2019 Speakers

Capital District Physicians’ Health Plan

Puneet Budhiraja

Chief Actuary
Commonwealth Care Alliance

LAUREN EASTON

Senior Director, Behavioral Health
Martin's Point Health Care

Josh Edwards, MBA, MSc

Medicare Stars Programs Manager, Health Plan Quality
Blue Shield of California

Torrie Fields, MPH

Senior Manager, Advanced Illness & Palliative Care, Healthcare Quality & Affordability
Regence Blue Cross Blue Shield

Kathleen Faulk

General Manager, Government Programs
Humana

Jessie Gatto

Design Strategy Advisor
CareMore

Piyush Gupta

Regional Medical Officer
Zelus

Jenny Graham

Partner
Turn-Key Health

John Halsey

Vice President, Business Development
Tufts Health Plan

Jonathan Harding

Senior Medical Director
PharmMD

Kent Holdcroft

Chief Revenue Officer
Harvard Pilgrim Health Care

Noreen Hurley

Program Manager, Star Quality & Performance
Providence Health Assurance & Providence Health Plan

Lisa Jensen

Director of Payment Integrity
Florida Blue

Aldiana Krizanovic, MPH,CPH

Senior Health Policy Consultant for Federal Government Relations
Priority Health

Lawrence Kuk

Director, Network Engagement
SelectHealth

David L. Larsen RN, MHA

Director, Quality Improvement
Cigna

CHRISTINE LEO

Vice President, Senior Products
UPMC for You

John Lovelace

President
Mom’s Meals NourishCare

Catherine Macpherson, MS, RDN

Vice President Product Strategy and Development Chief Nutrition Officer
Network Health

Gary Melis

Clinical Pharmacist
HealthEdge

Harry Merkin

Vice President, Marketing
Capital District Physicians’ Health Plan

Raj Munjuluri

Medicare Actuary
Freedom Health/Optimum Health

Mital Panara

Vice President, Revenue Management
EPIC Hearing Healthcare

Mike Reha, CEBS

Vice President of Sales and Marketing
Cleveland Clinic

Sharon Reichart, RDH, CRM

Director of Product Development, Market & Network Services
LA Care

Garrison Rios

Executive Director, Medicare
Providence Health Assurance

Keri Steege

Medicare Compliance Officer/Director of Medicare Compliance
SCAN Health Plan

Donna Sutton

Healthcare Informatics, Director of Medicare Star Quality Programs
Health Sun Health Plans

Karen W. Connolly, RN

Senior VP/QI and Accreditation
Carrot Health

Kurt Waltenbaugh

CEO & Founder
Speakers Biographies


Kathleen Faulk

General Manager, Government Programs
Regence Blue Cross Blue Shield

Responsible for growth, finance and operations of government programs, with accountability for overall performance of the company's Medicare Advantage and Federal Employee Programs (FEP) lines of business and other government programs. Additional accountability as executive liaison with external agencies such as Centers for Medicare & Medicaid Services (CMS), FEP Director's Office, and AHIP.

Jonathan Harding

Senior Medical Director for Senior Products
Tufts Health Plan

Dr. Harding is currently the Senior Medical Director of Senior products comprising a population of over 100,000 Medicare and Retiree members at Tufts Health Plan in Massachusetts. Prior to this position, he was at Touchstone Health Partnership, where he served as Vice President for Health Services. Prior to that he was Chief Medical Officer of the Fallon Clinic in Worcester, MA, a multi‐specialty group practice with over 300 practitioners, and held several different positions at FHP in California, a multi‐faceted health care company with HMO, medical group, and hospital businesses. He also continues his role as a physician reviewer for the National Committee on Quality Assurance (NCQA). He brings over 25 years of experience in medical management.

Dr. Harding received his bachelor's degree and his degree in medicine from Boston University and he is board certified in internal medicine and geriatric medicine. He also has been certified by the ABMM and ABQAURP, and is a Fellow of the American College of Physician Executives. Dr. Harding has previously taught Internal Medicine at the University of California, Irvine, School of Medicine; the University of Massachusetts Medical School in Worcester and in Uganda and South Africa.

