Michael S. Adelberg
Adam Barnhart, FSA, MAAA
Patrick Carroll, MD
Jordan Cates, FSA, CERA, MAAA
Evelyn Chojnacki, MPH
Denise Doucette-Ginise, MSN, RN, CCM, CHPN,
Julia Friedman, FSA, MAAA
Gregory A. Hanley, FACHE, CPHQ
Amie Hoffman, LCSW, MHA
Dr. Julia Hoffman
Elizabeth Klodas, MD, FACC
Dr. Tom Lutzow
Carrie Meyer, Au.D
Henry W. Osowski
Steven R. Peskin, MD, MBA, MACP
Darren Schulte, MD
Michael S. Adelberg
Formerly, Director of Medicare Advantage Operations, CMS
Mike Adelberg leads the Healthcare Strategy Practice at Faegre Baker Daniels Consulting. He has 25 years progressive healthcare industry and government experience in Medicare, Medicaid and commercial health insurance. Mike spent fifteen years at the Centers for Medicare and Medicaid Services (CMS), including concurrently serving as the director of the Insurance Programs Group and the acting director of the Exchange Policy and Operations Group in the Center for Consumer Information and Insurance Oversight (CCIIO) where he oversaw most of the functions of the federally-run health insurance exchanges; serving as the Director of Medicare Advantage Operations, where he supervised the annual cycle for review and award of Medicare Advantage bids and contracts, developed CMS’s operational policy, and led the monitoring of Medicare Advantage contractors; and serving as the associate regional administrator for Medicare operations (Chicago Region) and the director of education and assistance programs. Mike gained private sector experience as vice president of product development and government affairs for the Universal American Corporation, a multi-state health insurer which operated Medicare Advantage and Medicaid health plans (subsequently acquired by Wellcare).
He has also led or co-led health policy studies published in Health Affairs and The American Journal of Managed Care. Mike speaks and publishes frequently on healthcare topics and has served on numerous advisory committees. He’s been quoted in the Washington Post, New York Times, Modern Healthcare, NPR, and other leading media. In his spare time, Mike is an author. He’s written three novels, a history book, several scholarly journal articles, and over sixty book reviews.
Adam Barnhart, FSA, MAAA
Adam is a Principal and Consulting Actuary at Milliman, a global, independent professional services firm serving the insurance, employee benefits, and healthcare industries. His work focuses on healthcare, where he works with a diverse client base that includes Medicare Advantage organizations, Prescription Drug Plan sponsors, employer groups, providers, supplemental benefit organizations, and pharmacy manufacturers. He is passionate about improving the access, value, and outcomes across the healthcare industry, and working with his clients to help them meet their objectives.
Patrick Carroll, MD
Dr. Patrick Carroll oversees all matters pertaining to provision of care, clinical outcomes, patient
safety, healthcare information systems and strategic initiatives and programs that will enhance
the Vida Health care model. In addition, Dr. Carroll is instrumental in managing relationships
with health systems, payer partners and employer customers collaborating with the executive
team in the development of new clinical programs.
Prior to joining Vida Health in January of 2022 Dr. Carroll was the Chief Medical Officer for the telehealth company Hims-Hers. From 2014-2019 he served as Group Vice President and Chief Medical Officer of Walgreens. Prior to joining Walgreen’s in May 2014, Dr. Carroll served as the Chief Medical Officer of Integrated Care Partners, Hartford HealthCare’s clinical integration organization. He was also the Medical Director for Hartford HealthCare’s Medicare Shared Savings Program which currently has over 20,000 patients in a Medicare/CMS shared-risk pilot program. He played a key role in leading the Hartford HealthCare’s efforts in the transition to value-based care in a time of a rapidly changing healthcare landscape.
From 2010–2012, Dr. Carroll served as the Chief Medical Officer for the Granite Medical Group in Quincy, Massachusetts. Granite Medical Group is a 40-provider Multispecialty/Primary Care Group which is part of Atrius Health, a 1000 Medical Provider Group.
Dr. Carroll received his bachelor’s degree from the College of the Holy Cross and his medical degree from Dartmouth Medical School. He completed his residency training at Middlesex Hospital in family practice, where he served as Chief Resident. Dr. Carroll is Board Certified in Family Practice and in Adolescent Medicine.
