revenue optimization, and turnaround management
Mindi Knebel is the Founder & CEO of Kaizen Health, as well as Chair of the companys Board of Directors. A startup junkie who is passionate about social entrepreneurship, Mindi has worked across several industries and has seen companies from inception through successful exit.
Mindi was on the founding team at MATTER, a healthcare technology incubator formed through a public-private partnership in the city of Chicago. Prior to her time at MATTER, she led sales operations, corporate development, accounting/finance and human resources initiatives for growth stage companies in service, veterinary, and technology industries..
Mindi holds a bachelors degree from the University of Iowa and a masters in business from Colorado Technical University. She enjoys spending time with family and friends, running, yoga, reading and is an avid Packers, Iowa Hawkeyes, Cubs, Bulls and Blackhawks fan.
Ms. Leo oversees the overall performance, strategic direction and product development for Cigna Healthspring's Medicare products. Prior to joining Cigna, she worked for Aetna, where she was most recently was the National Head for Medicare Advantage product and strategy.
Previously, Ms. Leo held leadership roles at Aetna in national contracting, network contracting, operations and dental. She has an MBA from St. Joseph's University and lives in Philadelphia with her husband and daughter.
Sean has worked at the intersection of managed care and government benefit programs for the past 19 years. He is responsible for BeneLynk’s product development, new business acquisition, and strategic growth initiatives. Prior to BeneLynk, Sean served as the President of Freedom Disability and Alpha Disability, one of the nation’s largest Social Security Disability and Veterans Advocacy companies. Before that, Sean served as Vice President, Sales for SSC Disability, providing government program benefit services for Managed Care Organizations.
He is recognized by the Social Security Administration as a non-attorney representative (EDPNA) and has personally represented claimants in hearings for Social Security Disability Insurance and Supplemental Security Income throughout the country.
Sean is an expert on a wide variety of government benefit programs and has been quoted in Bloomberg, Business Week, and other national publications. He regularly publishes articles on managed care and government benefits for BeneLynk’s blog.
Sean is a graduate of Middlebury College and has a master’s degree from Yale University.
As the Senior Director for Quality, Patient Experience & Safety, Archana is responsible for the overall quality framework delivered under Walgreens Health. In her role, Archana works cross functionally across the organization to lead development of strategies, plans and operational processes to ensure compliance with value-based care arrangements. Archana brings over 15 years of leadership and operational experience across a portfolio of industry-leading businesses and services in healthcare quality, quality improvement, clinical quality outcomes and process improvement. She has a CPHQ as well as a Lean Six Sigma Black Belt.
Throughout her career, Archana has worked collaboratively with healthcare providers and administrators to provide standardized, patient-centric care and improve health & quality outcomes. This has become her area of focus as she operationalizes a comprehensive quality approach for Walgreens Health to further the company’s purpose to create more joyful lives through better health. As a transformational leader, Archana is passionate in her belief that a comprehensive, holistic, patient-centric model for care gap closures is needed - one that leverages the physical, virtual & digital sites of care, allows real-time access & availability to clinicians, focuses on health equity & SDOH and partners with payors to offer customized solutions for their population quality needs.
Eric C. Makhni, MD, MBA
Eric Makhni, MD MBA, is a sports medicine orthopedic surgeon and Medical Director of the Center for Patient Reported Outcome Measures at Henry Ford Health (Detroit, MI), as well as the Director of Quality and Informatics for the Orthopedic Service Line. He is also a team physician for the Detroit Lions (NFL).
Dr. Makhni completed his undergraduate training at the Massachusetts Institute of Technology (MIT) and went on to complete a dual MD/MBA degree at Harvard Medical School and Harvard Business School. He then went to Columbia University Medical Center in New York City for residency in orthopedic surgery, followed by specialty training in a shoulder and sports medicine fellowship at Rush University in Chicago, IL.
Dr. Makhni is an active clinical researcher in the fields of sports medicine and value-based health care. This research has led to formation of a joint venture with Henry Ford Health - Protera Health - of which he is a co-founder and CEO.
Henry W. Osowski
Hank Osowski, a Founding Member of Strategic Health Group, is an experienced health care executive and strategist who has provided leadership to commercial, Medicare and Medicaid health plans for more than 30 years. He currently is the Managing Director of Strategic Health Group, a new boutique strategic and financial advisory firm dedicated to bringing seasoned leadership to enable health care organizations to succeed in a challenging and changing environment. He is an expert in Medicare Advantage and Medicaid long-term care strategies.