Gary Melis

Clinical Pharmacist
Network Health

Gary Melis is a Clinical Pharmacist for the past six years at Network Health, a local health insurance provider in Northeast and Southeast Wisconsin. He is currently one of two pharmacists involved making MTM calls in-house. His responsibilities also involve NCQA, pharmacy appeals, P&T Committee, Member and Provider relations. Gary's also has experience as pharmacy manager for a national long term care company, pharmacy manager for retail pharmacy chain, and Pharmacy Director for a National Health Care provider. He has also been a pharmacy instructor at local medical college family practice clinic.

Josh Edwards, MBA, MSc

Medicare Stars Programs Manager, Health Plan Quality
Martin's Point Health Care

Josh is the Medicare Stars Programs Manager at Martin's Point Health Care in Portland, Maine. Over the last nine years his company's HMO contract has earned 5-stars four times, most recently in 2016.

In his role Josh is responsible for identification, development, and implementation of quality improvement initiatives to maintain and improve health plan quality measures, specifically Medicare Star Ratings.

Prior to his health care career Josh worked for several branches of the Walt Disney Company, including many years in production management at Walt Disney Animation Studios in Burbank, Calif. Josh has an MBA in Marketing from the American University in Dubai and a Master of Science in Health Communication from Boston University. He lives in Portland with his wife and seven-year-old daughter.

John Lovelace

President
UPMC for You

John Lovelace holds several positions within the UPMC Insurance Services Division, through which he oversees the government health program lines of business with UPMC. This includes the managed Medicaid programs, managed long-term services and supports, Children's Health Insurance Program, Medicare and Medicare Special Needs Programs, individual medically underwritten coverage and the operations of federally facilitated marketplace operations. He has been associated with UPMC insurance services for more than twenty years.

John serves on a variety of local, regional and national boards, including the Association for Community Affiliated Plans, which he serves as Board Chair; Medicaid Health Plans of America; and the National Managed Long-Term Services and Supports Health Plan Association. He speaks nationally on key issues affecting publicly financed health care programs, with emphasis on people with disabilities and social determinants of health. More locally, his advocacy efforts are focused on disabilities, services for women and children and behavioral health.

Mr. Lovelace holds graduate degrees in Rehabilitation Counseling from the State University of New York at Buffalo, as well as in Information Services from the University of Pittsburgh.

Lawrence Kuk

Director, Network Engagement
Priority Health

Larry's professional career within the healthcare industry has focused on the delivery, transformation, performance and measurement of healthcare services relative to cost, quality and utilization. He has served in executive, leadership, and consultative roles supporting provider-sponsored organizations, managed care entities, and insurers. His healthcare experience spans 30 years with functional expertise that includes -

  • Physician-hospital network and ACO performance strategy formation and execution
  • Value based reimbursement and financial risk arrangement development and management
  • Triple Aim implementation and measurement
  • Provider Organization governance and operations management
  • Managed care organization, insurer, and payer contract negotiations
  • Private label product creation and implementation
  • Healthcare budget development, financial analysis and reporting - inclusive of capitation management
  • Care management leadership
  • Patient Centered Medical Home/PCP management and practice transformation

Larry has earned an MBA from the University of Detroit with a concentration in Finance and International Economics. Additionally, he has completed graduate studies at Wayne State University in Healthcare and Labor Economics, and Econometrics.

Garrison Rios

Executive Director, Medicare
LA Care

Prior to joining L.A. Care in April 2016, Gar was working as a consultant for various MA organizations in the area of growth and start up planning. At his last health plan position for Care 1 st , he held the role of Director of Medicare Administration, where he helped Care1st launch its expansion plan into El Paso Texas and grew that plan in its first AEP to over 2000 members.

Most notably, Garrison served as Chief Marketing and Sales Officer/Senior Vice President of Arcadian Management's Medicare venture from 2004 to 2012, which he was a part of the initial launch team. Arcadian quickly grew from zero revenue in 2005 to over $650 million in annual revenue in less than five years, with no acquisitions, all organic growth, under Garrison's leadership. Garrison as a part of the Executive team successfully navigated a sale of Arcadian to Humana in 2012. His skills are based in community/grassroots marketing with a clear understanding of how consumers purchase healthcare products based on demographics and consumer research.

