Vishal Bhalla MBA,MS,CPXP,SPHR, Vice President and Chief Experience Officer

Parkland Health & Hospital System

Vishal Bhalla is the VP and Chief Experience Officer at Parkland Hospital; is a sought-after thought leader for his unique approach to Patient, Physician, and Team member Experience.

Transitioning to healthcare a few years ago from a successful career in hospitality, Vishal completed his Master of Business Administration from the Massachusetts Institute of Technology (MIT) along with a Healthcare Certificate from the joint Harvard-MIT Healthcare Innovation Initiative. He is certified in Diversity & Inclusion from Cornell and a Senior Professional in Human Resources (SPHR). Vishal also serves on the Dallas Fort Worth Hospital Council, representing Parkland as the Chair for the Workforce Collaborative. He is a graduate of the Texas Hospital Association (THA) Fellows Program for 2019, serves on the Patient Experience Board of The Beryl Institute, is a member of Press Ganey’s Patient Experience Regulatory Advisory Council, on the Advisory Board of HR Exchange Network, and Editorial board of Beryl Institute’s “Patient Experience Journal”. He also enjoys giving back to his alums as an Educational Counselor at MIT.

Laura Breisch VP of Value Capture

Oscar Health

Rafi Cices Associate Director-Value Capture Strategy & Analytics

Oscar Health

Rebecca Darnall Director of Product Managment

CIOX Health

Provides leadership and oversight into new product and business development, growth, and strategy to assist health plans in the optimization of revenue and risk mitigation. With more than 18+ years of healthcare experience, is known for creating and establishing solid operating policies and procedures for all risk adjustment and healthcare programs that comply with CMS requirements and industry practices. Prior to Ciox Health, was the portfolio owner of Risk Adjustment solutions at Cotiviti, an industry-leading healthcare optimization company serving health plans and providers.

Dr. Jatin Dave Chief Medical Officer and Director of Clinical Affairs

MassHealth

Dr. Jatin Dave joined New England Quality Care Alliance as Chief Medical Officer in 2016. Dr. Dave is an internist and geriatrician with more than 15 years of diverse health care experience in clinical, academic and managed care settings. He is board certified in internal medicine,
clinical informatics, geriatrics and hospice and palliative care. Before joining NEQCA, Dr. Dave served as the Medical Director of Geriatrics and Senior Care Options for Tufts Health Plan. He also practiced at Brigham and Women’s hospital for 12 years both as a primary care physician and consultant geriatrician. Dr. Dave completed his training in Internal Medicine at the University Of Illinois College Of Medicine and subsequently completed a General Internal Medicine fellowship at New York University. He then completed a fellowship in Geriatric Medicine at Harvard University where he received his master’s degree in public health. Jatin lives with his wife and two sons in Lexington, MA.

Ryan Davis Medicare Market & Operations, Senior Manager

Centene

Ryan is a Medicare aficionado with over eleven years of experience having been employed by some of the country’s largest managed care entities. Since 2014, Ryan’s responsibilities include oversight of Part D benefit implementation, claims adjudication, the Medication Therapy Management Program, and the Opioid Over-utilization Program for a health plan with over 90,000 Medicare enrollees. Ryan background is comprised of Medicare centric roles with some of the country's largest Pharmacy Benefit Managers. As a Senior Consultant with CVS/Caremark, he managed cross-functional initiatives related post sanction remediation efforts for member communications. At Express Scripts (formerly Medco Health Solutions) Ryan operated as the point-of-contact for multiple Medicare employer group plans to ensure successful benefit administration and client satisfaction.

Shannon Decker Vice President, Clinical Performance

Brown & Toland

Dr. Shannon Decker is the Vice President of Clinical Performance for Brown & Toland. Dr. Decker has more than 20 years of experience in healthcare--14 of which include working with risk adjustment 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, she consults in both the fields of healthcare and education. Her interests include the study of human behavior and how theories on motivation and learning may be brought to bear on population health management.