Jordan Cates, FSA, CERA, MAAA
Jordan is an Actuary at Milliman, where his work supports a variety of clients in the Medicare Advantage and Medicare Part D sectors. His experience includes pricing Medicare Advantage and Part D plans, preparing PACE Part D bids, and analytic and strategic support for pharmaceutical manufacturers and pharmacy benefit managers. Jordan assists numerous parties in the pharmacy space with the estimation of legislation reform impact, leads research on the competitive analysis in the Medicare space, and assists with the development of the Milliman MACVAT tool suite.
Evelyn Chojnacki, MPH
Evelyn joined SWORD Health in September 2021 bringing over 16 years of Health Plan experience having served clients and members across multiple roles and responsibilities. Building on deep experience rooted in employer group client management, health care program development, market deployment and sales strategy, she serves as the Director of Health Plan Product Strategy for SWORD Health.
Evelyn’s philosophy is focused on delivering the best outcome for the user, defined as the health plan, employer or member/beneficiary. This includes clinical effectiveness, access and convenience of when and where care is received, and improved bottom line - cost. Her motivation for joining SWORD was driven by an appreciation for the growing role of virtual care delivery in the healthcare ecosystem and the belief that physical movement is a freedom that we should all preserve and cherish.
Evelyn obtained her BBA in Healthcare Management from Marshall University and an MPH from UNC-Greensboro.
As Vice President of Sales and Marketing for Medicare at Independence Blue Cross, Kortney is a long-time leader accountable for marketing Medicare products and services to the communities we serve, and helping those communities enroll into the Medicare coverage they need. She is directly responsible for acquisition and member retention marketing, product development, sales operations and sales management at Independence in the Medicare area. Her goal is to deliver innovative and value driven communications, and she is passionate about enriching the connection between Independence Blue Cross and our membership.
Denise Doucette-Ginise, MSN, RN, CCM, CHPN,
Denise Doucette-Ginise, MSN, RN, CCM, CHPN is the Director of Care Management Senior Products at CarePartners of Connecticut in Rocky Hill, CT. CarePartners is a new Medicare Advantage plan created via a joint venture between 5-STAR Tufts Health Plan and integrated provider system Hartford HealthCare. Denise has held numerous leadership roles in the managed care industry, spanning Medicare Advantage, Medicaid, Duals, and Commercial lines of business. She has a history of developing targeted programs and collaborative strategies to align the plan and provider stakeholders of matrixed organizations, from C-suite to front-line teams, resulting in optimal clinical and quality performance. Her current plan, CarePartners of Connecticut, received 4.5 STARS in their first year of rating and Tufts Health Plan, CarePartners’ parent organization, received 5-STAR for its seventh year in a row.
Jim Egan is Vice President of Health Plan Sales for WEX Health. Jim works with new and existing health plan partners to deploy solutions that best complement and enhance health plans’ core offerings. Jim has 25 years of healthcare experience in operations and sales for health plans, administrators and solution providers.
Julia Friedman, FSA, MAAA
Julia is a Senior Consulting Actuary at Milliman with expertise in 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 over 250 Part C and D bids for a number of Medicare Advantage health plans, ranging from small to mid-size 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.
Senior Executive who has been with Premier over the last ten years in various leadership positions within the Licensed Agency, Article 49-Care Management, and Strategic Development. In her current role as Chief Operating Officer, her focus is developing and implementing strategic growth plans that reflect the organization’s mission and vision and directing all aspects of operations to support successful launch of strategic initiatives. A graduate of the University of Rhode Island, Jennifer is currently pursuing a Master’s degree in Public Health.
Gregory A. Hanley, FACHE, CPHQ
Greg is the Vice President of Quality Management & Pharmacy for UCare. UCare serves over 400,000 members in Minnesota and Wisconsin. Greg provides oversight and direction for the CMS Star Ratings improvement program, HEDIS, CAHPS, HOS, QRS, QIS, NCQA Accreditation, member complaints, appeals, and grievance process, practitioner credentialing, and Pharmacy. UCare has had an Excellent NCQA Accreditation rating since 2014 and has a 4.5 Star Medicare Advantage plan.
Prior to joining UCare, Greg was the Midwest Regional Director of Quality Improvement at Coventry Health Care in Kansas City, MO. As such, he oversaw Coventry’s credentialing, NCQA Accreditation, CAHPS and quality of care, as well as its quality Committees and all quality improvement projects.