Garrison's 29 years in the health care field have equipped him with intimate knowledge of the Medicare program and the needs of those beneficiaries. He has worked directly on Medicare Advantage program start-ups and program improvement plans. His executive skills are deeply rooted in the disciplines of execution and meeting deliverables.

Jessie Gatto

Design Strategy Advisor
Humana

Prior to joining L.A. Care in April 2016, Gar was working as a consultant for various MA organizations in the area of growth and start up planning. At his last health plan position for Care 1 st , he held the role of Director of Medicare Administration, where he helped Care1st launch its expansion plan into El Paso Texas and grew that plan in its first AEP to over 2000 members.

Most notably, Garrison served as Chief Marketing and Sales Officer/Senior Vice President of Arcadian Management's Medicare venture from 2004 to 2012, which he was a part of the initial launch team. Arcadian quickly grew from zero revenue in 2005 to over $650 million in annual revenue in less than five years, with no acquisitions, all organic growth, under Garrison's leadership. Garrison as a part of the Executive team successfully navigated a sale of Arcadian to Humana in 2012. His skills are based in community/grassroots marketing with a clear understanding of how consumers purchase healthcare products based on demographics and consumer research.

Garrison's 29 years in the health care field have equipped him with intimate knowledge of the Medicare program and the needs of those beneficiaries. He has worked directly on Medicare Advantage program start-ups and program improvement plans. His executive skills are deeply rooted in the disciplines of execution and meeting deliverables.

Karen W. Connolly, RN

Senior VP/QI and Accreditation
Health Sun Health Plans

Karen Connolly, RN, a health care professional, has over 40 years of extensive experiences in operational leadership in health care quality delivery and management including quality management and improvement in health care. She has been involved in nursing and hospital administration and in operational leadership with the health plan industry to include QI, accreditation attainment, HEDIS, health information, contract administration, risk management and strategic planning. Her expertise and experiences in quality improvement activities have included activities in both the hospital and ambulatory settings and interfacing with a number of external agencies in the promotion of quality and in the use of data to increase access to care and to increase the quality of health care delivery systems. She has worked consultatively in the health plan community with Medicaid Advantage, Medicaid, and Commercial health plans in the areas of compliance, QI, operational leadership, accreditation achievement, key metrics, and HEDIS with emphasis with the CMS Medicare Advantage Stars Program for over 14 years. She has facilitated strategic planning sessions and performed analytical evaluation, database management, and quality improvement of key performance indicators that have resulted in statistically significant improvements impacting health outcomes particularly focused in the health plan that has resulted in impacting star ratings including the achievement of a 5 Star Rating from CMS. Ms. Connolly has worked with organizations throughout the country in the achievement and continued compliance with accreditation with NCQA, AAAHC, and The Joint Commission.
Ms. Connolly has been an accreditation surveyor with the Accreditation Association for Health Care Administration (AAAHC) since 1998 and serves as faculty for AAAHC educational programs. Ms. Connolly serves as the Chair of AAAHC's Health Plan Advisory Committee and is a member of AAAHC's Standards and Survey Process Committee. She has served on a number of other committees, workgroups and task forces for AAAHC that have included the Medical Home Advisory Committee, the Task Force on Quality Improvement, the Task Force for Primary Care, and workgroups for Patient Center Medical Home and Scoring Methodology. She currently serves on 2 CMS national technical expert panels on Quality Improvement Strategies and the Quality Reporting System in conjunction with the Affordance Care Act. She is an under-graduate of DePauw University School of Nursing in Indiana and did her graduate studies at Oakland University and University of Michigan in Michigan.

