Megan Allison is the Director of Audit and Oversight at CVS Health, responsible for all phases of external audits conducted by regulatory agencies, including preparation, management of the audit process, remediation, and validation. As a seasoned compliance expert with more than a decade of experience in Medicare Advantage, Megan drives successful completion of audits conducted by the Centers for Medicare & Medicaid Services (CMS), State regulatory agencies, and other regulators. In her role, she has implemented an industry-leading Delegate Audit Readiness program to help ensure FDRs are able to accurately complete CMS audit universes, and has executed operation of a robust universe quality review tool and trend analysis software.
Megan thrives on leading large teams in pursuit of a common goal, building relationships, and collaborating with colleagues. Megan uses those interests in her work as a City Council member for her small hometown in Iowa and her work as a stakeholder in a small non-profit focused on proper housing for elderly in the area. In her time away from work, Megan can often be found watching the Kansas City Chiefs and the Iowa Hawkeyes with her family.
Ashley Cabrera, CHC
Senior Vice President Strategy and Chief Compliance Officer
Ashley Cabrera, CHC Senior Vice President Strategy and Chief Compliance Officer
Ashley Cabrera, CHC serves as MHK’s Senior Vice President of Strategy and Chief Compliance Officer. She is responsible for leading the day-to-day functions of the Compliance Department, managing the Compliance team and developing, implementing, operating, and monitoring all MHK Compliance Programs through collaborative client partnerships. She ensures the MHK product solutions and operations are in compliance with all state and federal laws through constant assessment, client education for new regulations, building timely solutions and ensuring best practices and compliance excellence are adopted, implementing practices consistent with the highest standards of business and professional ethics. In addition, as Senior Vice President of Strategy, she oversees all aspects of strategic planning for MHK, including policy assessment and development, internal and external growth initiatives, and operational process improvement.
Prior to her current role with MHK, Ashley served as MHK’s Senior Director for Program Compliance. Ashley’s experience includes managing compliance for MHK clients with state and CMS regulations and NCQA Standards for Medicare, Medicaid and Commercial plans, as well as product compliance experience at Health Integrated and operations experience at PMSI.
With over 18 years of hands-on experience leading and coaching in fast-paced, complex, high-performing healthcare environments, Ashley is an accomplished healthcare executive, leader, communicator, organizer, and cross-functional collaborator with a proven track record generating significant increases in revenue, efficiency and compliance audit scores through focused and consistent service delivery, policy development, process improvement and standardizations. Ashley holds a bachelor’s degree in Business Administration with a minor in Economics from the University of Florida. Ashley is also Certified in Healthcare Compliance (CHC) and COSO Enterprise Risk Management.
Pamela Cleveland is the Chief Compliance Officer of Sidecar Health based in California. In this role, she is responsible for implementing an Effective Compliance Program that ensures that the organization complies with all state and federal laws, regulatory requirements, as well as policies and procedures. She has more than 30 years of leadership experience, which includes a well-rounded mix of health care, government, and legal proficiency.
Prior to joining Sidecar Health, Pam was the Chief Compliance Officer at Henry Ford Health System for their payer side known as Health Alliance Plan (HAP). Pam also previously served as the Chief Compliance Officer and Vice President of Strategy at Beacon Healthcare Systems in Huntington Beach, Calif. Before that, she was director of Medicare compliance at Medical Mutual of Ohio in Cleveland. She also served as compliance officer at Scott and White Health Plan in Temple, Texas. Earlier in her career, she held a variety of compliance leadership roles at Kaiser Foundation Health Plan of Ohio also in Cleveland.
Having earned a Juris Doctorate degree from Case Western Reserve University School of Law, Pam practiced law in various aspects in Ohio inclusive of serving 11 years as a Magistrate and three years she served as president of the board of education for Warrensville Heights, Ohio.
In addition to her JD, Pam holds a Bachelor of Science degree in social work from The Ohio State University. She is a licensed social worker (LSW) and is certified in healthcare compliance (CHC).
Margaret Crowley has over 20 years of success in leveraging technology to drive sustainable business improvement with profound knowledge of process re-engineering, process mapping, training and change management in highly regulated industries including health plans and pharmaceutical companies. She most recently led the requirements, training and change management functions on the rollout of an Appeals and Grievances system to several lines of business, delegates and partners at a mid-tier health plan. Margaret has vast experience with instituting BPM both from a Business Process Transformation, Optimization and Standardization perspective as well as from a technology perspective including workflow automation, process monitoring and process control. She is passionate about driving operational excellence and helping organizations optimize people, process and technology to drive growth.
Margaret is currently the lead consultant in Medicare/Medicaid compliance at Inspire Innovations working with some of the best health plans in the country.
