Rise

Fred Bentley Managing Director

ATI Advisory

Fred Bentley is a Managing Director in ATI's Post-Acute/Long-Term Care and Senior Living Practice. He provides strategic consulting services to leading post-acute and long-term care organizations along with health plans, investors, and innovators in the senior care industry. He focuses on payment and delivery system innovations that lead to more efficient, better-integrated care for vulnerable patient populations.

Prior to joining ATI, Bentley served as Managing Director at Avalere Health. In that role, he was Avalere’s lead spokesperson on value-based care, CMMI models, and post-acute care issues. He worked with leading payers, providers, and technology companies to define their growth strategies and develop innovative partnership models. Bentley’s experience with post-acute and long-term care organizations stretches back ten years to his days at The Advisory Board Company, where he launched the Post-Acute Care Collaborative. This research program provides strategy and operational research and consulting to leading senior care providers.

Bentley’s work sits at the intersection of payers and providers, helping forge innovative partnerships and new business models that improve the quality, efficiency, and patient experience for Medicare and Medicaid beneficiaries. As a keynote speaker and panelist at industry conferences, he is frequently asked to provide an expert perspective on the future of the post-acute care industry and opportunities for innovation and disruption. Bentley earned a master’s degree in Public Health and Public Policy from the University of California, Berkeley, and a bachelor’s in Political Science from Haverford College.

Michael Cheek President & CEO

Special Needs Plan Alliance

Mike Cheek is the President & CEO of SNP Alliance, a national force for improving the health and well-being of individuals living with significant, complex needs through specialized managed care. Mike comes to the SNP Alliance from his role as the Senior Vice President for Reimbursement and Market Strategy for the American Health Care Association/National Center for Assisted Living (AHCA/NCAL). Prior to this role he was the Director of Medicaid Long Term Care for the District of Columbia’s Medicaid agency, the Department of Health Care Finance.

Dr. Shannon Decker MD, PhD., MBA, M.Ed., Risk Adjustment Expert

VBC One

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.

William Dede Health Policy Associate

Special Needs Plans Alliance

Will Dede is currently the Health Policy Associate at the Special Needs Plan Alliance, where he focuses on advancing the integration of Medicare and Medicaid services for individuals dually eligible for Medicare and Medicaid. Will primarily works to advance integration at the federal level on behalf of SNP Alliance members, who provide benefits for about 60% of beneficiaries enrolled in special needs plans and Medicare-Medicaid plans.

Will Dede joined the SNP Alliance from Duty First Consulting, where he supported the Center for Medicare and Medicaid Services (CMS) in its administration and oversight of the Affordable Care Act. During his time there, Will supported the state technical assistance team’s oversight of the 39 state Exchanges using the federal platform HealthCare.Gov. Will provided these 39 states policy and operational guidance with matters related to the certification of Qualified Health Plans intended to be sold on HealthCare.Gov.

Additionally, Will was a Program Analyst with the National Resource Center for Participant-Directed Services (NRCPDS). At NRCPDS, Will worked directly with the Veterans Health Administration on oversight of the Veteran-Directed Home and Community-Based Services (VD-HCBS) program by providing management and policy guidance to medical centers on the implementation of VD-HCBS.

Will holds a Bachelor of Arts with a double-major in Political Science and History from Randolph College and a Master of Public Policy from American University.

Kerry Delaney Chief Executive Officer

Partners Health Plan & Care Design New York

Kerry Delaney currently serves as the Chief Executive Officer for Care Design NY (CDNY), Partners Health Plan (PHP), and Partnership Solutions. These three companies collectively serve nearly 30,000 New Yorkers with Intellectual and Developmental Disabilities (I/DD), providing comprehensive and integrated care management, a managed care program for dual-eligible individuals with I/DD and a management service organization dedicated to bringing top-tier administrative and management services to I/DD organizations.  Prior to joining these organizations, Kerry served for over four years as the Acting Commissioner of the New York State Office for People With Developmental Disabilities (OPWDD), a service provider, employer of over 18,000 staff, and oversight agency for over 700 providers. In this capacity, she constituted a stakeholder Transformation Panel and oversaw implementation of its 40-plus recommendations to improve the system of services for people with developmental disabilities; developed and oversaw implementation of Care Coordination Organizations, a new, comprehensive care coordination model developed by OPWDD providers; put the State on a path toward provider-led managed care for developmental disability services; and oversaw a redesign of the State’s rate structure and quality measurement for OPWDD not-for-profit providers. Prior to serving as Acting Commissioner, she served as Executive Deputy Commissioner and General Counsel at OPWDD and was an Assistant Counsel to the Governor. Ms. Delaney is a Summa Cum Laude graduate of Albany Law School where she served as an Executive Editor for Lead Articles on the Albany Law Review and a Dean Thomas Sponslor Honors Teaching Fellowship.

Lana Djordjevic Director, Product Development, DSNP

Priority Health

Lana Djordjevic is the director of the D-SNP product at Priority Health. In her role, she oversees all aspects of product performance and lifecycle, including ideation, strategic feasibility assessment and implementation. Djordjevic is also responsible for establishing innovative solutions and care interventions that address critical social determinants of health within the dually eligible population. Under her leadership, her team increases access to quality care for members, ensures compliance with state and government contracts and drives meaningful member engagement.

Emsija Dolic-Muratagic DSNP Business Development Director Performance Optimization Office

Cigna Healthcare

Emsija Dolic-Muratagic is Business Development Director of the DSNP product at Cigna. In her role Mrs. Dolic-Muratagic is responsible to establish and set direction on where the Duals product should be offered geographically, including expansion and penetration objectives.