Aldiana Krizanovic, MPH,CPH

Senior Health Policy Consultant for Federal Government Relations
Florida Blue

Aldiana Krizanovic is the Senior Health Policy Consultant for Federal Government Relations at Florida Blue. In her prior role she served as a Health Policy Analyst for the Florida Blue Center for Health Policy. She holds a Master's in Public Health with a concentration in Health Policy from the University of North Florida. She specializes in Medicare regulation, with a focus on Medicare Advantage and Part D. In her role she monitors and analyzes Medicare regulatory changes and their impact to the business. Aldiana is passionate about advancing development of health policy that improves access to care for vulnerable populations, decreases cost of care, and improves individual's quality of life. She serves as an advisor to the Age-Friendly Public Health System Advisory Committee led by Trust for America's Health and the John A. Hartford Foundation.

Kent Holdcroft

Chief Revenue Officer
PharmMD

Kent Holdcroft joined PharmMD in March 2013, bringing over a decade of operational, consulting, and sales experience in the healthcare technology and services industry. His leadership at PharmMD has quickly expanded well beyond the management of business development, client negotiations, and relationships, taking on integral roles in marketing operations and product development. His charismatic personality is helping shape the culture of this rapidly growing team.

"PharmMD holds the potential to be a game-changer," comments Holdcroft. "This team is focused on being the market innovator as emerging regulatory requirements position our solutions to return millions of dollars to our customers, reducing cost, and building healthier lives."

Holdcroft came to PharmMD following 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. He was a key player as a part of Optum's growth strategy representing all of Optum's provider-facing solutions. He managed healthcare accounts in the community hospital, academic medical center, integrated delivery network, as well as a variety of managed care plans and government settings.

Actively involved in the community, Holdcroft currently serves on the Board of Directors at BrightStone, Inc., and as a Stephen Minister. Holdcroft holds a BA in Psychology from the Miami University and a MA in Counseling from The University of Toledo.

Lisa Jensen,

Director of Payment Integrity
Providence Health Assurance & Providence Health Plan

Lisa is the Director of Payment Integrity for Providence Health Assurance/Providence Health Plan in Beaverton, OR. Lisa has a Master's Degree in Healthcare Business Leadership. She is a Certified Professional Coder (CPC) since 1996 and a Fellow in the American College of Medical Practice Executives (FACMPE) since 2008. She has had the good fortune to spend much of her over 23 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.

Keri Steege

Medicare Compliance Officer/Director of Medicare Compliance
Providence Health Assurance

Keri is the Medicare Compliance Officer and Director of Medicare Compliance for Providence Health Assurance in Beaverton, Oregon. She has over 20 years of Compliance experience in the Medicare industry, as well as a broad range of healthcare experience throughout her career. She has built a Medicare Compliance Program from the ground up and has a passion for doing so. She has been with Providence for over 14 years.

Kurt Waltenbaugh

CEO & Founder
Carrot Health

Kurt Waltenbaugh is CEO & Founder of Carrot Health, creator of Carrot MarketView: a cloud-based Healthcare Business Intelligence platform used to analyze data, generate reports and provide real-time insights into your population and market. Kurt is a serial entrepreneur who has built successful analytic solutions, products and companies in the healthcare, retail, manufacturing, education/credentialing and fundraising industries. His previous companies were sold to Oracle and Pearson Education. Most recently, Kurt was responsible for Product Strategy at Optum, Inc. (UnitedHealth), building data analytic businesses for the Provider, Payer and Employer markets.

Catherine Macpherson, MS, RDN

Vice President Product Strategy and Development Chief Nutrition Officer
Mom's Meals

Catherine is a senior leader in healthcare product strategy and product management. She is a product innovation leader who has launched successful multi-channel, consumer-focused, technology-enabled health, wellness and condition management products at leading healthcare companies and organizations.

Catherine is the VP of Product Strategy and Development and Chief Nutrition Officer for PurFoods, the leading national provider of home-delivered meals that allow people to recover and age at home. She also served as Vice President over the Medication Adherence and Immunizations businesses at Walgreens, led Healthcare Product Strategy at WebMD and managed health and wellness products and programs for Ceridian, the National Institutes of Health and the American Institute for Cancer Research. Catherine earned her Masters of Science degree in Human Nutrition from the University of Minnesota and her BA from the University of Michigan. She is a Registered Dietitian and has training and expertise in product management, behavior change, weight management, tobacco cessation, medication adherence, health coaching, disease management and culinary arts.