Laurie serves as the Vice President of Appeals & Grievances at Beacon Healthcare Systems. With more than 20 years of experience overseeing Medicare appeals and grievances for two of the nation’s largest and most highly respected health plans, she currently provides oversight of the company’s highly acclaimed Virtual Appeals Manager (VAM), the industry’s most intuitive and easy-to-use appeal and grievance tool.
Mark is the Compliance Manager at Commonwealth Care Alliance, Inc., a D-SNP and MMP plan sponsor in Massachusetts. Formerly an investigator with CCA's Fraud, Waste, and Abuse team with CCA, Mark has worked in the Medicare and Medicaid Compliance function for just under 5 years. He has worked on regulatory needs on multiple issues for Medicare and Massachusetts Medicaid (also known as MassHealth). These include oversight and guidance on Medicare/MassHealth items of issue around Appeals and Grievances, Compliance Investigations, Claims issues, Vendor Procurement, Pharmacy and PBM, Hospice/Palliative Care, and Ethics. He is also the head of the Regulatory Research program, working closely with CCA Legal on key items.
His current primary charges are the development of CCA's First Tier, Downstream, Related Entity, and Medicaid Material Subcontractor (FDR-MS) Program, and the implementation of CCA's Governance, Risk, and Compliance (GRC) system. The former involves broadening and enhancing CCA's oversight and reach, while the latter involves directly handling the digital transformation of many CCA processes into an automated, cloud-based infrastructure.
Tufts Health Plan
Director Quality Improvement, Accreditation & Regulatory Programs
Director Quality Improvement, Accreditation & Regulatory Programs
Christie serves as the Director of Quality and Accreditation at Tufts Health Plan/Harvard Pilgrim and is also an administrative surveyor with NCQA. Christie has 20 years of experience overseeing regulatory and accreditation visits for one of the nation’s most highly respected health plans.
Linda Gates-Striby has specialized in documentation, coding and compliance for over 30 years. Linda is the Director of Quality Assurance for Ascension Indiana Medical Group.
Linda serves as a nonphysician member on the ACC Coding Task Force, served 8 years as the non-physician member on the HRS coding subcommittee, and serves on the ACC’s CV Management Publications Workgroup
Linda served as the cardiology chair on the Board of Advanced Medical Coding and lead the development of the Advanced Cardiology Examination, and Specialty Coding Examination for cardiology. Linda served as the technical editor for the Cardiology Coder’s Pink Sheet and the technical co-editor of the Interventional Radiology Procedures Pink Sheet published by Decision Health.
Linda is the Owner of Gates Physician Services and provides a variety of consulting, auditing, and educational services to practices throughout the United States
Craig Giangregorio Vice President of Product Management
Craig Giangregorio (MBA) is a serial entrepreneur who launched and sold several software companies. As a senior leader for a Medicare & Medicaid health plan, Craig elevated its service level above 90% and, year after year, helped the plan outperform other managed health plans in California. Having initiated best practice improvements for people, processes and technology, he improved his organization’s overall customer satisfaction from 75% to 94%. Craig also designed and implemented best-in-class operational practices for Health Plan Enrollment, Marketing, Member Services, and A&G departments, which allowed his health plan to pass several CMS and state audits with zero findings. As a Global Service Delivery team leader, his organization achieved the "Highest in Customer Satisfaction" designation by JD Powers and Associates. Craig’s operational, compliance and technology expertise empowers him to architect and facilitate the development of compliance platforms for the Member Services and Appeals & Grievances departments used within the largest and highest rated (i.e., 5 Star) health plans in the United States. Craig is certified in Six Sigma and as a Support Leader by SSPA.
Ana Handshuh, Principal at CAT5 Strategies, is a government programs executive with expertise in creating and implementing corporate programs for the healthcare industry. Her background includes Quality, Core Measures, Care Management, Benefit Design and Bid Submission, Accreditation, Regulatory Compliance, Revenue Management, Communications, Community-based Care Management Programs and Technology Integration. Ms. Handshuh currently serves on the Board of the Resource Initiative and Society for Education (RISE), the preeminent national professional association dedicated to managed and accountable care financing and delivery. She is a sought after speaker on the national healthcare circuit in the areas of Quality, Star Ratings, Care Management, Member and Provider Engagement, and Revenue Management. Her recent consultancy roles have included assisting organizations create programs to address the unmet care management needs in the highest risk strata of membership, document their processes and procedures, achieve accreditation status, design and submit government program bids, institute corporate-wide programs and create communications strategies and materials. She possesses sophisticated business acumen with the ability to build consensus with cross-functional groups to accomplish corporate goals. Ms. Handshuh served as the Vice President of Managed Care Services at Central Florida Inpatient Medicine (CFIM). In this role, she provided leadership and strategy on CFIM projects and collaborations with physicians, risk entities, hospital health care systems, and health plans. CFIM is the largest Hospitalist group in Central Florida, with 70 providers discharging over 50,000 patients annually from multiple hospitals across two health care delivery systems and 24 skilled nursing facilities. At CFIM Ms. Handshuh previously served as the Vice President of Operations. Prior to those assignments, she worked with Precision Healthcare Systems as their Vice President of Quality Improvement. In that capacity, she led the IPA’s Quality efforts and collaborated with payers on implementing programs to move the needle on Quality and Star Rating initiatives. Ms. Handshuh also served as the Director of Corporate Program Development at Physicians United Plan. In this role, she led the Quality Management and Corporate Communications departments and spearheaded the development of innovative integrated technology solutions to drive business excellence and Star Rating achievement initiatives. For the past fifteen years Ms. Handshuh has taken an active role in redefining and implementing changes that have led to improvements and greater efficiency within Government programs and healthcare delivery. Prior to joining Physicians United Plan Ms. Handshuh was the founder of I-Six Creative. Under Ms. Handshuh’s vision and leadership, I-Six Creative provided expertise in the areas of managed Medicare benefit design, MSO/IPA operations, provider network strategy, new market launches, technology integration, corporate communications and quality improvement.