Joshua Edwards STARS Program Manager

Martin's Point

Josh heads Medicare Star Ratings at Martin’s Point Health Care in Portland, Maine where he helped guide his company’s LPPO contract to its first 5-star Overall Rating in 2020. Martin’s Point’s HMO contract has achieved 5-stars five times since 2010, most recently in 2019.

Kathleen Ellmore Co-Founder and Managing Director

Engagys

Kathleen is a pioneer in bringing the best of consumer marketing and data-driven methodologies to healthcare to motivate better health decisions. As Co-Founder and Managing Director of Engagys, Kathleen leverages the best of behavioral economics, the latest in evidence-based communications combined with the insights from over a billion consumer interactions in health to help healthcare organizations close the last mile of consumer engagement. She consults on all topics related to consumer engagement and experience for the top healthcare organizations in the country.

Kathleen has been recently named as a consultant to the first ever FDA Patient Engagement Advisory Committee (PEAC). She received Stevie awards for highlighting opportunities for improving the lives of people with chronic conditions. She speaks regularly on the national stage on many topics including: driving consumer health engagement, creating better consumer experience in healthcare, and using data to drive consumer behavior.

Kathleen also participates in various healthcare advisory boards, including HealthComp’s Consumer Experience Advisory Board, Linkwell Health’s Marketing Advisory Board and RISE’s Consumer Engagement Advisory Board

Kathleen spent the first twenty years of her career in brand marketing at leading consumer marketing organizations, including General Mills and P&G. Additionally, she was a Vice President at Digitas, one of the leading direct marketing firms in the country. Kathleen has an undergraduate degree from the University of New Hampshire and an MBA from the Kellogg School at Northwestern.

Renee Golderman Senior Vice President, Chief Quality Officer

Capital District Physicians' Health Plan (CDPHP®)

Renée S. Golderman, MS, RN, NE-BC joined CDPHP in 2007 and currently serves as senior vice president of health care quality. In this role, she leads the design, implementation, and management of a quality improvement program focused on providing CDPHP members with efficient, cost-effective, and timely care. Renée also oversees credentialing and appeals.
With more than 30 years of progressive experience in the health care industry, Renee is also responsible for directing HEDIS, NCQA, and Medicare Stars initiatives, which includes collaboration among Medicare risk, medical management, and network providers to drive innovative initiatives to improve quality outcomes and ensure member satisfaction with their health care. She has led health care transformation initiatives, including tools for population health and clinical integration strategies, and assists in design and operational aspects of primary care incentive programs.

Renee served as the director of nursing for Seton Health System, part of the Ascension Health System where she was a recipient of the NYSNA Nursing Excellence Award in Administration/Management. In addition, she held clinical management positions at New England Baptist Hospital in Boston, Mass., and New Britain General Hospital in New Britain, Conn. She also served as a clinical educator for The Eddy in Troy, N.Y.

Renee earned a Bachelor of Science degree in nursing from SUNY Buffalo, and a Master of Science degree in health care management from Rensselaer Polytechnic Institute. Renée is an executive-board certified nurse by the American Nurses Credentialing Center (ANCC) and is a member of the National Association for Health Care Quality.

Ana Handshuh Principal

CAT5 Strategies

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.

Jennifer Hayes Manager, Quality, HEDIS & Coding

Highmark

Kent Holdcroft Executive Vice President of Growth

HealthMine

Kent Holdcroft is the Executive Vice President of Growth at HealthMine, bringing over 15 years of operational, consulting, and business development experience with healthcare technology vendors to our team. Prior to HealthMine, Kent was Executive Vice President at AdhereHealth where he installed the teams and processes that led to record growth and innovation in product strategy. Before that, Kent had multiple successes with AIM Healthcare (now a part of Optum, a United Health Group, Inc. company), rising to National Director as it expanded into new markets. Kent received his Bachelor’s degree in Psychology from Miami University and Master’s in Counseling from the University of Toledo. In his free time, Kent serves on the Board of Directors at BrightStone, Inc., as well as with the Tennessee Crohn’s & Colitis Foundation.

