Fernando Arbelaez Sr Director, Research, Development and Analytics
Fernando Arbelaez serves as the Senior Director of Research, Development and Analytics at Gateway Health Plan®. He oversees advanced analytics programs and medical excellence initiatives, and makes recommendations to executives regarding financial position, quality ratings, clinical stratification and market decisions. Fernando is an Economist, holds a Doctoral degree in Economic Development. He has worked at Gateway Health Plan® for over ten years, his experience has given him comprehensive knowledge of the organizations and the markets that the Health Plan serves.
Nancy Archibald, MHA, MBA, is a senior program officer at the Center for Health Care Strategies (CHCS), where she works on initiatives related to managed long-term services and supports (MLTSS) and integrated care for individuals enrolled in both Medicare and Medicaid. She leads CHCS’ work on the Measurement, Monitoring, and Evaluation of State Demonstrations to Integrate Care for Dual Eligible Individuals, and co-leads CHCS’ efforts for the Integrated Care Resource Center. Ms. Archibald also supports a variety of other projects including Promoting Integrated Care for Dual Eligibles (PRIDE) and Advancing Value in Medicaid Managed Long-Term Services and Supports.
Prior to joining CHCS, Ms. Archibald was a freelance writer and principal of the Blaxhall Group, specializing in health services research. She also was an analyst at Mathematica Policy Research where she conducted both qualitative and quantitative evaluations of federally sponsored demonstrations such as the Medicare Coordinated Care Demonstration, Informatics for Diabetes Education and Telemedicine Demonstration, and the National Home Health Prospective Payment Demonstration. Ms. Archibald also served as a project director for the Peer Review Organization of New Jersey, designing and managing health care quality improvement projects for Medicare beneficiaries.
Ms. Archibald earned master’s degrees in both health policy administration and business administration from the University of Pittsburgh where she received a fellowship from the Health Policy Institute. She holds a bachelor’s degree in biology/psychology from Bates College.
Kim Chen is the Director of Operations for Humana at Home’s (HAH) Special Needs Plans (SNP). Her teams currently provide Care Management to 250,000 SNP members throughout the United States. She has been with Humana 22 years, overseeing various operations and consulting. Prior to joining HAH SNP, she was a Strategic Consultant, where she contributed to $39M in optimization improvements by developing operational strategies to drive financial outcomes while improving quality and compliance. She also spent several years leading Humana Government Business (HGB) teams responsible for administering TRICARE, the federal health and benefits insurance for active duty military and retirees as well as their respective families. Kim currently resides in Crestwood, KY with her husband and children.
Lara is the Director of Care Coordination for Cantex Continuing Care Network. In her role, Lara oversees the company’s focus on alternative payment model strategies with hospital, physician partnerships, value based programming with ACO and bundle partners. She also works with all business lines to focus on the company’s Care Transitions Program. She is the corporate champion for lowering readmissions, INTERACT, and disease management training. She is part of the company executive team for the development of provider owned ISNP. Working closely on network development, model of care and NP model for the ISNP product. Her additional responsibilities include overseeing new company initiatives that target the changing health care landscape, healthcare policy and legislative issues in Washington DC and Austin.
Lara earned her B.S. in Psychology at Texas A&M College Station and her B.S.N. at University of Texas Medical Branch Galveston. She earned her Master’s in Nursing as a family nurse practitioner from the University of Colorado Health Sciences Center in Denver. She is currently an appointed member of AHCA, American Healthcare Association, where she serves on the Survey and Regulatory committee.
Kara Curtis has 20 years of experience in operations, regulatory affairs, compliance, and business strategy for health plans contracting with federal and state governments to serve Medicare and Medicaid populations. Ms. Curtis has over 10 years of experience working for both Fully Integrated Dual Eligible Special Needs Plans (FIDESNP) and Medicare‐Medicaid Plans (MMP). She even worked for one of the first Fully Integrated Dual Eligible Special Needs Plan, Commonwealth Care Alliance in Massachusetts, dating back to 2006. Other organizations include Tufts Health Plan and Cambridge Health Alliance in the Boston area as well as Blue Cross Blue Shield in Illinois. She currently works for Boston Medical Center HealthNet Plan which launched a FIDESNP In 2016.Ms. Curtis has served as adjunct professor in the Elder Care Management Program at Lasell College in Newton, Massachusetts for 4 years. She taught classes in Long Term Care Policy + Finance, Elder Care Policy + Politics, and Long Term Care Housing. Ms. Curtis has Bachelor of Arts from Pennsylvania State University and Masters of Public Administration from Syracuse University.