Greg retired from the Army in 2005 after a 21-year career as a Medical Service Corps Officer and in Psychological Operations. Greg is board certified by the American College of Healthcare Executives (ACHE) as a Fellow (FACHE) in health care management and a Certified Professional in Healthcare Quality (CPHQ). He earned a Bachelor of Arts degree from St. Cloud State University and a Master of Business Administration from Portland State University.
Amie Hoffman, LCSW, MHA
Amie Hoffman is currently Director of Behavioral Health for Geisinger Health Plan and is a goal-driven, accountable, and empathetic healthcare professional with over 17 years of experience in both acute and outpatient settings, last 8 in the managed care industry. In her current role, Amie was instrumental in the successful in-sourcing of Geisinger Health Plan’s behavioral health benefit from an outside vendor and the development of an innovative, expanded care model to serve members in the community. An experienced leader with a demonstrated history of working in the hospital and health care industry, she has a proven track record of successfully managing staff, impacting managed care outcomes and improvement of patient engagement strategies. Amie obtained a Bachelor of Arts in Psychology, Master’s in Social Work and more recently obtained her Master’s in Health Administration from St. Joseph’s University in 2018. She is currently licensed as a Clinical Social Worker in Pennsylvania.
Dr. Julia Hoffman
Dr. Julia Hoffman is Head of Mental Health Strategy for Teladoc Health, a company empowering people everywhere to live their healthiest lives by transforming the healthcare experience. She was previously National Director of Mobile Health for Mental Health and Suicide Prevention at the U.S. Department of Veterans Affairs, the largest integrated healthcare system in the country. Dr. Hoffman is a licensed clinical psychologist (CA) who attended Stanford University, completed a Psy.D. in clinical psychology at the PGSP-Stanford Psy.D. Consortium, and a fellowship at Yale University School of Medicine.
Dr. Hoffman has led the creation, evaluation, and broad international dissemination of numerous technology-based behavioral health tools. She founded and scaled mobile development for behavioral health at both the United States Department of Defense (DoD) and the United States Department of Veterans Affairs (VA) and has been honored for these efforts by President Barack Obama, the US House of Representatives, the FCC, the American Telemedicine Association, and the American Psychological Association.
A recognized thought leader at the intersection of digital and behavioral health, Modern Healthcare named Dr. Hoffman to the Top 25 Emerging Leaders program and Silicon Valley Business Journal listed her among their 40 Under 40.
Kent Holdcroft is the Executive Vice President of Growth at Healthmine, bringing over 15 years of operational, consulting, and business development experience with healthcare technology vendors to our team.
Most recently, Kent was the Executive Vice President for Enterprise Accounts and Strategic Partnerships at AdhereHealth. For over 8 years, Kent installed the teams and processes that led to record growth and innovation in product strategy. Additionally, Kent had multiple successes with AIM Healthcare (now a part of Optum, a United Health Group, Inc. company), rising to National Director as it expanded into new markets. As a Client Account Executive, Kent was a key player in Optum’s growth strategy representing solutions for providers, managed care and government entities through a period of high growth and acquisition.
Today, Kent works within his zone of genius building the Healthmine Growth Team. Drawing on his expertise in strategy and innovation, Kent is focused on expanding Healthmine’s strategic partnerships, improving sales processes and optimizing pipeline management.
Kent received a Bachelor of Science degree in Psychology from Miami University of Ohio and Master’s degree in Counseling from the University of Toledo. Residing in Franklin, TN, he is an avid outdoorsman and enjoys spending time exploring new activities with his two teenage boys, watching college sports, and giving back to his community. He sits on the Board of Directors at BrightStone, Inc., as well as the Tennessee Crohn’s & Colitis Foundation.
Naomi Irvin is a California native who relocated to North Carolina in 2006. She earned her undergraduate degree and MBA with a Marketing Certificate from East Carolina University (ECU). With over a decade of health insurance experience, Naomi currently leads a team of Compliance Consultants within the Sales, Marketing and Communications division of Blue Cross and Blue Shield of North Carolina. Her focus is balancing business objectives with compliance requirements.
Lisa is the Director of Payment Integrity at Providence Health Plans in Beaverton, OR. She has had the good fortune to spend much of her over 30 year healthcare career educating colleagues on coding, revenue cycle improvement and compliance. She has a broad range of healthcare experiences in small physician’s clinics, multi-practice medical/surgical practices, a large teaching hospital, compliance consulting, and a medium-size health plan. Lisa is a national speaker at conferences and seminars regarding healthcare reimbursement, and coding skills. Lisa has a Master’s Degree in Healthcare Business Leadership. She is a Certified Professional Coder (CPC) since 1996 and has a certification in Health Care Compliance.