John Halsey

Vice President, Business Development
Turn-Key Health

John W. Halsey, Vice President, Payer Development, Turn-Key Health, is a healthcare executive with 20+ years of experience helping organizations drive revenue by strategically assessing opportunities, developing marketing strategies and executing on sales. Previously, he served as a managing partner at AXON Strategy. He has also held business development and management leadership positions at Real Time Medicare Data, MDLIVE, Inc., and Teladoc.

John is a member of the AHIP Foundation, American Telemedicine Association, ACO Development Group, the Institute for HealthCare Consumerism, MCO Executives, Urology Health Foundation and the MacJannet Foundation. He holds a bachelor's degree in History from the University of Alabama at Birmingham

Noreen Hurley

Program Manager, Star Quality & Performance
Harvard Pilgrim Health Care

Noreen has spent her career in the healthcare arena. She blends operational, strategic and technology perspectives as well as payer and provider expertise to lead major initiatives and strategies. She started in hospital operations and was Director of the Admitting & Registration department in the New England Deaconess Hospital, a Harvard teaching hospital in Boston. Transitioning to IT, she implemented the EMPI (Enterprise Master Patient Index) when the Deaconess merged with the Beth Israel Hospital to form what is now the Beth Israel Deaconess Medical Center. From there she moved to the vendor world and ran implementations of EMPI's, HL7 integrations and HIPAA EDI transactions for SeeBeyond Technologies.

Most recently, she has focused on the payer space. She started and oversaw the Star program at Tufts Health Plan, as well as working in IT, developing a senior products PMO and managing the member call center. Moving back to technology, she developed data driven solutions in the healthcare space while working at Informatica. Her current role is developing the Star program at Harvard Pilgrim Health Care, which has recently re-entered the Medicare Advantage market. As a leader in the Clinical Informatics Division, the program focuses on leveraging non-traditional data and analytics to craft targeted initiatives to improve performance in the Star program and the Harvard Pilgrim Stride product

Mike Reha, CEBS

Vice President of Sales and Marketing
EPIC Hearing Healthcare

Mike Reha is director of sales and marketing for EPIC Hearing Healthcare, the leading provider of hearing care insurance in America. Reha has more than 20 years of experience in the hearing industry, ranging from serving as managing director for Qualitone, a subsidiary of Starkey Laboratories hearing aid manufacturing facility, to his current role directing strategic customer relationships and marketing initiatives for EPIC.

Founded in 1997, EPIC is the first in the country to provide access to hearing care as an ancillary or specialty benefit. With its extensive network of audiologists and hearing healthcare physicians, and distribution relationships with major hearing aid technology manufactures, EPIC is now the national leader in hearing healthcare, and the only organization to offer hearing as a fully insured indemnity plan. EPIC Hearing Service Plan (HSP) manages the process of referrals; professional services and diagnostics; access to all technology; and billing and collections for hearing care. In this manner, members throughout the country can be assured of standardized and consistent procedures for assessment and evaluation, technology selection, programming, and outcomes measurements. Reha leads contact with all third-party administrators, brokers, employer groups, insurance companies and Taft Hartley funds, through which EPIC HSP covers millions of lives. With a concentration in human resources, Reha earned a bachelor of science in business administration from the University of St. Thomas in Minnesota and has a CEBS designation from the International Society of Certified Employee Benefits Specialists through The Wharton School of the University of Pennsylvania.

Torrie Fields, MPH

Senior Manager, Advanced Illness & Palliative Care, Healthcare Quality & Affordability
Blue Shield of California

Torrie leads the development and implementation of programs and processes at Blue Shield of California that work to improve the quality of life for individuals with serious illness and their families.

Torrie has led the development of highly successful palliative care initiatives including benefit design, case management, caregiver support, medical home development, and policy and engagement efforts. Prior to joining Blue Shield, Torrie worked as an applied health services researcher in a variety of settings, including health plans, health delivery systems, local and federal health departments, and in university research laboratories. She has extensive experience in health policy development and implementation. In addition to her work with Blue Shield of California, Torrie acts as a consultant and curriculum developer for The Center to Advance Palliative Care and California State University Palliative Care Institute.