Katharine Iskrant Practice Leader

Healthy People, Inc.

Sharalee Johnson Director, Quality Solutions

Pulse8

Julia Joseph-Di Caprio, M.D., M.P.H. Senior Vice President and Chief Medical Officer

UCare

Dr. Joseph-Di Caprio leads the Medical Director, Clinical Services, Mental Health and Substance Use Disorder Services, Pharmacy, and Quality Management departments.  Her extensive professional career in the Twin Cities community includes 22 years at Hennepin County Medical Center (now Hennepin Healthcare System) where she began as a Pediatric and Adolescent Medicine Specialist and advanced to several physician leadership roles, including Chief of Pediatrics.  Joseph-Di Caprio also has been a Medical Director for Medica, Senior Medical Director of Care Management for HealthEast, and most recently Fairview Health Services Medical Leader, Connected Care.

Community service is a hallmark of Joseph-Di Caprio’s career.  She serves on the Boards of Directors for University of Minnesota Physicians and Planned Parenthood North Central States, and has served on the Boards of the Loppet Foundation, Minnesota Chapter of the American Academy of Pediatrics, the Bridge for Youth and the Minneapolis Medical Research Foundation.  Joseph-Di Caprio has been a Diversity Climate Expert Panelist for the University of MN Medical School, and is a member of the Health Equity Advisory Council for MN Community Measurement.  She is a long-time Assistant Professor for the University of Minnesota Department of Pediatrics.

Joseph-Di Caprio has a B.S. in Physiology from McGill University in Montreal, Quebec, Canada, an M.D. from the University of Illinois and a Masters in Public Health from the University of Minnesota.

Tejaswita Karve Director, Quality Improvement

Johns Hopkins HealthCare

Tejaswita Karve is the Director of Medicare STARS with the Johns Hopkins Health System. She has previously held roles at several Fortune 500 companies, including Accenture and CVS Health, as well as with Presbyterian Healthcare Services and most recently at UPMC Health Plan in Pittsburgh.

Karve holds a Ph.D. in Biochemistry and Cellular & Molecular Biology from Georgetown University.

Alex Keltner

Innovacer

Mansoor Khan ScD, CEO

Persivia, Inc.

Dr. Khan is a 20-year veteran of the software and healthcare industries. He is a serial entrepreneur who has been developing advanced technologies and cutting-edge software since the mid 90s. Over the years he has led teams that have developed technology and applications for Disease Surveillance, Artificial Intelligence, Quality Management, Analytics, Care Management and Cost and Utilization Management. He has had a particular interest in helping providers and patients transition from Fee-for-Service to Value Based Care. These efforts have won numerous awards over the years including best Decision Support System for ACOs (Blackbook) and Top 100 AI companies. Previously Dr. Khan founded and had successful exits from KeyCommerce (1997 – 2004), DiagnosisOne (2005 – 2012) and was CEO of Alere Analytics (2012 – 2015).

Sharon Kuhrt, RN, DNP Advisor, HEDIS

Priority Health

Sharon Kuhrt is an innovative healthcare leader with experience in health plan quality, acute, post-acute, and outpatient settings.  She currently is the Manager of Quality Improvement at Priority Health in Grand Rapids Michigan.  Here primary responsibility at Priority Health is the HEDIS Program.  Sharon has 12 years of HEDIS experience in health plans, achieving 30% increase in HEDIS scores, leading to five-star results.  Sharon also teaches graduate level                 health informatics, finance and marketing for Northeastern University, Simmons University, and University of New England.  Sharon is an RN and holds a bachelor’s degree in nursing  from Loretto Heights College, master’s degree in nursing from Regis University and doctorate in nursing from Northeastern University.  

