Deana Bell is a Principal & Consulting Actuary with Milliman, based in Seattle, WA. Deana’s consulting is focused on Medicare Advantage and Part D programs, year-end financial reporting and reserving for health plans, Managed Medicaid Organizations, risk adjustment, and pharmacy benefits. Deana volunteers extensively with the Society of Actuaries Health Section Council.
Puneet Budhiraja Chief Actuary and Senior Vice President
Capital District Physicians Health Plan
Puneet is a Chief Actuary at the Capital District Physicians Health Plan (CDPHP) with over 15 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 graduate and found interest in Actuarial science while pursuing his master’s program at the University.
Paul is a career product management professional, having worked in many industries including consumer packaged goods, pharmaceuticals, healthcare information and Medicare Advantage. Currently he is AVP for Medicare Advantage products at Cigna Medicare where he oversees product management across all markets.
Paul has experience in new product development, product strategy and planning, competitive analysis and data and analytics. He has an MBA from St. Joseph’s University and lives in the Philadelphia suburbs with his family.
Patrick Coulson has more than 25 years of experience leading healthcare sales, specializing in early-stage companies, new product launches and C-level new business sales. With expertise in Medicare Advantage, risk adjustment, technology services and member engagement, he has a record of enhancing start-up organizations – doubling revenue year-over-year, in many cases.
Prior to joining Emerging Markets as Advantasure’s Chief Growth Officer, Coulson served as Senior Vice President of Business Development for engagement services company Integra ServiceConnect. Within two years, Coulson helped triple the client base and double the annual revenue. He was previously Vice President of Sales for medical cost management company MedSolutions, where he was responsible for Medicare Advantage sales nationwide.
Lisa Franklin is currently a Market Portfolio Manager at CareFirst BlueCross BlueShield leading the product strategy, discovery, design, and implementation process to launch both Individual and Group Medicare Advantage plans in the Maryland, District of Columbia, and Northern Virginia areas. Her focus is leading cross-functional teams to meet milestones of the product roadmap to meet both short and long-term strategic goals. Lisa previously worked at Johns Hopkins Healthcare as Product Development Manager in a similar role. She has over 4 years of experience leading the Medicare Advantage Bid process at multiple organizations with a passion for ensuring that data is the driving force for every element of the product lifecycle. In her spare time, she enjoys spending time with her husband and corgi, Turbo, as well as spinning and shopping (more online now!).
Pamela began leading Vermont Blue Advantage, a Vermont start-up Medicare Advantage plan in 2020. Prior to launching this new MA plan, Ms. Getsie served as corporate director of Strategic Growth and Business Development for Blue Cross Blue Shield of Vermont and over the last two decades, held successive leadership positions at BCBS VT in the areas of enrollment services, large group account retention, underwriting, and actuarial services. She has an MBA from Norwich University and a Bachelor of Science, Quantitative Analysis, from Bentley College. Pam serves on the board of directors for her local Meals on Wheels organization and is passionate about reframing aging to reduce age bias and create a more age-integrated society.
Managing Director Brian Goetsch advises health plans, specialty health organizations and private equity investors on a variety of strategic and operational topics. Brian has led successful healthcare engagements across a wide range of topics including market entry and expansion; product development and launch; transaction advisory services; and performance improvement. Prior to joining HealthScape, Brian served as a senior executive at EyeMed Vision Care leading the development and execution of its partner channel “One-Stop-Shop” strategy. During his tenure, he successfully led multiple cross-functional initiatives including EyeMed’s expansion into Medicaid; investment in its Medicare Advantage solution and the launch of its medical-surgical vision solution. He also supported efforts to develop, implement and contract more than 10 successful partner deals. Previously, Brian was a Director at HealthScape Advisors and started his career with Huron Consulting Group. Brian earned his Masters and Bachelors in Accountancy from the University of Illinois.
Principal, CAT5 Strategies
Chair, The RISE Association, Quality & Revenue Community
Chair, The RISE Association, Quality & Revenue Community
Ana Handshuh, CHC, is a government programs executive with expertise in creating and implementing corporate programs for the healthcare industry. Ms. Handshuh is the Principal at CAT5 Strategies, a healthcare advisory practice specializing in Regulatory and Operational Compliance, Revenue Management, Communications, Quality, Care Management Programs, Benefit and Formulary Design, Program Bid Submission, Accreditation, and Technology Integration. She recently founded TRACSCOUT, a technology startup SaaS platform for managed care processes.