Formerly, as Senior Vice President Corporate Development, he was a key member of the senior leadership team that the company from a near death experience to an exceptionally strong financial position. He led SCAN Group's efforts to expand into seven additional California counties. Hank also led SCAN's entry into Arizona and served as the initial President of SCAN Health Plan Arizona and SCAN Long Term Care. The service area expansions represent approximately a quarter of SCAN's membership and added nearly $450 million to SCAN's revenue. He also led the organization's strategic planning efforts and initiated an innovation development regimen to seek improvements in care coordination practices and future care outcome protocols.
Prior to SCAN, Hank served as a Principal in a national health care consulting organization providing a range of strategic, financial and development services for health plans, physician groups and hospitals. He began his California career as a member of the senior management team responsible for the turnaround and financial survival of Blue Cross of California. In this capacity, Hank led the financial turnaround of the Individual and Small Group Division and provided leadership to the organization's strategic planning efforts.
Earlier he served as Vice President International Operations for American Family Life Assurance Corporation where he directed the activities of the company's Canadian and European operations. In this role he directed the development of start-up operations in the United Kingdom, Germany and Italy, as well as the financial turnaround of the company's Canadian operations. Earlier, Hank also served as Director of Insurance Consulting Services for Coopers and Lybrand, a predecessor to PriceWaterhouse Coopers.
Throughout his career, he has been a frequent speaker on critical issues and challenges facing the Medicare and Medicaid programs. In 2011, Hank spoke to the Managed Medicaid Congress about principles for structuring effective long term care programs, to the Medicare Market Innovations conference about opportunities for strengthening a plan's five star quality rating and offered his strategic projections for the future of Medicare. He also spoke to a diverse health care and technology audience at the Healthcare Unbound conference about leveraging the power of technology to improve the quality of health outcomes and care interventions.
Jenn brings 20+ years experience in health management and consulting to Hello Heart including roles at AJG and Mercer consulting firms. A former professor of Health at her alma mater the University of Houston and exercise physiologist by training, Jenn began her career in clinical research on multiple NIH and biopharma studies focused on cardiovascular health generating multiple publications highlighting successful interventions. She then moved into the employer space designing award winning wellness programs delivering clinical outcomes and ROI.
Jenn leads Employer Health Strategy for Hello Heart and serves as a clinical subject matter expert. She is married with 3 children, 2 dogs, 1 cat, 2 bunnies and a gaggle of chickens on her small, sustainable farm "Robertshire", just outside of Houston.
Ellen Rudy, PhD
Dr. Ellen Rudy serves as the Vice President of Health and Social Impact at Papa with the responsibility to evaluate Papa’s impact on members’ quality of life, health outcomes and total cost of care. Dr. Rudy earned her Ph.D. in Epidemiology from University of California, Los Angeles and completed a postdoctoral fellowship in Health Policy and Research at RAND/UCLA. She most recently worked at Molina Healthcare, a managed care organization providing Medicaid and Medicare health care services with leadership responsibility across Population Health Management, Health Policy and Research, Quality and Healthcare Operations.
She currently serves as an expert faculty member at University of Southern California Sol Price School of Public Policy. She is an avid hiker, skier, and mom of two kids and two rescue dogs.
Nazanin is a Manager of Health Data Exchange Adoption and Analytics Consulting at Health Care Service Corporation which operates Blue Cross and Blue Shield® Plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. Nazanin’s current role at HCSC focuses on building core capabilities for a real-time bi-directional health data exchange. Nazanin’s work involves strategic and operational activities in acquiring health data to facilitate treatment, payment, and operations. She is also responsible for the adoption, value realization, and analytics needed to drive the Health Data Exchange program at HCSC. Prior to HCSC, Nazanin worked in an administrative role at Northwestern Medicine’s Feinberg School of Medicine in their outcomes transplant research group. Nazanin earned her bachelor’s degree in psychology from the University of Illinois at Chicago and holds a certificate in Leadership Principles from Harvard Business School Online. She is currently pursuing her Master of Science in Health Informatics with a focus on Healthcare Administration at Northwestern University. Nazanin has over a decade of combined healthcare and health insurance experience. Nazanin has a passion for solving healthcare’s biggest challenges and improving patient outcomes by using technology and data.