David Larsen Director, Quality Improvement

SelectHealth

David L. Larsen has been the Director of Quality Improvement for SelectHealth in Salt La¬ke City, Utah for the past 31 years and has worked for Intermountain Healthcare for 38 years. SelectHealth is a mixed model HMO with more than 900,000 members in Utah, Idaho and Nevada. 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 2020 and 4 Star rating in 2021, maintaining NCQA accreditation; HEDIS performance measurement; CAHPS measurement and reporting, public reporting (transparency) and population health.

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 providers, and direct patient improvement interventions related to chronic illnesses including patient adherence monitoring, reminders and incentive programs.

Rosaneli Loza Manager, Connecting Provider to Home

SCAN Health Plan

Gary Melis Clinical Pharmacist

Network Health

Clinical Pharmacist for the past eight 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.

Haidy Metz, CPC, CRC, CPMA Supervisor, Quality, HEDIS & Coding Revenue Program Management

Highmark

Haidy Metz has over 25 years experience in the healthcare industry specializing in Risk Adjustment, HEDIS, Medicare Stars, and CMS Innovation Models.  She is currently Supervisor of Quality, HEDIS and Coding at Highmark, Inc. where she leads a team that supports Highmark's HEDIS and Risk Adjustment initiatives. Her passion is to a pioneer healthcare reform and achieve maximal impact on patient outcomes through innovative approaches to the business of medicine.

David Meyer Member

RISE Policy Commitee

David Meyer is a nationally recognized thought leader and change agent, with over 20 years of experience in healthcare commercial and government programs operations, data science, clinical outcomes, revenue and quality.  He currently serves as the Senior Vice President of Health Outcomes and Informatics at NationsBenefits, where he is building-out the Research and Data Services unit of the company.  In pervious roles, he has run revenue, quality and healthcare informatics for both regional and national health plans, spanning both Medicare Advantage and Commercial products.  He has been a RISE Advisory Executive Board Member 12+ years, and is a frequently invited speaker at conferences and summits.  

Jennifer Pereur VP of Solutions

Apixio

Noris Reyes Chief Operating Officer

PrimeHealth Physicians

Janine Sala Director, Population Health, Quality Improvement

UnitedHealthcare

Janine Sala, Director of Quality Improvement for UnitedHealthcare Nevada has worked in the Quality Department since 2010 and brings over 20 years of experience in the health care industry, specifically working in the areas of quality, performance improvement and HEDIS®.

Currently Janine oversees the Population Health Team that includes oversight of our member facing teams; disease management, pregnancy concierge, call outreach and health education and wellness. These teams work together to ensure our members have favorable health outcomes, manage chronic conditions and are able to live healthy lives.

As a long-term quality operations administrator, Janine is highly skilled in performance improvement, analytical skills and strategic planning, combining both metrics and operational strategy to promote and sustain success.

Steven Selinsky VP of Product Strategy, Marketing and Community Outreach

Health Alliance Plan

As the vice president of product, marketing and community outreach, Steve Selinsky is responsible for coordinating all sales and enrollment activities for HAP’s individual and Medicare customers, as well as the development of HAP’s government and commercial products.  He is also responsible for all of HAP’s marketing and communications activities, as well as the company’s community engagement, which includes sponsorships and community partnerships in the geographic areas in which HAP does business.

Steve joined HAP in 2013, having held sales leadership positions at several major health insurers throughout his 25-year career.  He served as the president of the National Association of Health Underwriters from 2010 to 2011 and was a board member and chair for NAHU’s education foundation.  In 2017, Steve received the Harold R. Gordon Memorial Award from NAHU.  The award is NAHU’s highest honor and recognizes him as the Health Insurance Person of the Year.

Steve is a board member and past president of the Metro Detroit Association of Health Underwriters, as well as a board member and chair of the Health Underwriters Political Action Committee (HUPAC).  He also serves on the board of the Hannan Center, which is dedicated to serving the senior population, as well as RISE, an association that provides quality resources for health care professionals.  He previously served on the boards of Oakland Literacy Council and the Village School for Autistic Children.

Steve holds a bachelor's degree from Albion College in Albion, Mich.  He is also a graduate of Leadership Oakland and Leadership Detroit.