Matthew Ketterman is Sr. Manager, Provider Interoperability at Florida Blue where he is responsible for the strategy and execution of a bidirectional clinical data exchange program to connect providers, electronic medical record vendors, and other solution vendors at Florida Blue. During his 30 years in healthcare, Matthew has successfully developed, built, and marketed products to enable the exchange and integration of administrative, clinical, and financial data between healthcare stakeholders.
Prior to joining Florida Blue in 2018, Matthew held various Director level positions at Availity, LLC where he led mandates and standards, the product strategy for the health plan and vendor portfolio and implementation of new customers and vendors. Previous roles involved leadership roles at other BlueCross and BlueShield plans in electronic data interchange, project management, technical solutions, and sales.
Matthew is a graduate of the University of New Mexico’s Anderson School of Management and has been an active volunteer in several healthcare and children’s causes since 1994. He lives in Jacksonville, Florida.
Elizabeth Klodas, MD, FACC
Elizabeth Klodas MD, FACC is Founder and Chief Medical Officer of Step One Foods, based in Minneapolis, Minnesota. Dr. Klodas completed her Cardiology fellowships with both the Mayo Clinic and Johns Hopkins School of Medicine, and founded Preventive Cardiology Consultants, where she continues to see patients. She is the author of a book for patients: Slay The Giant: The Power of Prevention in Treating Heart Disease, and served as the Founding Editor of Cardiosmart, the patient education website of the American College of Cardiology. Having authored multiple scientific articles, serves as a member of the Nutrition Workgroup of the ACC, and a medical editor for webMD.
Gaurav has a broad range of product management experience in healthcare technology ranging from EMRs, data platforms and analytics to consumer health technologies such as digital therapeutics and prescription delivery.
At Ciox, Gaurav leads the strategy and execution of new product initiatives from ideation to scale. He also currently serves as an advisor to several early stage health tech startups. Prior to joining Ciox, he led the design and development of FDA authorized apps that use behavioral medicine to reduce symptom severity of GI conditions in patients. During his stint in the world of e-commerce, he built out a nationwide prescription delivery service on top of Instacart's grocery delivery platform.
Gaurav has a Master’s in Electrical Engineering from University of Southern California and stays curious about astronomy, neuroscience, music and modern art
Paula has over 20 years’ experience in healthcare. Most recently she was Executive Director and General Manager of Outpatient at Glytec. Previously she was Head of Operations at Onduo and President and CEO of Telecare, where she directed the company’s successful acquisition by BioTelemetry. Paula has an MBA from Bentley University and an MA in Healthcare Delivery Science from Dartmouth College.
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.
Dr. Tom Lutzow
Dr. Lutzow was formerly the CEO of Independent Care Heath Plan (iCare) which was jointly owned by Humana and a Milwaukee non-profit organization until January, 2021. iCare is presently owned wholly by Humana. iCare began as a research and demonstration program funded by CMS to test that value of managed care for SSI recipients in 1994. iCare currently has multiple lines of business that include Medicaid, SSI, DSNP, and FIDESNP programs. 100% of its plan membership is poor and 70% of its SSI and SNP members are disabled. iCare is rated as a 4-star plan by CMS and has a robust premium adequacy program through retrospective and prospective member condition review. iCare’s service management programs include short-term case management for readmission-risk members, member loyalty programs for disenrollment-risk members, and others. Dr. Lutzow is immediate past chair and current Board Member of the Milwaukee County Mental Health Board. Since leaving iCare, Dr. Lutzow has also assumed the position of Managing Partner for Pentac Consulting.
Catherine is a Registered Dietitian Nutritionist and leader in healthcare innovation. She is the Senior Vice President of Healthcare Strategy and Chief Nutrition Officer for Mom’s Meals, where she works closely with health plan partners on clinical program design. She also served as Vice President of Medication Adherence and Immunizations at Walgreens, led Healthcare Product Strategy at WebMD and managed health and wellness programs for Ceridian, the National Institutes of Health and the American Institute for Cancer Research. Catherine earned her Masters of Science degree in Nutrition from the University of Minnesota and her BA from the University of Michigan.
