Omar joined Community Health Plan of Washington, CHPW, as the Director of Pharmacy in 2019 after sixteen years with Walgreens Co., where he led Specialty Pharmacy operations for the Pacific Northwest Region.
Omar has extensive experience in Specialty Pharmacy, Managed Care including government programs, and Clinical Pharmacy quality initiatives. Omar’s current role is focused on PBM relationship oversight, clinical pharmacy integration, and utilization management of medical and prescription drug benefits.
Omar received his Doctorate of Pharmacy Degree from the University of Washington in 2005 and continues to reside in the beautiful Pacific Northwest.
Dr. Shannon Decker is principal at VBC One, a consulting firm assisting physician groups, health plans and vendors maximize the performance of their value based contracts and offerings. Dr. Decker has more than 20 years experience in health care and most recently led teams in risk, quality, data and analytics, telehealth, COVID response and delegation compliance. Of her more than 20 years of experience in healthcare--15 include working with risk adjustment, quality and Medicare. Dr. Decker has a PhD. in Interdisciplinary Studies, dual MBA degrees--in Finance and in Marketing, as well as an M.Ed. in Secondary Education and a M.Ed. in Administration and Leadership. Dr. Decker is on the faculty at Arizona State University and is also an associate professor of Higher Education & Adult Learning (HEAL) and chief methodologist for Walden and Capella Universities where she chairs and oversees the dissertations of doctoral students. An author of two books and several peer-reviewed articles, and a prolific national public speaker, her interests include the study of human behavior and how theories on motivation and learning may be brought to bear on population health management.
His background is in management and operational processes for 15 years, and began working in the Risk Adjustment arena 12 years ago. Ryan has proven himself by helping Medical Groups raise their RAF scores to their proper levels. He directed the movement of a 10,000 member group up 43% over a two year period, and an 1800 member group up 53% in the first year. Ryan achieves these results through chart documentation audits, provider and staff documentation training, and provider relationship building. In his most current role Ryan works with multiple groups to optimize their RAF score, while at the same time achieving CMS 5 Star quality. Ryan explains to these groups that getting their RAF score to the correct level will not only drive revenue, but it will also lead to better patient care with improved documentation habits. Ryan is a Certified Risk Adjustment Coder (CRC) credential through the AAPC.
Nichole Hageman, CHC, CHPC, is the Director of Medicare Compliance for Mutual of OmahaRX and serves as the Compliance Officer for the Prescription Drug Plan. She holds a Bachelor’s degree from Indiana University of Pennsylvania and is based in the Kansas City, MO area currently. Nichole has worked in various areas of healthcare for over twenty years, including skilled nursing facilities, radiology and durable medical equipment. She has worked in health plan compliance for over a decade, working with Medicare Advantage and Prescription Drug Plans in Florida, Texas, and Nebraska. Nichole has been with Mutual of Omaha for five years and is responsible for the management and oversight of the Compliance Program.
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, is a Principal & Consulting Actuary with Milliman, Inc. Matthew’s experience includes nearly 20 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 has helped numerous Part D plans and PBMs on Part D strategy to drive savings and create membership growth. Matthew also advises Pharmaceutical Manufacturers on pricing, reimbursement, and market access. 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.
Peter Heinen is a consulting actuary with the Chicago office of Milliman. He joined the firm in 2015. His areas of expertise include Medicare Advantage, Medicare Prescription Drug (PDP), employer plans, and general prescription drug market analytics. In the Medicare market, Peter has assisted Medicare Part D plans with bid preparation and strategic analyses. He also conducts firm-wide research in PDP market dynamics and Part D risk score analysis. In the pharmacy space, Peter has worked with pharmaceutical companies, industry organizations, and government entities. His recent work includes helping clients with payment strategy and regulatory issues, as well as evaluating strategic partnership drug acquisitions. For employers, Peter has assisted with rate setting and reserving for their employee health plans, with emphasis on self-insured plans.
Nikki Hungate, a long-time resident of Western NY region, currently serves as the Director of Medicare & Government Product Strategy at MVP Health Care. Utilizing the 17 years of experience in the health plan industry she us accountable for leading a team of product innovators that create and deliver a suite of high-quality government products that address the needs of the community in a customer-centric fashion, placing emphasis on those populations that are most vulnerable and undeserved. Nikki holds a Bachelors and Master of Science in Health Administration from Roberts Wesleyan College. She is currently an Executive Leadership doctoral candidate at the University of Charleston. Nikki has a passion for sharing knowledge, and also serves as an adjunct professor in the health sciences degree programs at Monroe Community College and Roberts Wesleyan College. In her free time she volunteers as the fundraising coordinator for the local Vietnam Veterans of America chapter in Rochester, NY.
Michelle Juhanson VP, Chief of Staff II, Medicare Part D
Magellan Rx Management
Michelle Juhanson, CHC, CHPC, is VP and Chief of Staff II to the SVP /Plan President at Magellan Rx Management. She is a 2022 Health Care Businesswomen’s Association Luminary and CHIEF member. Michelle is a breast cancer survivor, polyglot, public speaker, and strategist. With 15 + years Medicare and Medicaid compliance and quality experience. Michelle advises industry coalitions and councils on health equity (AHIP, PCMA), pharmacy quality (PQA), compliance (HCCA), and accreditation (NCQA). Michelle is certified in Health Care Compliance and Health Care Privacy Compliance by the Health Care Compliance Association.
Dr. Liu is the Vice President of Pharmacy Operations for the ATRIO Health Plans, where she is responsible for the management and oversight of all Part D related operations. Dr Liu has an extensive background in clinical pharmacy, managed care operations, and data outcome analysis. Prior to this role, she has developed and implemented the inpatient Drug Use Management program at Kaiser Permanente.
Clinical Pharmacist for the past twelve years at Network Health, a local health insurance provider in Northeast and Southeast Wisconsin. I am currently one of three pharmacists involved making MTM calls in-house. My 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.
David Reid
Senior Director, Operational Performance, Risk & Support
David Reid Senior Director, Operational Performance, Risk & Support
Florida Blue
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 Commercial and Government market segments at Florida Blue as well as other entities under the GuideWell Mutual Insurance Holding Company. David’s background is in internal auditing, process improvement, operations management, regulatory/accreditation compliance, systems development and database administration.
MSN with 10 years’ experience in Medicare, Medicaid, and Marketplace Managed Care with proven success in Risk Adjustment. Confirmed track record in operations, program management and process improvement. Demonstrates effective leadership, innovative problem solving techniques, and goal oriented focus to execute business objectives and meet performance expectations. Designed and coordinated all team activities including provider education, training, auditing, data mining, and data analysis to steer program success and achieve performance metrics.