Torrie holds a Master's in Public Health in health management and policy from the Oregon Master of Public Health Program at Oregon Health and Sciences University, a Certificate in Gerontology from Portland Community College, a Bachelor of Science degree in sociology from Portland State University, and a Bachelor of Arts degree in communication theory from University of California, San Diego.

Mital Panara

Vice President, Revenue Management
Freedom Health/Optimum Health

Currently working as Vice President of Freedom Health, Optimum Health, Beacon Health and AFCSC Health plan responsible for all the Revenue Management including develop plan benefits,  Medicare Risk Adjustment, RAPS, Encounter, CSNP, Analytical, Revenue compliance monitoring and Successfully integration of other companies into Umbrella Organization. Joined Freedom Health since inception of the company and helps to achieve the 7 th fastest growing Private Company in USA as per INC 500.

Served as Executive Committee member of Chamber of Commerce and Professor at West bay Career University. Graduated Magna Cum Laude with MBA in Business/Finance, also served as President of Honor Society and President of Learning Society.

Proficient and well-known Public Speaker. Spoke at various conferences held by   leading organizers in Healthcare Industry, including World Congress, Financial Research, RISE Group, World Research Group, Opal Group etc. on Medicare, Health Care Revenue Management and Compliance.

David L. Larsen RN, MHA

Director, Quality Improvement
SelectHealth

David L. Larsen has been the Director of Quality Improvement for SelectHealth in Salt Lake City, Utah for the past 25 years and has worked for Intermountain Healthcare for 32 years. SelectHealth is a mixed model HMO with more than 650,000 commercial, 90,000 Medicaid, 35,000 Medicare advantage and 10,000 CHIP members in Utah and Idaho. Intermountain Healthcare is an integrated health care delivery system with 23 hospitals and over 1500 employed physicians.
As the Director of Quality Improvement, David has responsibilities for oversight of the Medicare Advantage Stars program for which SelectHealth received a 4.5 Star rating in 2015; maintaining NCQA accreditation, SelectHealth is currently accredited with a Commendable rating; as well as, HEDIS performance measurement, public reporting (transparency) and disease management. David was a past co-chair of America's Health Insurance Plans Subcommittee on Accreditation and Industry Standards.

David has also been responsible for the oversight and development of chronic disease registries, performance measurement and web based reporting systems, quality improvement pay for performance incentives for physicians, and direct patient improvement interventions related to chronic illnesses including patient adherence monitoring, reminders and incentive programs. David led initiatives that were successful in applying for and receiving the 2001 American Association of Health Plans National Exemplary Practice Program Award for Diabetes, the 2002 George W. Merck Quality Award for cholesterol management, the 2002 American Association of Health Plans Innovations in Immunizations Award and the 2003 Best Provider Engagement Initiative Award from the Disease Management Association of America.

Piyush Gupta

Regional Medical Officer
CareMore

Dr. Piyush Gupta is the Regional Medical Officer of CareMore Health of Arizona, a Medicare Advantage health plan and delivery system with a focus on caring for the frailest populations by harnessing the power of teamwork to proactively manage their complex medical needs. CareMore Health provides care to over 100,000 Medicare and Medicaid beneficiaries across eight states, including Arizona, California, Nevada, Virginia, Tennessee, Iowa, Georgia, and Connecticut. As the Regional Medical Officer of CareMore Health in Arizona, Dr. Gupta leads the market in strategy, operations, and quality improvement. Prior to joining CareMore, Dr. Gupta was an attending physician at Kaiser Permanente where he also completed a fellowship in patient safety and quality improvement. He is board certified in internal medicine and trained in internal medicine at Brown University. Dr. Gupta received his medical degree from the University of Vermont and graduated with honors from Carnegie Mellon University with a bachelor's degree in biological sciences.

CHRISTINE LEO

Vice President, Senior Products
Cigna

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.