Carrie Meyer, Au.D
Dr. Meyer is a clinical audiologist with over 30 years of experience in diagnostic assessment of hearing loss, tinnitus, and balance dysfunction as well as hearing aid evaluation, fitting, and verification. In her role as Director of Clinical Programs, Dr. Meyer works with providers, health plans and members to optimize member hearing health outcomes by improving clinical care pathways through provider innovation, member education, and support. Dr. Meyer successfully led her team through the accreditation process and on July 1 st , 2021, Amplifon Hearing Health Care was granted full accreditation for Health Utilization Management by the Utilization Review Accreditation Committee (URAC).
Tim Murray, FSA, MAAA, is a Principal & Senior Consulting Actuary based in Wakely's New York office. He joined the firm in 2017 and has worked as a health actuary for more than seventeen years. Over the course of his career, Tim has consulted to and served health plans on matters of pricing strategy, product design, forecasting, financial reporting, and Merger & Acquisition due diligence. Prior to joining Wakely, Tim spent 4.5 years leading the actuarial forecasting and budgeting functions of a Medicare Advantage-focused health plan, encompassing a wide array of traditional (e.g. Medicare bidding, M&A due diligence) and less traditional (e.g. payment policy lobbying) project work. Tim also spent 2 years in an equity research role covering publicly traded managed care and health care facility stocks, providing investment/industry guidance to institutional investors.
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.
Steven R. Peskin, MD, MBA, MACP
Steven R. Peskin, MD, MBA, MACP is the Executive Medical Director, Population Health at Horizon Blue Cross Blue Shield of New Jersey. His expertise encompasses physician leadership, population health management, clinical and operational performance improvement in health care, medical education and scientific communications. He has been one of the driving forces for the creation of and successful maturation of value based models in New Jersey. Dr. Peskin is an Associate Clinical Professor in the Department of Medicine at Rutgers Robert Wood Johnson Medical School. He is a clinical preceptor at The Eric B. Chandler Clinic for interns and residents in Internal Medicine. Dr. Peskin assists with the Population Health and business of medicine training for the Rutgers RWJ Internal Medicine physicians in training. Dr. Peskin was advanced to Master of the American College of Physicians in 2020. Dr. Peskin received his bachelor’s degree from The University of North Carolina Chapel Hill and medical degree from Emory University School of Medicine. He completed residency at Saint Elizabeth’s Medical Center in Boston and holds an MBA from the Sloan School of Management at Massachusetts Institute of Technology.
Amy Riegel is the Senior Director of Housing at CareSource, where she designs strategies which address the
Social Determinants of Health, specifically focused on innovative and sustainable approaches to integrating
health and housing. She is focused on building collaborative partnerships to address affordable housing
through development, financing, and policy with an emphasis on improved health outcomes. She initiated
and lead the deployment of $50M strategic investments in affordable housing across multiple states with
more than a dozen CDFIs. She oversees CareSource’s role as a strategic leader, funder, and implementation
partner in Healthy Beginnings at Home, a nationally recognized research study looking at the relationship
between housing stability and healthy birth outcomes. Previously she was the Director of JobConnect Ohio
at CareSource, leading the effort to assist Medicaid members in removing barriers to high quality
Prior to joining CareSource, Amy worked as a community developer with non-profits and government agencies. She provided policy leadership and designed programs in the areas of housing development, asset based community development, community engagement, education, and homelessness. She serves on numerous Boards within Ohio and nationally that are focused on poverty elimination, affordable housing, and neighborhood revitalization.
Darren Schulte, MD
Darren Schulte, MD, is President of Advanced Technology at Centene Corporation. Prior to Centene, Darren served as CEO of Apixio, a technology company that applies AI for risk and quality measurement, which was acquired by Centene in 2020. Before joining Apixio, Darren served in executive leadership roles at Anvita Health and Resolution Health, both of which were acquired by national payers. Darren is a nationally recognized speaker on the topics of healthcare analytics and quality improvement, and he serves on the NCQA Committee for Performance Measurement. Darren received his BS degree from Berkeley, his MPP degree from Harvard, and his MD from Stanford. He is the co-inventor of 6 US patents.
Gretchen is the Vice President of Plan Operations for Clover Health, where she leads teams that design, manage, and innovate member and provider experiences to improve health, cost and service outcomes. She also served as Vice President of Group Retiree Products and Services for UnitedHealthcare, Vice President of New Service Development for Satellite Healthcare, and West Region Operations Leader for Oscar Health. She has thirty years of experience in government-funded health insurance programs, and is a population health enthusiast with interests in systems thinking, behavioral economics and solutions to address inequities in the health system. Gretchen earned her Master of Applied Science degree in Population Health Management from The Johns Hopkins University Bloomberg School of Public Health and her Bachelor of Arts Degree in English and Science, Technology and Society from Pitzer College in Claremont, California.