Yisel De Llano was born and raised in Miami, Florida. She received a Bachelor of Science in Psychology from Nova Southeastern University in 2004. She then pursued her Master’s degree in Marriage & Family Therapy from Carlos Albizu University from Miami, Florida in 2006.
In 2004 she began working as a Case Manager for the Medicaid Long Term Care Program at United Health Care. After a short tenure with United Health Care she was promoted to a position as a Transitional Care Coordinator where she was responsible for overseeing the Inpatient Department including leading the mandatory Interdisciplinary Care Team conferences and working side by side with their Medical Director. In 2007, she was asked to lead a new initiative at United Health Care throughout all of the Medicaid Long Term Care programs in Florida to reduce recidivism rates and improve in post-discharge outcomes. She trained under Dr. Eric A. Coleman, MD, MPH on the Care Transitions Program (Transition Coach) and went on to roll-out the training throughout the state of Florida for all the United Health Care LTC programs. She was eventually promoted into a leadership position and spent 7 years with the company before moving on to complete her clinical practicum.
In 2011 she was offered a position in Coventry Health Care of Florida as the Health Services Director for the Special Needs Plan. During her time at Coventry she went on to grow the program from 14,000 to 40,000 members, In addition to effectively passing all NCQA structure and process measures and CMS audits, she was also able to establish company-wide clinical best practices acknowledged by CMS for the case and disease management of the SNP members while overseeing and guiding the successful implementation of the D-SNP plans across 3 additional states.
Currently she holds a position as Sr. Director for the Special Needs Plans at Florida Blue. She was asked to join Florida Blue in 2016 to develop and implement their first ever DSNP plan. The program began in January 2018. Yisel is currently responsible for leadership and direction in the development and of the Medicare Advantage Special Needs Plans. She provides oversight of the current Medicare SNP performance, vendor management and segment related activities. In 2018, Yisel served as a speaker for the RISE Special Needs Leadership Summit where she shared her experience with successful communication of ICT to improve the ICPs
Roseann DeGrazia is the VP, Regional Network Management. Ms. DeGrazia is responsible for executive oversight and management of the Tower Health UPMC Health Plan Joint Venture. In this role Ms. Degrazia evaluates strategic options that will both facilitate immediate financial stability and position the Joint Venture for future growth in the face of rapidly changing national and local health care markets. Effectuating this strategic analysis to include social, demographic, and economic drivers of current and future health care industry trends that will impact the Joint Venture. Ms. DeGrazia has 20 years of experience in managed care. Ms. DeGrazia’ s background includes leadership positions in managing MSSP contracts, Medicare, Medicaid, Dual Eligible programs, strategic planning and business operations, Utilization Management, Clinical Affairs, population health management and Compliance. Ms. DeGrazia has a BSN from the University of Pittsburgh and a MEd from Penn State University. She is a graduate of Pittsburgh Regional Healthcare Initiative Toyota University and Leadership Pittsburgh.
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 30,000+ 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.
Nancy E. Erickson, BSN, MHA is currently a Director with BluePeak Advisors. Nancy has been in the managed care industry for over 25 years and currently advises Medicare Advantage plans on Medicare compliance and operational requirements, conducts CMS mock program audits, supports plans during CMS program audits, conducts validation audits, assists in remediation of CMS audit conditions and supports development of monitoring and oversight programs. Nancy also provides support to plans regarding Medicare business operations, strategic planning, Medicare policy and program management, including Stars Ratings, Risk Adjustment/Encounter data, product and annual bid review. In addition to health plan support, Nancy has provided support to vendors and providers who are contracted with Medicare Advantage plans.