Her recent consultancy roles include conducting compliance risk assessments, performing Compliance Program Effectiveness audits, conducting FDR and PBM pre‐delegation audit, preparing for CMS program audit, and writing and implementing post‐audit corrective action plans. Ms. Handshuh has also assisted government program sponsors achieve higher Star ratings, create and implement care management programs, document their processes and procedures, achieve accreditation status, design and submit government program bids, institute corporate‐wide programs and create communications strategies and materials. She is a member of the Health Care Compliance Association and is Certified in Healthcare Compliance by the Compliance Certification Board. Ana currently serves on the Board of the Resource Initiative and Society for Education (RISE), the preeminent national professional association dedicated to managed and accountable care financing and delivery.
Ms. Handshuh previously served as the Vice President of Managed Care Services at Central Florida Inpatient Medicine (CFIM), providing leadership and strategy on CFIM projects with physicians, risk entities, hospital systems, and health plans. Prior to that assignment, she worked with Precision Healthcare Systems as their Vice President of Quality Improvement, leading the IPA’s collaborations with payers to implement Quality and Star Rating initiatives. Ms. Handshuh also served as the Director of Corporate Program Development at Physicians United Plan (PUP), leading the Medicare health plan’s Quality Management and Corporate Communications departments and spearheading the development of innovative integrated technology solutions to drive business excellence and Star Rating achievement. Prior to joining Physicians United Plan Ms. Handshuh was the founder of I-Six Creative. Under Ms. Handshuh’s vision and leadership, I-Six provided expertise in the areas of managed Medicare benefit design, MSO/IPA operations, provider network strategy, new market launches, technology integration, corporate communications and quality improvement.
Matthew Hayes, FSA, MAAA Principal and Consulting Actuary
Matthew’s experience includes 15 years in the actuarial field working in both the health and life sectors. Matthew’s expertise lies in all areas of the pharmaceutical space including formulary and rebate analysis, competitive analytics, network analysis, policy research, PBM analysis, benefit design, and Part D pricing. Matthew also has extensive experience in Medicare Advantage pricing, research, experience analysis, and regulatory and compliance review.
Prior to joining Milliman, Matthew spent seven years at a large national insurer, helping to double PDP membership during that time while honing his leadership, management, and technical actuarial skills.
Lucretia Hydell, MS, MFA, ASA, MAAA, is a Principal of Growth & Partner Analytics at CityBlock. Formerly, she was the Director of Actuarial Services at Johns Hopkins HealthCare.
She is a healthcare actuary with many years of experience working with and for providers in Medicare, Medicaid and value based care delivery. Lucretia is a thought leader and subject matter expert with a deep understanding of Medicare Advantage analytics and bid strategy. As an actuary, she has worked for some of the largest healthcare organizations in America, including United, Wellcare, Coventry and Willis Towers Watson as well as for innovative solution driven companies, such as Evolent Health. As a Sr. Director at Evolent, she spent four years working with a wide range of clients across the country creating paths to risk, building out a Medicare Advantage strategy team and supporting strategic blueprints. Since joining JHHC as the leader of the newly formed actuarial department, her responsibilities include growing the actuarial team and developing the tools and capabilities to support JHHC’s 400,000 lives across four lines of business.
Prior to starting a career as an actuary, Lucretia toured as a Dancer with Garth Fagan Dance, taught at Alvin Ailey Arts in Education and worked at Carnegie Hall in administration.
Mr. Jensen is Vice President for Independent Care Health Plan (iCare) in Milwaukee, Wisconsin.
Mr. Jensen is responsible for all of iCare’s sales, marketing, public relations and new business development activities. Previously, Mr. Jensen was Corporate Strategy and Compliance Officer for Group Health Cooperative of South Central Wisconsin, a staff-model HMO consistently ranked among NCQA’s top ten nationally. Throughout his career, Mr. Jensen has developed many commercial and government-sponsored managed care products. Mr. Jensen began his career in advertising, working on national brands such as Famous Footwear, Mercury Marine and Miller-Coors. Mr. Jensen holds an MBA in marketing and a BA in journalism from the University of Wisconsin – Madison. He is a member of workgroups sponsored by The Center for Healthcare Strategies and The SNP Alliance.