John Snyder oversees all aspects of Sanford Health’s insurance arm, which serves members in South Dakota, Minnesota, Iowa, and North Dakota. He develops managed care products, payment models and integrated service-delivery strategies.
Snyder has more than 40 years of experience in health care. Before assuming duties as Sanford Health Plan’s top leader, he held dual roles as president and CEO of Health Alliance Medical Plans and executive vice president/system chief operating officer of Carle Health System. Snyder worked for Carle Health System for more than three decades in a variety of leadership positions in operations, and health plan administration. A native of Tennessee, Snyder holds a pharmacy degree from the St. Louis College of Pharmacy and an MBA from Eastern Illinois University. He also completed an executive fellowship program through Northwestern University’s Kellogg Management Program.
Dirk Soenksen is a strategic results-oriented healthcare executive with a demonstrated track record of building winning teams to commercialize novel technologies and services.
Dirk Soenksen is co-founder and CEO of Ceresti Health, the leader in virtual care for patients with conditions that require high levels of family caregiver support, starting with dementia (i.e., Alzheimer’s Disease and related dementias), the most expensive disease in the America. Ceresti offers a digital caregiver empowerment program that increases caregivers’ knowledge, skills and confidence, and has demonstrate, with statistical significance, that more knowledgeable and confident family caregivers can reduce patients’ medical costs.
Prior to co-founding Ceresti, Mr. Soenksen was founder and CEO of venture-backed Aperio which he built into the recognized global leader in digital pathology. Aperio was acquired by Danaher/Leica Biosystems in October 2012. In 2006, Mr. Soenksen founded the Digital Pathology Association (DPA), a non-profit organization comprising major vendors and leading pathologists, with the goal of establishing best practices and increasing awareness of digital pathology. Dirk served as President of the DPA from its inception until 2012, and as a board member of the DPA through the end of 2014. He has an undergraduate degree in Chemistry from Bowdoin College, and a graduate degree in electrical engineering from the University of Pennsylvania. He also earned his MBA from Pepperdine University.
Carissa brings more than 15 years of healthcare experience in both the delivery and payer markets to Insightin Health. Prior to joining Insightin Health, Carissa served as the Director of Clinical Operations for Gateway Health and had a 7-year tenure with Highmark Blue Cross Blue Shield. Carissa currently serves as the President of the Western PA HIMSS Chapter. With a background as a Licensed Clinical Social Worker and a passion for caring for others, she strongly believes in the connection between the member experience and healthcare outcomes. Her experience providing direct practice services at organizations such as UPMC Western Psychiatric Institute and Clinic has given her a unique perspective on technology and innovation. She believes both are key in scaling the important work of improving the health and wellness of the community at large, one individual at a time.
Jordan is Vida’s SVP of Market Access. Jordan has a diverse background working with both payers and providers nationwide and has spent much of his career forging new partnerships and bringing value-based models to market. Most recently, Jordan was the VP of Health Plan Accounts at Lumeris, where he led the launch of a start-up Medicare Advantage plan and was responsible for strategy, growth, and account management. Prior to Lumeris, Jordan was a consultant to health systems and health plans at both The Chartis Group and HealthScape Advisors and spent a number of years in the Blues at Health Care Service Corporation.
Adele Towers, MD MPH FACP CRC
Dr. Towers is the Director of Risk Adjustment for UPMC Enterprises, and is also a geriatrician on the faculty at the University of Pittsburgh. At UPMC Enterprises, she is directly involved in the development of healthcare related technology, with emphasis on use of Natural Language Processing (NLP) for Risk Adjustment coding and use of Clinical Analytics to optimize clinical performance. Prior to this role, she has served as the Medical Director for Health Information Management at UPMC with responsibility for Clinical Documentation Improvement as well as inpatient coding denials and appeals. She has been on the faculty in the Division of Geriatric Medicine at the University of Pittsburgh for over 25 years and continues to see patients at the Benedum Geriatric Center in UPMC. She is the former Medical Staff President at UPMC Presbyterian, and her prior positions have been as Vice Chair for Quality Improvement and Patient Safety for the Department of Medicine, Medical Director of UPMC Home Health, Medical Director of the Benedum Geriatric Center and Medical Director of Primary Care at the Western Psychiatric Institute and Clinic. Dr. Towers has presented the experience at UPMC with use of NLP and Clinical Analytics at multiple regional and national conferences.