Reva Sheehan Government Programs Strategic Market Executive

mPulse Mobile

With more than 15 years’ industry experience ranging from long term care and compound pharmacy management to health plan quality and operations, Reva excels in engaging internal and external stakeholders to improve processes for optimal outcomes while keeping the member’s experience at the heart of every conversation.

Kristy Smith HEDIS Program Manager

Martin's Point

I started my career in healthcare in 2007, working in the mental health field, cardiothoracic intensive care then in the emergency department of a level 1 trauma center. In 2017 I left bedside nursing to work for Martins Point Health Care as a CDI nurse/HEDIS reviewer, then as the HEDIS Administrator in 2018. I live in Gorham Maine with my husband, two children, and dogs that keep me busy.

Melissa Smith EVP of Consulting & Professional Services

Healthmine

Melissa Smith brings over 25 years of experience in Star Ratings, strategy, sales, and marketing for health plans, providers, pharmacy benefit managers, and industry vendors. As the Executive Vice President of Consulting and Professional Services, Melissa draws on her extensive industry experience to help health plans become better, faster, and stronger. Her team of consultants understand the challenges clients face day-to-day because they have worked within health plans prior to consulting. Fueled by this valuable perspective, Melissa develops strategic and tactical solutions that meet client needs and improve performance on clinical, medication, patient survey, and administrative quality measures.

Melissa is a well-known thought leader and healthcare strategist with proven success developing enterprise-wide solutions to improve Star Ratings, quality performance, health outcomes, and the member experience. She has helped dozens of clients in a consulting capacity improve performance within HEDIS®, Star Ratings and other quality programs and helps clients evaluate market dynamics and opportunities, optimize distribution channels, and support our clients’ strategic planning needs.

Prior to entering the consulting industry, Melissa served in a leadership capacity at Cigna-HealthSpring where she led Star Ratings efforts for approximately 25 Medicare Advantage contracts. Before working in Medicare Advantage and quality ratings systems, Melissa was an Associate Director at Vanderbilt University Medical Center.

Melissa received her degree from Purdue University and began her career at KPMG, LLP.

Melissa’s unique background of business process, regulatory compliance, and healthcare quality provides a unique combination of healthcare strategy, quality performance, revenue optimization, and other vital elements required for strong Star Ratings.

Kimberly Swanson Vice President, Quality and Clinical Integration

Network Health

Kimberly Swanson is responsible for developing and leading Network Health’s quality improvement program and maintaining quality standards consistent with NCQA, CMS Star ratings and other regulatory agencies. She oversees and implements innovative quality
strategies to improve the health of members and improve care delivery and coordination across Network Health’s broad network of providers. Kimberly also manages Network Health’s appeals and grievances department. Prior to joining Network Health, Kimberly served in a number of positions with Valence Health in Chicago, Illinois, most recently as Manager of Consulting Services and Interim Director of Operations at Community Care Partners. Kimberly has also worked with APS Healthcare and the New York City Department of Health and Mental Hygiene. She has more than a decade of experience in the health care and health insurance industries.
Kimberly specializes in strategic development for quality improvement and value-based care, population health management administration and health plan process and operational improvement. Kimberly is a graduate of Vanderbilt University and also holds a Master of Public
Administration from the Robert F. Wagner School of Public Service at New York University. She is a member of the American College of Healthcare Executives.

Sally Szumlas VP, Enterprise Quality & Performance Outcomes

CareSource

Jeff Tobe M.Ed, CSP, Customer Experience Expert and Author

“Coloring Outside of the Lines”

Certified Speaking Professional, Jeff Tobe’s credentials are impressive.  Insider Magazine dubbed him “The Guru of Creativity” and readers of Convention & Meetings Magazine chose him as one of their favorite speakers along with other celebrities including Bill Clinton, Anderson Cooper, Condoleezza Rice and Daniel Pink.  He is a creativity and customer experience expert, professional speaker and bestselling author who works with companies and organizations who want to increase their bottom line by changing their customer experience and retaining great talent.