Prior to consulting, Nancy worked with Care Improvement Plus, a large CSNP plan, as Senior Director for Operations. In this role, Nancy was accountable for operational areas, which included enrollment services, membership reconciliation, credentialing, regional contracting and network management. In addition, she provided oversight of the national vendor and was a contributor in testing, configuration and implementation of in-sourcing key health plan operations with full implementation in 6 months. Prior to this, Nancy worked for WellMed, Inc. a large provider/medical management company in San Antonio, Texas. As Vice President of Business Development, Nancy led a team in the implementation of Disease Management Programs in Ischemic Heart Disease, Congestive Heart Failure and Diabetes with a 50% decrease in emergency room visits and 25% decrease in hospital days. She also led the implementation of a Risk Adjustment program, to ensure appropriate coding of services. She led and implemented a self- funded health insurance plan for 300 WellMed employees and their families in 120 days, providing better benefits at no cost to employees and reduced cost to employer. Finally, she led the development of a provider owned Medicare Advantage Prescription Drug/Special Needs Plan (MAPD/SNP) plan. She developed, implemented and attained state HMO licensure in ninety days. Completed and secured a MAPD contract with CMS for 2006. Accountable for all implementation, including development of new areas for the company– customer service, quality improvement, credentialing and disease management. Following go live, Nancy was Executive Director of the plan, Physicians Health Choice. Before this, Nancy worked for PacifiCare of Texas in various roles, lastly as Vice President of Health Services. During her tenure with PacifiCare, she led a team to National Committee for Quality Assurance, (NCQA) accreditation with 3 clinical “best practice” clinical studies in asthma, diabetes, and Pediatric immunization. She was accountable for operations of Quality Improvement, Health Management/Health Education Programs, Disease Management, Credentialing, Utilization Management/Medical Management and Delegation Management. She led a team to successful merger acquisition review with NCQA, developed in house credentialing shop, redesigned medical management area to improve performance, and implemented disease management programs in Chronic Obstructive Pulmonary Disease, (COPD) and coronary artery disease (CAD). She also led a team to successful integration of QI operations in six months with a 300,000-member health plan, twice the size of PacifiCare.
Melodie Farmer is the Quality Assurance Program Manager for CareOregon’s D-SNP Model of Care Program.
She oversees all internal and external Model of Care campaign components and regulatory Care Coordination services within CareOregon’s Population Health Partnerships program.
Melodie Integrates multi-departmental staff & workflows related to HRA outreach, leads audit preparedness efforts and develops & facilitates Care Coordination Process Improvement strategies.
Melodie’s healthcare experience includes leading successful D-SNP Medicare Program Audit (no findings!), Specialty Clinic Management, Community Health Education, Health Coaching utilizing Motivational Interviewing and Project Management of High Risk Population Health programs.
Michelle Fogg serves as Manager of Operational Compliance for Health Partners Plans. In this role, she is responsible for leading and overseeing the internal and external monitoring processes under the Medicare line of business; ensuring compliance with state and federal laws and regulations.Her direct oversight spans from Pharmacy, Transition Letters, Member Relations, Enrollment, Sales (internal and external), Organization Determination, Coverage Determinations, Appeals (C & D), Grievances (C & D), Claims, LEP, LIS, Network Management, and SNP MOC.She is also responsible for creating and implementing Health Partners Plans’ FDR Program.
Michelle has over 17 years’ experience working within the insurance industry, with 13 years working directly under the Medicare umbrella in local Philadelphia plans as well as national plans.Michelle’s initial introduction to insurance started out in the call center where she developed a strong sense of wanting to educate the members on their health benefits.It was not until she began working with the Medicare business that she truly fell in love with compliance.This resolve stuck with her through her many positions that she has held under Medicare that includes creating a platform in a national organization to review the impact of complaints, process improvement efforts, and conducting monitoring efforts to ensure operational compliance to proactively foresee negative impacts to name a few.
After nearly 15 years working in and around government, Suzanne formed State Health Partners with a passion to improve health care, especially for underserved individuals, by building capacity and bringing innovation to state Medicaid programs.
As Deputy Secretary of Health and Human Resources and Senior Advisor on Healthcare for Governor Terry McAuliffe and as Special Assistant of HHR for Governor Mark Warner, Suzanne has had an instrumental role in shaping and administering state health policies across agencies in Virginia. In her most recent position as Deputy Director of the Virginia Medicaid program, she oversaw the policy, legislation, appeals, innovation, and regulatory divisions of the agency. In that role, she developed a broad network of professional relationships with federal regulators, health care providers, insurers and managed care organizations, citizen stakeholder groups and industry consultants.