Reggie Wardoku is the Health Services Analytics Manager at UCare in Minneapolis, Minnesota. For the last decade, Reggie has devoted himself to using data to understand the needs of people on Medicaid and Medicare. His most recent work includes helping build segmentation, medical risk, and self- management risk models for UCare’s programmatic response to member needs. He holds a Masters of Public Health from the University of Minnesota.
Austin is the Vice President of Medicare at Hinge Health, where he leads and grows the digital musculoskeletal services they provide to seniors . Prior to this, he was the Vice President of Payer Strategy and Network Innovation at OptumCare, which is the largest provider of care for Medicare beneficiaries in the US. Additionally, Austin was a Partner at the Advisory Board Company, leading its Value Based Care consulting practice with over a decade of advising health systems, payers, and the US Congress on key strategic initiatives. Austin specialized in healthcare while earning his MBA from Vanderbilt’s Owen Graduate School of Management and graduated with honors from the University of Notre Dame.
Daniel Weaver is the Executive Vice President of Product Operations and Stars Strategy at NationsBenefits, with nearly 25 years of experience in Operations and Star Ratings strategy. Daniel most recently served as VP, Government Quality Programs at Gateway Health, where he led the company to its first 4.5 Star Rating and an improved Medicaid NCQA Accreditation rating. 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 NationsBenefits, Daniel will drive strategic planning, facilitate execution, oversee product financial performance, manage operational performance across all products, and ensure strong internal controls are in place to enable efficiency in the growth of the business. Daniel will also help drive prospective and retrospective investigation into quality outcomes and customer engagement across the company’s distinct benefit management programs while continuing to innovate new solutions for health plan partners focused on growth and strong quality performance.
Michelle Werr is a strategy and business development consultant who collaboratively works with healthcare executives to navigate the evolving market, bringing a laser focus on execution to realize the client’s strategic goals. She has worked across all facets of health plan strategy and operations to support launching new lines of business, introducing new business models, provider alignment tactics, value-based models and leading due diligence efforts. She has worked with clients launching and winning new government contracts and has helped to shape new innovative areas to support physical and behavioral health integration, member engagement and social determinants of health. Her expertise in both the commercial and government markets helps her untangle the complex healthcare financing world to identify opportunities to grow and mitigate risk in the evolving world.
Wickman is a nurse by background and started her career at UCare in 2009 holding various clinical and quality roles until 2019 where she was promoted to the VP of Clinical Services. Wickman brings more than 23 years of nursing experience working in the hospital, community and health plan industry. Wickman provides strategic oversight for clinical operations, clinical innovation, care management, quality assurance and community projects. Her most recent work includes the development of a full Maternal & Child Health Program model that supports moms, babies and families from pregnancy to post-partum, infant, well child, as well as supporting youth to adulthood transitions.
Mary Yeh, FSA, MAAA
Mary is a consulting actuary with the Milwaukee office of Milliman.
She joined the firm in 2015.
Mary’s primary area of expertise is Medicare Advantage consulting. She has experience consulting for small to midsize Medicare Advantage organizations, including startups and mature plans. Additionally, Mary is a key team member in the development of the Milliman MACVAT. In the employer market, Mary assists small plans with quarterly reserving.
Ivan Yen, ASA, CERA, MAAA
Ivan Yen is a senior actuarial analyst with the Chicago office of Milliman. He joined the firm in 2020.
Ivan’s primary area of expertise is in Medicare Advantage. He has experience assisting small to mid-size Medicare Advantage organizations, including startups and mature plans. Additionally, Ivan is a key team member in the development of the Milliman MACVAT tool suite. Examples of Ivan’s engagements include MA-PD bid development and strategy, MA-PD desk review support, and preparing Statements of Actuarial Opinion.
Have had over 20 years of Healthcare experience w/ 10+ years in risk adjustment with an emphasis on Medicare Advantage. Experience has ranged from managing RAF coding production, estimating risk adjusted financial accruals, managing vendor relationships, RAPs and EDS processes, In home assessments, and other prospective CDI programs. Have spent the past four years as the Director of Risk Adjustment and Quality for AdventHealth. Current role leverages prior health plan experience to educate AdventHealth providers on the importance of risk adjustment and coding to the highest level of specificity.