With more than 15 years’ industry experience ranging from long term care and compound pharmacy management to health plan quality and operations, Reva excels in engaging internal and external stakeholders to improve processes for optimal outcomes while keeping the member’s experience at the heart of every conversation.
Melissa Smith is the Executive Vice President of Consulting and Professional Services at Healthmine, bringing over 25 years of experience in Star Ratings, strategy, sales, and marketing for health plans, providers, pharmacy benefit managers, and industry vendors. Melissa has extensive experience developing strategic and tactical solutions to meet client needs and a strong background of building productive partnerships across internal teams and with external vendors to improve performance on clinical, medication, patient survey, and administrative quality measures.
Most recently, Melissa was Senior Vice President of Sales, Marketing, Strategy and Stars at Gorman Health Group. She is a well-known thought leader and healthcare strategist with proven success developing enterprise-wide solutions to improve Star Ratings, quality performance, health outcomes, and the member experience. Melissa’s team helps clients improve performance within quality ratings systems, evaluate market dynamics and opportunities, optimize distribution channels, and support our clients’ strategic planning needs.
Prior to Gorman Health Group, Melissa served in a leadership capacity at Cigna-HealthSpring. Before working in Medicare Advantage and quality ratings systems, Melissa was an Associate Director at Vanderbilt University Medical Center. Melissa received her degree from Purdue University and began her career at KPMG, LLP. Melissa’s unique background of business process, regulatory compliance, and healthcare quality offers our clients unique access to healthcare strategy, quality performance, revenue optimization, and more.
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 is the Vice President, Clinical Strategy at Insightin Health. She brings over 15 years of healthcare experience on both the delivery and payer sides. Prior to joining Insightin Health, Carissa was the Director of Clinical Operations for Gateway Health as well as having a 7-year tenure with Highmark Blue Cross Blue Shield. She is a Licensed Clinical Social Worker and spent her early years providing direct practice services to consumers at organizations such as UPMC Western Psychiatric Institute and Clinic. Carissa has proven outcomes streamlining and simplifying processes to improve the customer experience and reduce costs. As a passionate clinician she understands the need for technology and innovation to scale the important work of improving the health and wellness of the community at large, one individual at a time. Carissa currently serves as the President for the Western PA HIMSS Chapter.
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.
With over 25 years’ experience, Elaine Taverna has spent the last 10 years improving revenue trend
and lowering medical expense for healthcare providers and payers within the United States and
A career of success in health care
Elaine has overseen medical management, risk adjustment and quality programs, primarily within the government funded product sector. As senior vice president of risk adjustment and quality for Advantasure, she is responsible for performance in revenue stream areas such as risk adjustment and quality five-star programs. As the vice president of revenue management and risk adjustment at Health Alliance Plan of Michigan (HAP), a subsidiary of the Henry Ford Health System. Elaine led the evaluation, design and implementation of HAP and Henry Ford risk adjustment and provider performance programs for all government-funded revenue streams. She also designed and implemented a chronic care outpatient ambulatory program for Henry Ford Medical Group and, as director of government programs, developed a strategic plan to integrate physical and behavior health for members. At Concerto Health in Detroit, a physician organization, Elaine served as the national director of care management - with responsibility for provider performance for risk adjustment, quality and cost containment - designing and overseeing care management programs, quality assurance initiatives and contract compliance. Elaine also served as Meridian Health Plan’s national director of long-term care supports and services, administrating lines of business in three states with over 500k of membership; at Community Living Services (CLS) as the division director of long-term care services and business development; and, earlier, as CLS director of operations for its Personal Supports and Services Department.
Education in social work and health administration
A licensed registered social worker in Michigan, with 12 years of national consulting experience, Elaine earned a Master of Science degree in health administration from Central Michigan University and a Bachelor of Science in social work from Eastern Michigan University.
Ashley Tyrner is the founder and CEO of FarmboxRx. Ashley has gone from being a single mom on food stamps to the CEO of a national brand that aims to break down the social barriers of access to nutritious food. With a clear conviction that everyone deserves the right to eat healthy, Ashley works tirelessly to disrupt the food policy and healthcare space.
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 is an experienced 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.