In between state government stints, Suzanne worked in the non-profit sector where she spearheaded the Center for Health Care Strategies’ efforts to help states develop integrated care and managed long-term services and supports programs. Suzanne has extensive practical experience with Medicaid policy, managed care, waivers, program development, and implementation and knows the challenges states face on a daily basis. She understands how to navigate the state political landscape and influence the legislative and budgetary process.
Her academic background includes business, law and social work as she earned a Bachelor of Science in Commerce degree from the University of Virginia, a Juris Doctor from George Mason University School of Law, and a Master of Social Work degree from Virginia Commonwealth University.
Angela Lloyd Dir. Medicare Audit & Corrective Action
Health Partners Plans
Angela Lloyd, MPH is the director of Medicare audit and corrective action at Health Partners Plans of Philadelphia (HPP). Angela is responsible for the oversight of Medicare audit program, which includes operations and processes, analyzing data, reviewing Policies and Procedures, documenting work and drafting audit reports. She also works collaboratively with leadership of operational units, and partners with vendors to ensure corrective action plans are developed and manages them through implementation.
Angela has worked at HPP for 13 years and has over twenty years of product, compliance and operations experience in Medicaid and Medicare programs. Angela’s creative and result focused program has proven successful in driving compliance throughout the organization. Her expertise in the execution of regulatory contractual requirements with the understanding of policy in various channels has improved the companies understanding and awareness of the products offered under the Centers of Medicare and Medicaid Services especially the Special Needs product. Angela truly strives for excellence in everything she does keeping the HPP communities and membership in mind. Angela received a bachelor’s degree in business law and graduate degree in public health from Drexel University.
Dr. Cynthia Napier Rosenberg is the Associate Vice President of Medical Services for UPMC Special Needs Plans and Community Health Choices. In this role, she is responsible for the medical direction, clinical leadership and oversight of these programs.
Dr. Rosenberg has over twenty-five years of professional experience in a wide variety of payer and provider settings, including health care insurance, disease management, government programs, hospital clinical administration, medical school and residency training programs, hospice, long-term care, and clinical practice. She has also developed educational programs and outreach related to the senior population for newspaper, radio, and television. Her special interests include population health, social determinants of health, behavioral and physical health integration, and health care for the frail elderly and other vulnerable populations.
Dr. Rosenberg received her medical degree from the University of Pittsburgh. She also received a Master of Arts degree in English Language and Literature from the University of Michigan and additional graduate training in business administration at the University of Pittsburgh Katz Graduate School of Business. She is board certified in Family Medicine and Geriatrics.
Caroline Wilson McDonald is a Principal at Prizm Health Advisory, LLC, a consulting firm focused on Medicare Advantage Special Needs Plans (SNP) implementation, quality improvement and compliance. Prior to founding Prizm Health, Caroline was the SNP Quality Improvement Director at Cigna-HealthSpring where she oversaw the Plan’s SNP products (Dual, Chronic and Institutional) representing approximately 22% of membership and over $1 Billion in revenues. During her time at Cigna-HealthSpring, she developed structures and detailed processes to monitor and comply with SNP regulatory requirements and led the department that provided oversight, quality improvement and project management functions to the operational areas responsible for implementing the company’s SNP Models of Care. Caroline began her career working in Market Intelligence for Healthways and then joined the Business Development and Managed Care Department at Community Health Systems. Caroline has a BA in Economics from Vanderbilt University and a MBA from Harvard Business School. She is also a SNP Model of Care Surveyor on behalf of the National Committee for Quality Assurance (NCQA).
Jim Milanowski has over 30 years’ experience in the management of mental health, substance abuse, behavioral health managed care and medical care coverage programs. Jim currently serves as the President and Chief Executive Officer of Genesee Health Plan. Previously, Jim served as the Vice President of Marketing and Development for the Genesee, Saginaw and Bay Health Plans, administering community based indigent health care plans and subsidized employer plan (1/3 Share Plan). Together, the health plans have covered over 125,000 residents in the three counties. During his leadership, Genesee Health Plan has received the national quality award from URAC for Best Practices in Patient Empowerment and Protection, the Greater Flint Labor Council’s Community Partnership Award, the Robert M. Pestronk Excellence in Public Health Award and the Michigan Association of Health Plans Pinnacle Award for Best Business Practices. He is a limited-licensed psychologist in the state of Michigan, and has extensive counseling experience with adult, child, and adolescent populations. As a strong advocate and community partner, his expertise includes working to reduce racial disparities, uncompensated care, and the impact of social determinants on health access. Mr. Milanowski received his Bachelor of Arts degree in Psychology from Spring Arbor University and his Master’s of Science degree in Clinical Psychology from Eastern Michigan University. He is the President of the Michigan Association of County Health Plans and is a Board of Directors member for the Shelter of Flint.