After having started and sold three successful businesses, Tobe founded Coloring Outside the Lines in 1994 and since then has worked with hundreds of clients ranging from ones with less than 20 employees to Fortune 500 companies including Microsoft, PepsiCo, Bank of America, ReMax International and many more!

Jeff Tobe’s most requested VIRTUAL or LIVE programs focus on CREATIVITY/INNOVATION, CUSTOMER EXPERIENCE and EMPLOYEE ENGAGEMENT.  His high-energy, high-fun and high-content programs create the ideal presentation for any kind of corporate or educational forum.

Jeff’s articles have been read in hundreds of publications and he is the author of the hugely popular book, Coloring Outside The Lines. He is the co-author of three other books and his newest book, ANTICIPATE: Knowing What Customers Need Before They Do is quickly becoming one of the hottest business books on the market. He is also the creator of the Touch Point Focus initiative in which he helps organizations re-examine their customer touch points and change their customer experience.

Rex Wallace Principal

Rex Wallace Consulting

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.

Kurt Waltenbaugh Founder and CEO

Carrot Health

Kurt Waltenbaugh, Founder and CEO of Carrot Health, 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, he was responsible for Product Strategy at Optum, Inc. (UnitedHealth), building data analytic businesses for the Provider, Payer and Employer markets.

Daniel Weaver VP Stars and Government Quality Improvement Programs

Gateway Health Plan

Daniel Weaver is an established leader with extensive experience developing and implementing intervention strategies to improve Medicare Stars performance. With demonstrated success through innovative programs, Daniel led a Stars Quality team at Highmark for 6 years where they consistently delivered market-leading performance and forward-thinking engagement with providers and members. Daniel moved to Gateway Health Plan to help an underperforming DSNP plan achieve 4 Stars, boost Quality Improvement performance across multiple State pay for performance programs, and expand Risk Adjustment programs.

Melanie Weir Chronic Condition Project Principal

SCAN Health Plan

Richard E. Wild Chief Medical Officer, Atlanta and Boston Regional Offices

Centers for Medicare and Medicaid Services (CMS)

Dr. Wild received his MD degree from the University of Vermont, College of Medicine. Heis board certified in Emergency Medicine by the American Board of Emergency Medicine and is a Fellow of the American College of Emergency Physicians. His internship and residency training were at Letterman Army Medical Center, San Francisco; San Francisco General Hospital; and Walter Reed Army Medical Center in Washington, DC. He served five years as an active duty officer with the US Army Medical Corps and also served as a Department of Defense civilian emergency medicine specialist at Martin Army Hospital, Fort Benning, Georgia. Dr Wild earned his BA in Biology from Dartmouth College, his JD degree from George Washington University National Law Center in Washington, DC, and his MBA from the Columbia University Graduate Business School, in New York City. Dr. Wild has 30 years of experience as a practicing emergency physician ranging from small rural Georgia hospitals to large university teaching centers. He has served on the Medical School faculties of Boston University, University of Massachusetts, and Brown University and was Chairman of the department of Emergency Medicine and Chief of Emergency Services at a teaching hospital of Brown University Medical School. He has taught emergency medicine, health policy, and legal medicine to resident physicians and medical students. Dr. Wild hasserved as President of the Rhode Island College of Emergency Physiciansand as chairman or member of several American College of Emergency Physicians (ACEP) and American Medical Association (AMA) national committees dealing with government affairs, coding, and physician reimbursement. Dr. Wild is an active member of the Massachusetts and U.S. Federal Bar. He has practiced asa health care attorney with a large Boston law firm representing hospitals, physicians, skilled nursing facilities and a major Boston teaching hospital. He was medical director of Medicare’s direct fiscal intermediary in Baltimore and also CMS (then HCFA) Chief Medical Officer for reimbursement policy during the initial implementation the Hospital Prospective Payment (DRG) system. He subsequently served on the Medicare Prospective Payment Assessment Commission staff (now MedPac).