Christina Latterell-Loganimoce Healthcare Change Agent
Christina is an accomplished strategic leader with the ability to transform the US healthcare delivery system through application of population-based metrics; driving advanced quality outcomes while decreasing medical cost. She has demonstrated success in developing and implementing clinical quality metrics, achieving cost reductions, and improving satisfaction with internal and external healthcare customers. She has exceptional problem-solving skills and a keen ability to aggressively identify opportunities, develop focus, and provide tactical business solutions. Her background and expertise includes experience in many areas from CMS Medicare Star Measure program development, Claims, Configuration, Payment Policy, Electronic Data Interchange (EDI) management, Call Center oversight, Medicare Risk Adjustment program management and oversight to NCQA accreditation programs.
David is a consulting actuary with the Milwaukee office of Milliman. He joined the firm in 2016.
David has more than 10 years of health actuarial experience in managed care pricing, financial reporting, strategic analysis, and regulatory analysis and compliance. His areas of expertise include Medicare Advantage, Medicare Prescription Drug, and general prescription drug market analytics.
In the Medicare market, David has assisted clients in the design and pricing of Medicare Advantage and Prescription Drug plans, analyzing the impact of proposed legislative and regulatory changes, projecting and analyzing risk adjustment payments, and various other strategic engagements.
In the prescription drug industry, David has worked with manufacturers, insurers, and other entities, advising them in the areas of payment strategy and regulatory issues affecting the market.
Prior to Milliman, David worked at a large managed care organization as a certifying actuary for Medicare Advantage and Medicare Prescription Drug plan bids. He also worked in roles in commercial pricing, corporate strategy, and regulatory analysis.
Benjamin Nadler, director, actuarial services, oversees Independent Health’s actuarial processes related to Medicare and state products. This includes pricing, budgeting, long term forecasting, financial accruals and regulatory reporting. Nadler also plays a key role in assessing regulatory guidance for the organization and provides strategic input for the portfolio.
Additionally, Nadler supports risk adjustment efforts for Medicare, Affordable Care Act and State lines of business, including overseeing analytics, risk suspecting, and reporting as well as operational activities around data submission, chart retrieval and vendor management.
Nadler joined Independent Health in 2010 as an analyst, and was later promoted to Manager, Actuarial services. Prior to joining Independent Health, he worked as an actuarial analyst for BlueCross BlueShield of Western New York.
He holds a bachelor’s degree in mathematics from the University of Pittsburgh and a master’s degree in business administration, with a concentration in finance, from the University at Buffalo.
Monica Pagels is a Senior Product Manager for Health Alliance Plan (HAP) in Detroit, Michigan. HAP is a regional health plan with HMO, PPO and SNP plans that serve over 70,000 Medicare lives in over 40 counties across the state of Michigan. HAP is a solution based health plan, providing meaningful benefits that support community needs, including aging in place, removing barriers to care and managing insecurities. Monica has been with HAP since 2017 and has worked in the health insurance field since 2009. Monica holds a Master of Science from Eastern Michigan University and a BS from Central Michigan University. She has extensive experience in Project Management, program design and improving health outcomes. She has worked with special populations and helped to create chronic condition management programs.
Tom Pelegrin Senior Vice President & Chief Revenue Officer
Convey Health Solutions
As Senior Vice President and Chief Revenue Officer Tom is responsible for Convey’s market growth, sales, business development, brand and marketing. Tom brings more than 25 years of sales and business development experience in the healthcare markets specifically related to payer technology and operations. Most recently, he was the Founder and CEO of MDInnovate, an organization focused on providing primary care services and improved patient care coordination through unique and innovative delivery models. Prior to this, Tom was a Partner with Optimity Advisors, a leading Washington, DC – based healthcare operations consulting firm where he provided subject matter expertise related to State and Federal Health Exchanges and payer enrollment and billing technology and operations. Tom also led the firm’s business development efforts and helped grow the firm into a multi-national operation with offices throughout the US and Europe. Prior to Optimity Advisors, Tom was Vice President of Enterprise Sales for Benefitfocus, a leading cloud-based benefits management technology provider. While at Benefitfocus Tom was instrumental at building and expanding Benefitfocus’ footprint within the payer markets and founded the government programs group, which was one of the earliest providers to serve the State and Federal Health Exchange marketplaces. Tom received his bachelor’s degree from the University of South Florida and remains an active member of their alumni association.