Teneshia is the Manager of Service Operations with Blue Cross North Carolina. She is responsible for providing leadership and direction to business unit leaders who oversee day-to-day business area activities. She has a bachelor’s and graduate degree in Business Administration which allows her to apply her knowledge to increasing best business practices. For the past 20 years, Teneshia has been committed to elevating the customer experience through Quality call auditing, training new or current employees, and creating efficiencies to make work easier for all at Blue Cross NC. Her passion is researching issues proactively to provide solution and resolve quickly.
Nicole Henderson, MBA
Manager of Operations Quality & Compliance, Regulatory Complaints
Nicole Henderson, MBA Manager of Operations Quality & Compliance, Regulatory Complaints
Blue Cross Blue Shield of North Carolina
Nicole Henderson joined Blue Cross Blue Shield of North Carolina (Blue Cross NC) in 2017. She became the Manager of Operations Quality and Compliance with a distinct focus on Regulatory Complaints. In her role, she is responsible for escalation management across multiple teams and implementing compliance strategies that promote a customer-focused culture.
Before joining Blue Cross NC, Nicole served in various roles at Horizon Blue Cross Blue Shield of New Jersey for 15+ years. Nicole has over 18 years of experience in the health insurance industry, which includes 10+ years of experience in the Medicare Advantage line of business related to appeals and grievance management, claims, as well as the Complaints Tracking Module (CTM) complaints. Nicole’s multidisciplinary experience allows her to strategically approach multifaced complex situations and solution effectively in the service organization.
Nicole earned a Bachelor of Business Administration from Thomas Edison University as well as a Master’s of Business Administration from the University of Mount Olive.
Tracy is a Senior Compliance Coordinator at SummaCare Health Plan, where she has worked for the past 20 years. Tracy specializes in the development and creation of compliance tools to better assist in the over-sight of the Compliance program. A strong believer in the power of curiosity in the workplace, Tracy campaigns to assists employees with the art of questioning and leadership influence skills.
Hannah LaMere is Cody’s Director, Special Projects. She brings more than 25 years of experience in the health insurance industry, including expertise in operational processes, compliance and regulatory guidance. Hannah is responsible for managing teams to develop workflows and content for new CodySoft® software modules and reviewing internal policies and procedures to ensure proper documentation of workflows. She also works as a project manager on outsourced document development projects. Hannah has worked with Medicare and Medicaid plans in a number of roles. Prior to joining Cody she was Manager, Medicare Advantage Operations for Dean Health Plan, Inc. in Madison, Wisconsin. She also spent several years as the Federal Government Relations Manager at UCare Minnesota.
Deborah joined SummaCare as the Medicare Compliance Officer in January 2015, and became the Chief Compliance Officer for the insurance arm of Summa Health (SummaCare and Summa Insurance Company) later that year. She is responsible for the health plan compliance program, encompassing all lines of business with an emphasis on Medicare Advantage, Part D, and Marketplace products. Deborah became the health plan Privacy Officer in 2017.
Prior to joining SummaCare, Deborah served as the Compliance & Privacy Officer for Health Alliance Plan in Detroit, Michigan for 12 years. She was in-house counsel, focusing on regulatory compliance, for Univera Healthcare in Buffalo, NY from 1996 to July 2002.
Qualifications and Credentials
Deborah earned a law degree from Case Western Reserve University in Cleveland Ohio in 1995 and is licensed to practice in Ohio (inactive status), New York (retired status), and Michigan (active status). She received her certification in healthcare compliance (CHC) in 2009.