Hank Osowski, a Founding Member and Managing Partner of Strategic Health Group, is an experienced health care executive and strategist who has provided leadership to commercial, Medicare and Medicaid health plans for more than three decades. He has led several engagements for the firm’s clients on the key challenges of Medicare and Medicaid Managed Care programs in diverse markets, such as California, Wisconsin, Michigan, Illinois, New Mexico, Florida, West Virginia and Hawaii. He has also provided leadership to more than a dozen client plan development undertakings for commercial, Medicare Advantage and Medicaid business startups in multiple states. Formerly the senior vice president of corporate development for SCAN Health Plan, Hank was a key member of the senior leadership team that turned the company around from a “near death experience” into an exceptionally strong financial position and one of the largest nonprofit Medicare Advantage plans in the country. He led SCAN’s expansion into seven additional California counties and as well as its first out-of-state expansion into Arizona where Hank then served as CEO of SCAN Health Plan Arizona and SCAN Long Term Care. He has also led the organization’s strategic planning efforts and initiated an innovation development regimen to seek improvements in care coordination practices and future care outcome protocols. Prior to SCAN, Hank served as a Principal in a national health care consulting organization providing a range of strategic, financial and development services for health plans, physician groups and hospitals. He also served as vice president International Operations for American Family Life Assurance Corporation where he directed the development of start-up operations in the United Kingdom, Germany and Italy, as well as the financial turnaround of the company’s Canadian operations. Hank began his California career as a member of the senior management team responsible for the turnaround and financial survival of Blue Cross of California. In this capacity, Hank led the financial improvement of the individual and small group division and provided leadership to the organization’s strategic planning efforts. A frequent speaker on critical issues facing the Medicare and Medicaid programs, including the opportunities for strengthening a Medicare Advantage plan’s market position, the challenges of supporting programs for the Dual Eligible populations, as well as the principles for structuring effective long term care programs. His insights on some of the challenges facing the healthcare industry have been published in “Healthcare Marketing Report”, “Managed Care Contracting & Reimbursement Advisor”, “Payers and Providers” and “Becker’s Hospital Review” among other publications.
Dr. Cheryl Phillips is the President and CEO of the Special Needs Plan Alliance, a national leadership association for special needs and Medicare-Medicaid plans serving vulnerable adults. Prior tothisshe was the Senior VP for Public Policy and Health Services at LeadingAge. She has also served as the Chief Medical Officer of On Lok Lifeways, the originator of the PACE (Program of All-Inclusive care for the Elderly) model based in San Francisco, and the Medical Director for Senior Services and Chronic Disease Management, for the Sutter Health System, a network of doctors, hospitals and other health providers in Northern California. As a fellowship-trained geriatrician, her clinical practice focused on nursing homes and the long-term care continuum. While at Sutter Health, she developed and led a care coordination program for high-risk seniors enrolled in the Medicare Advantage plan. Dr. Phillips is a past president of the American Geriatrics Society, the organization representing health care professionals committed to improving the health of America's seniors; and is also a past president of the American Medical Directors Association, the physician organization for long-term care. She continues to serve on multiple technical advisory groups for chronic care, nursing home quality and home and community-based services and has provided multiple testimonies to the U.S. Congress. She is a frequent speaker to boards of directors for aging service providers, state and national meetings. She served as a primary care health policy fellow under Secretary Tommy Thompson, and was appointed by the Governor as a California Commissioner on Aging and appointed to the Olmstead Advisory Committee for California. Dr. Phillips is on the Board of Directors of the SCAN Foundation.