Patrick Petty is a Certified Professional Coder (CPC) with over 17 years of healthcare experience in the Managed Care/Payer setting. Patrick has specialized in all areas of Risk Adjustment in both the commercial and Medicare space for the past 10 years, including retrospective retrieval and coding programs, design, execution and oversight of large Clinical Documentation Improvement (CDI) programs, oversight of provider engagement programs around documentation and coding and prospective tool utilization, data leakage/submission monitoring, and leading end-to-end Risk Adjustment Data Validation (RADV) solutions in both the ACA and Medicare Advantage programs.
Prior to joining the GHG team, Patrick was most recently a Manager within Optum Advisory Services. His key responsibilities included designing and leading nine full RADV campaigns in both the MA and ACA space with high validation rates. Patrick also authored a comprehensive provider documentation and coding education program that was launched at several high-priority integrated delivery systems across the country.
Prior to Optum, Patrick spent 7 years in Humana’s Risk Adjustment business in multiple operational leadership, project management, and coding roles in both the corporate setting supporting the internal business, and in the market setting supporting local Medicare markets and providers manage success towards value-based arrangements.
Before Humana, Patrick spent 7 years in the Worker’s Compensation business at Sedgwick CMS/CompManagement. Key responsibilities included multiple coding roles for prior authorization, CPT audit, and operative report review, as well as pioneering improvement processes to aid in review and recovery of high-dollar facility bills.
In addition, Patrick also brings strong experience in project management, vendor oversight, compliance best practice review, revenue cycle consulting, and worker’s compensation compliance auditing.
Patrick earned his Bachelor’s degree from the University of Cincinnati, and is certified by the American Association of Professional Coders.
Kathryn Y. Qin, FSA, MAAA Vice President of Pricing
Blue Shield of California
Kathryn Qin is Vice President of Pricing for Blue Shield of California, a nonprofit health plan serving over 4 million Californians. She is responsible for the pricing decisions for all lines of business, and leads the company’s product and pricing strategy. Kathryn and her team work to ensure that the company is able to provide all Californians access to affordable and comprehensive health care benefits.
Prior to joining Blue Shield of California in 2021, Kathryn held the position of Corporate Vice President, Chief Actuary and Acting Chief Financial Officer for SCAN Health Plan since 2012. She led all aspects of actuarial analysis for SCAN, including Certifying for Medicare bids, Medicaid rate filings, financial forecasting, reserving and contract negotiations. Kathryn also worked at Health Net as a director of actuarial services overseeing analysis in Medicare bids, risk scores, star and financial forecasting and reporting. She began her career at Towers Perrin, a financial services consulting firm, progressing from an actuarial student to a senior consultant helping US and international clients on the design, valuation and financing of employee retirement programs.
Kathryn is a Fellow in the Society of Actuaries and a member of the American Academy of Actuaries. She holds a Master of Business Administration from the Anderson School of Business at University of California, Los Angeles, and a Bachelor of Science from the University of Manitoba in Canada.
Ryan is a consulting actuary with the Atlanta office of Milliman. He first joined the firm’s Scottsdale, Arizona, office in 1994 and moved to the Atlanta office in 2004.
Ryan works with Blue Cross and Blue Shield Plans, HMOs, health insurance carriers, and provider organizations. He assists clients in developing and evaluating strategies in the commercial, Medicare, and Medicaid markets. His client activities include the following:
Pricing and rate development
Healthcare cost analysis and actuarial cost model development
Preparing regulatory rate filings
Developing provider reimbursement and risk-sharing arrangements
Analyzing feasibility of participating in Medicare and Medicaid programs
Preparing Medicare Advantage annual filings
Analysis of actuarial liabilities Financial reporting, forecasting, and projections
Rex Wallace is the founder and principal of Rex Wallace Consulting, LLC, a firm that specializes in improving Star Ratings for Medicare Advantage health plans. Rex assesses plans and guides them in the development and implementation of-leading strategies to drive material Quality Improvement. Since its inception in 2017, RWC has helped multiple Medicare Advantage contracts achieve significant improvements in Star Ratings, including single-year full-Star improvements. Prior to launching RWC, Rex spent twenty-three years in strategic healthcare roles, with a strong focus on Medicare Advantage. Most recently, he led Stars for a large, multi-state plan that consistently achieved 4 and 4.5 Stars across its multiple contracts.