JoAnn has more than 10 years of experience in healthcare and human services. Prior to joining Community Care Plan, JoAnn served as Corporate Compliance and Privacy Administrator for MDLIVE, as well as Corporate Compliance Manager for MDLIVE, based in Sunrise, FL, and Corporate Compliance Analyst for Gateway Health Plan, in Pittsburgh, PA. JoAnn received her Master of Science in Criminal Justice Administration and her Bachelor of Science in Criminal Justice from Point Park University. JoAnn is a member of the Healthcare Compliance Association. She has demonstrated her commitment as a volunteer for South Florida Cares Mentoring Movement for Broward Public Schools.
Angela Muncy, CHC is the DVP, Regulatory and Government Programs Compliance at Blue Cross and Blue Shield of Kansas City and serves as the Government Programs Compliance Officer. Angela has fifteen years of Medicare, Medicaid, Commercial and Health Insurance Exchange health plan and pharmacy benefit management experience. She specializes in interpretation and implementation of federal and state regulations, risk management, and auditing/monitoring. Angela has extensive experience leading cross-functional teams in developing and implementing compliant end-to-end solutions for multiple platforms.
Angela serves as a board member of MAPA, a plan-governed organization whose mission is to facilitate the compliance of Medicare Advantage Health Plans throughout the United States with federal regulations and requirements.
David Reid Sr Director, Operational Performance & Regulatory Support
David Reid is the Senior Director of Operational Performance at Florida Blue with over 17 years of experience in the insurance industry. A Certified Information Systems Auditor (CISA), he is accountable for ensuring business processes across multiple divisions are operationally effective and adhere to regulatory and industry requirements for both Commercial and Government market segments. David’s background is in systems development, database administration, internal auditing, process improvement, operations management and regulatory/accreditation compliance.
Cortney Resto is the Assistant Vice President of Grievances & Appeals at EmblemHealth with over 17 years' experience in the industry. Leading a team of 150+ associates, she is responsible for Grievances and Appeals across Commercial, Medicaid and Medicare lines of business, including ongoing compliance monitoring, audit preparation and readiness and driving action and process change across the organization. Cortney knows that partnering with internal and external business partners is the key to successful Grievance and Appeal operations, leveraging those relationships to drive change and improve the member and provider experience. Under Cortney’s leadership, her team recently completed a multi-year transformation, migrating their Grievance and Appeal platform as well as multiple other operational systems. Fresh out of a CMS program audit, Cortney is passionate about using lessons learned to continually improve her organization.
Melissa Rusk, CLSSBB, CPC Director Claims and BPO Operations
Melissa Rusk CLSSBB, CPC is the Director Claims and BPO Operations at SummaCare in Akron Ohio. In this role, Melissa is responsible for leading Claims, Claims Recovery, and Document Management Services. She leads and oversees multiple internal efforts to ensure compliance with federal and state regulatory requirements and plan performance guarantees. This includes: Fraud Waste and Abuse, FDR management, payment integrity, implementation of new plans and plan changes, weekly and monthly performance monitoring, system upgrades and new system implementation, encounter submissions, and plan audits. She oversees business decisions associated with coverage and payment policies.
Melissa has over 30 years’ experience working within the insurance industry in customer service, compliance and operations.
She is a Lean Six Sigma Black Belt and is certified in Lean by the University of Akron and earned her CPC designation in November 2020.
Beth is the Chief Strategy Officer at Socoski Design & Consulting. She has worked in the healthcare industry for over 20 years, focusing on compliance, patient outcomes, quality improvement, and innovation.
Beth believes that we all have the ability to make a difference, and that everyone should. She is the curator and host of TEDxWestshore, the Board Vice President of Tampa Crossroads, the Board Chair of the American Lung Association in Tampa Bay, author of the #1 best-selling book collaboration "Living Kindly", and runs her own small non-profit helping bring awareness to other organizations doing good in the world.
Beth has an MSW from the University of Pittsburgh, an MBA from Waynesburg University, and an MSCL from Duquesne University.
Delores Stewart Senior Manager, Senior Manager, Medicare Operations Optimization
Delores Stewart (MAcc) is a Senior Manager within Medicare Regulatory Support at Florida Blue. She is accountable for the CMS Mock Audit Program and vendor oversight activities. An experienced Senior Auditor from Deloitte & Touche, Delores is a licensed CPA, former Finance Manager at UF Health (First Coast Advantage, LLC) and worked for Florida’s Office of the Attorney General as a Medicaid Fraud Auditor prior to joining Florida Blue.
Jon Swisher is the VP, Sales and Product for Kiriworks, a leading provider of information and process management solutions that optimize and transform today's business. He has worked as a trusted advisor with both healthcare providers and insurers; utilizing software solutions to drive innovation and process improvement. Jon's team is responsible for designing enterprise-class case management platforms, building integrations with industry leading EMRs and developing technology roadmaps for the interconnected healthcare ecosystem.