Patsy Tschudy is the Corporate Director of Managed Care for Cantex Continuing Care Network. She is a Registered Nurse and CCM with over 40 years of experience. In her role at Cantex she completes all Managed Care Contracting and credentialing activities and has established the infrastructure to support the ever growing needs of the Managed Care environment for in-patient SNF. This includes establishment of a Managed Care Precertification department and Regional Case Management team.
She is the Chair of the Executive Managed Care Committee for Texas Health Care Association (THCA) and is a frequent speaker for this organization as well as local hospitals and Case Management Conferences.
Ms. Tschudy is a graduate of Mobile College School of Nursing. She has served as President and various Board positions at the Case Management Society of America. She was the Co-Chair for Elder Services Provider’s Network, has worked with the American Association of Managed Care Nurses and various other committees in health care. In addition, she has worked on projects with Texas Medical Foundation.
Gretchen is a Certified Internal Auditor (CIA), and a Certified Risk Management Auditor (CRMA) with over 20 years of broad experience in quality assurance, education, compliance, and audit. Gretchen obtained her Bachelor of Arts degree from the University of Richmond and her Master of Arts degree from New York University. She is also a graduate of SACUBO’s College Business Management Institute (CBMI). Gretchen joined Humana in 2012 as part of the Internal Audit Consulting Group where performed audits, oversight and consulting for the Owned Provider and Clinical segment, with a large focus on Humana at Home, Special Needs Plan (SNP) Compliance, Humana Behavioral Health, and Humana’s Owned Provider Practices. Gretchen joined Healthcare Services Compliance and Risk Management in 2017 as the Director of Risk Management aligned to Humana at Home. Her team spearheads all compliance audit activity; CMS audit readiness and execution, risk identification and mitigation, and compliance implementation activities.
Taib Dedic is a Director with Centene’s Complex Care Development and Innovation team. Operating in 31 states and with revenue of $60 billion, Centene Corporation, a Fortune 500 company, is a diversified, multi-national healthcare enterprise that provides a portfolio of services to government sponsored healthcare programs, focusing on under-insured and uninsured individuals. Taib is responsible for product management of Centene’s Medicare-Medicaid Plans (CMS Dual Demonstration) and Aged, Blind, and Disabled (ABD) Plans. Centene operates MMP plans in six states and ABD plans in 18 states.
Prior to joining Centene, Taib worked for several years at UnitedHealthcare. His work there focused on network contracting and unit cost management activities. Taib has a Bachelor’s degree and an MBA from Lindenwood University.
Karissa Smith, LPC, CADC I, Senior Operations Manager
Karissa Smith, LPC, CADC I is the Senior Operations Manager and leads the Regional Care Teams who provide care coordination services to CareOregon’s most vulnerable and underserved members. overseeing the care coordination functions for CareOregon. She is a Licensed Professional Counselor and Certified Alcohol and Drug Counselor within the state of Oregon. Karissa received her BS in Psychology from Oregon State University and her MA in Marriage and Family Therapy from George Fox University. Over the past 12 years Karissa has worked with individuals of all ages and in a variety of settings within the healthcare field including residential substance use treatment, outpatient individual and family therapy, crisis services, and behavioral health care coordination. She enjoys working collaboratively with teams to develop and implement processes that reduce barriers to care and promote effective efficient systems.
Toc Soneoulay-Gillespie, MSW
Social Services Manager, Population Health Partnerships
Toc Soneoulay-Gillespie, MSW Social Services Manager, Population Health Partnerships
Toc Soneoulay-Gillespie has over 20 years of experience working with and advocating for refugees and immigrants. As a 1.5 generation refugee, she brings a unique perspective for understanding the strengths and complexities of this community. She holds a bachelor’s degree in Anthropology/Sociology from Eastern Oregon University and a Master of Social Work from the University of Alaska Anchorage. As an interpreter, consultant, trainer, and community organizer, she believes strongly in raising awareness about meaningful language access and when introduced with humility, can reshape the narratives of historically under-served limited English proficient communities and ultimately transform systems. Ms. Soneoulay-Gillespie serves as a commissioner on the Oregon Commission on Asian Pacific Islander Affairs and in her current role as the Social Services Manager at CareOregon, she continues to be a fierce advocate, promoting health equity within the healthcare network.