Sharon Reichart, RDH, CRM

Director of Product Development, Market & Network Services
Cleveland Clinic

Sharon is the Director of Product Development and Strategy at the Cleveland Clinic. Her role keeps her connected with the market, both payers, employers and brokers, as she collaborates on opportunities to link the excellence in health care delivery found at the Clinic, with consumers. Her 20+ years of experience in the insurance industry, includes working as Risk Manager for CNA in NYC, holding multiple Claims, Marketing and Sales positions at CIGNA and most recently 6 years with Anthem, where she developed and managed product portfolios across multiple segments and markets, as a Product Director. She is skilled in Market Research, Project Portfolio Management, New Product Implementations and Business Process Improvement. She earned a Bachelor of Science - BS focused in Dental Hygiene / Hospital Administration from University of North Carolina at Chapel Hill and prior to that, as a University of Pennsylvania Dental Hygiene Graduate, she taught at the School of Dental Medicine. Sharon also holds a Certificate in Risk Management, from the Philadelphia School of Medical Law. Sharon resides in the historic village of Hudson, OH.

LAUREN EASTON

Senior Director, Behavioral Health
Commonwealth Care Alliance

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.

Harry Merkin

Vice President, Marketing
HealthEdge

Harry Merkin has worked with both payers and providers through many dynamic changes in healthcare for a number of years. He is currently responsible for Marketing at HealthEdge, including product marketing, demand generation and thought leadership. He previously had similar responsibilities at Evariant and NaviNet and has collaborated with many transformative entities across the healthcare landscape. Harry has helped introduce and promote innovative enterprise software solutions that enable payers to improve their competitive effectiveness, as well as perform valuable communications between payers, providers, and consumers. He is a frequent speaker at industry conferences and forums and contributor to the 'Edge Report, the HealthEdge blog.

Puneet Budhiraja

Chief Actuary
Capital District Physicians’ Health Plan

Puneet is a Chief Actuary at the Capital District Physicians Health Plan (CDPHP) with over 14 years of health actuarial experience working with insurers as well as with consulting firms. Puneet is currently responsible for all lines of business, value based contracting and population health management initiatives. Puneet is an Electrical Engineering and found interest in Actuarial science while pursuing his masters

Raj Munjuluri

Medicare Actuary
Capital District Physicians’ Health Plan

Raj is a member of the American Academy of Actuaries with over 14 years of health actuarial experience working with insurers as well as with consulting firms. Raj is currently the Medicare Actuary at Capital District Physicians Health Plan (CDPHP) and manages the Medicare bidding process and various value based contracting initiatives and population health management initiatives. Raj holds an MBA from New Mexico State University and a bachelors in Mechanical Engineering.

Jenny Graham

Partner
Zelus

An expert in operational performance and excellence, Jenny has over 15 years of experience developing and implementing innovative operational strategies to improve overall business performance and utilization. As a founding partner, Jenny has led engagements for clients in the Health Insurance and Insurance Brokerage industries. Her functional expertise includes customer service, correspondence, claims, medical management, enrollment, brokerage servicing, policy management, underwriting operations, requirements development, and information technology.

working in collaboration with executives and their teams, Jenny focuses on developing strategic recommendations at make a positive impact on the customer experience by vastly improving internal processes and management.

Jeny has led instructional design teams, developed member centric operating models and best in industry training and skills development programs. Effective in both off- and on-shore projects, Jenny has experience handling aggressive ramp up timelines including 30-day implementations. A recognized Project Management Professional (PMP), Certified Professional in Learning and Performance (CPLP), And a Lectora Certified Advanced Author, an eLearning development tool. Jenny was member of the Honor's Program at Babson College and holds a bachelor of science in Business Administration

Donna Sutton

Healthcare Informatics, Director of Medicare Star Quality Programs
SCAN Health Plan

Donna received her MBA from the University of Southern California (USC) and is a Certified Master Black Belt in Six Sigma. She has over 14 years of experience managing and conducting process improvement projects. Her most recent experience prior to SCAN includes various process improvement roles at OptumInsight and OptumRx. Her responsibilities at SCAN include managing the deployment of and providing oversight over SCAN's 5 Star programs and interventions.