Executive Director of Cal MediConnect and Medicare Operations
Garrison Rios Executive Director of Cal MediConnect and Medicare Operations
L.A. Care Health Plan
Garrison Rios is Executive Director of Cal MediConnect and Medicare Operations at L.A. Care Health Plan. In this role, Mr. Rios is responsible for top line revenue growth, as well as net operating results and compliance for the population segment of Cal MediConnect and Medicare products. With a strong external focus, Mr. Rios has substantial involvement in providing organizational direction and solving business strategic issues.
Mr. Rios joined L.A. Care after nearly two decades of experience in the healthcare industry, holding executive and director positions at Blue Shield of California Promise Health Plan/Care1st Health Plan, Humana/Arcadian Management and Kaiser Permanente.
Mr. Rios has a Business Management degree from Holy Names University.
Chief Deputy Director
Virginia Department of Medical Assistance Services
Virginia Department of Medical Assistance Services
Karen Kimsey currently serves as the Chief Deputy for the Virginia Department of Medical Assistance Services (DMAS). Prior to this appointment, she held the position of Deputy Director of Complex Care and Services at DMAS. Karen has over 23 years of experience working at DMAS with an emphasis on vulnerable populations in need of long-term and behavioral supports and services. She has held previous positions in policy and program management.
In her role as Chief Deputy, Karen oversees the daily operations of the agency and works with the Agency Director, Jennifer Lee, MD, to provide leadership and management to all of the programs in DMAS, including the expansion of the Medicaid Program to 400,000 newly eligible adults effective January 1, 2019.
As Deputy Director of Complex Care and Services, Karen’s responsibilities included the oversight of long-term care, behavioral health, and integrated care approaches for vulnerable Medicaid populations, including the Commonwealth Coordinated Care (CCC) Demonstration. This model of care was then expanded statewide to cover over 200,000 individuals in what is now known as CCC Plus. Karen made sure Virginia was the third state in the country to develop the CCC Plus program and now she has become a national leader on how to develop programs that blend funding sources and services for the benefit of individuals who use long term care and behavioral health services.
Another significant program that Karen led the development of is the Addiction, Recovery and Treatment Services (ARTS) program, which began April 1, 2017 to address the Opioid epidemic. This is a major transformation within the Medicaid program to serve those with substance use disorders and offers a new comprehensive continuum of care that provides evidenced-based services to promote recovery for those with addiction.
In addition, Karen led the major redesign of the community-based Developmental Disabilities programs, which serves more than 30,000 Virginians. This was accomplished under her leadership and in partnership with the Department of Behavioral Health and Developmental Disabilities. Karen provided consistent leadership and guidance related to the redesign, advocacy with our federal partner, housing efforts, and development of complex regulations. Often this leadership included creative ideas and options to be considered in moving forward with true community integration.
Karen obtained her Bachelors in Social Work from James Madison University and has a Master’s degree in Social Work with a Certificate in Aging Studies from Virginia Commonwealth University. Karen enjoys staying active and spending time with her two sons Evan and Andrew. She also enjoys yoga in her spare time.
Abner Mason is the founder and CEO of ConsejoSano, a patient engagement platform that connects payers, providers and health systems with their multicultural Medicaid, Medicare and undeserved populations. Before creating ConsejoSano, Abner was Founder and CEO for the Workplace Wellness Council of Mexico, now the leading corporate wellness company in Mexico. From 2003-2008, he was founder and Executive Director of AIDS Responsibility Project, driving the creation of CONAES and JaBCHA, the first business councils on HIV/AIDS in Mexico and Jamaica. Abner previously served as Chairman of the International Committee and member of the Presidential Advisory Council on HIV/AIDS (PACHA), appointed by President Bush in 2002. He spent ten years in the Massachusetts State government, including roles as Chief Policy Advisor to Massachusetts Governors Paul Cellucci and Jane Swift, Governor Cellucci's Undersecretary of Transportation, and Deputy General Manager of the Massachusetts Transit Authority. Before joining state government, Abner worked as an Associate Consultant for Bain & Company. In 2018, he founded Health Tech 4 Medicaid (HT4M), a non-profit coalition of healthtech leaders collaborating to create technology for Medicaid programs. Additionally, he is a founding council member of U.S. of Care, a nonprofit centered on improving healthcare access developed by former Medicare/Medicaid administrator Andy Slavitt. Abner is a graduate of Harvard.