She also served as subject matter expert on process integration during system migrations and new business implementation. She is resourceful and experienced leader offering an array of skills within team leadership, new product implementation, strategic operational planning, time, and labor with 20 years’ experience in health insurance administration. She holds undergrad degree from University of Missouri Saint Louis and master’s in healthcare administration from Webster University.

Bill Friedman Vice President of Payer and Provider Engagement

Wider Circle

Bill has deep expertise in selling and marketing digital health engagement solutions to payers and providers with an intimate knowledge of the health payer landscape. Most recently, Bill led payer sales at Carrot Fertility, a global provider of fertility benefits. Prior to Carrot, Bill led all sales and lead generation for Zipari, a SaaS-based consumer engagement solution for health insurers. His team was instrumental in the company's growth from startup to scale and eventual acquisition by Thoma Bravo, a leading private equity firm. Additionally, he was Senior Vice President and Chief Sales Officer for Health Republic Insurance of New York, the largest CO-OP health insurance carrier in the nation, leading sales operations, broker relations, strategic sales planning, and marketing growing the company from startup to 220,000 members in less than three years. Prior to joining Health Republic, Bill served as Senior Vice President of Sales at Easy Choice Health Plan of New York, where he was vital in launching the company’s Medicare Advantage products, and Atlantis Health Plan, a provider-owned HMO focused on the commercial health insurance space.

Mr. Friedman’s recent speaking engagements include AHIP and The RISE Summit on Social Determinants of Health.

In his spare time, Bill enjoys live music, playing guitar, the NY Yankees, and he is currently studying for his private pilot’s license. He lives in New York's lower Hudson Valley with his wife, Lisa, four children, and two poodles.

Rick Grinrod CEO

Provider Partners Health Plan

Rick leads Provider Partners' overall business by establishing strategic relationships with long-term care providers through a Medicare Advantage Special Needs health plan and an ACO REACH company. He is the CEO & President of Provider Partners which includes a Health Plan operating in Illinois, Maryland, Missouri, Pennsylvania, Texas and North Carolina; Provider Partners Management Services and Provider Partners Care Management which specializes in value-based care services for other provider sponsored health plans and Provider Partners Connect Care, which falls under the CMS ACO REACH model. 

Joshua Habib Chief Operating Officer

Together Senior Health

Joshua Habib is a growth, operations and product leader (15 years at UnitedHealthcare) with a proven record of
successfully creating, bringing to market and growing payer-, provider- and employer-facing products and services.
With unique expertise in Medicare and elder care, Josh’s comfort with complexity and ambiguity has led him to
succeed with integrity by looking around corners, walking toward challenges and creating collaborative partnerships.

Josh is currently the Chief Operating Officer of Together Senior Health, a Redesign Health-backed company that
improves the quality of life and reduces the cost of care for the 1 in 9 seniors with Alzheimer’s disease. Josh oversees
clinical and general operations, commercial traction, and client success in this role. Josh directly helped secure
Together’s first ACO and first Medicare Advantage clients in 2023, and he is currently leading their successful
implementation and execution.

Previously, Josh co-Founded UnitedHealthcare’s (UHC) Group Retiree Medicare Advantage business, which
organically grew to $18B in annual revenue during his tenure. Among many notable achievements, Josh developed
UHC’s retiree member reward program (achieving a 4.5-star rating for UHC’s largest CMS contract); formalized the
go-to-market approach for national Medicare Advantage PPO products; sold the first UHC national group Medicare
Advantage plan; sold the first UHC private Medicare exchange program; and identified and closed product-market
gaps leading to $3 billion in additional sales. At times Josh supported or led the sales, growth strategy, product, and
total cost of care management functions.

While at UHC, Josh received numerous awards and honors including the UnitedHealthcare Living the Values Award;
2-time Pinnacle winner (top sales performance); UnitedHealth Group Innovation Champion; and authorship of
articles that were published in the UnitedHealth Group Enterprise Research and Development portfolio.

Josh has been a Medicare thought leader for nearly 25 years. Before joining UHC, he was a national Medicare expert
at Towers Perrin, advising large employers on the strategy, design and funding of post-retirement benefit programs.

In addition to his work at Together Senior Health, Josh is a member of the LionBird Rings, a venture capital
community of proven executives and entrepreneurs who support the next generation of digital health leaders. He is
also President of Astra One Consulting, providing advisory services for cutting-edge health care companies.

Josh is active in organizations that preserve local history (Long Island, NY) and the quality of life for seniors with
Alzheimer’s disease. Josh is an Alumni Admissions Ambassador for Cornell University and is proficient in French.

Josh holds a Bachelor’s degree from Cornell University and an MBA from the Zicklin School of Business, Baruch
College, City University of New York.

Melinda Karp President & CEO

The Center to Advance Consumer Partnership

Ms. Karp has almost thirty years of experience as a leader in the health care sector working within numerous health plans and care systems to develop innovative approaches to transform health care experience and outcomes through authentic engagement and cultures of partnership with those who possess the expertise of lived experience. Melinda is a co-founder and the President and CEO of the Center to Advance Consumer Partnership (CACP) where she leads the organization in delivering on its mission to be a catalyst for forward-looking healthcare and human services leaders in building organizational infrastructure and culture that ensures consumers with complex needs become enduring partners, meaningfully engaged in creating systems of care and service that fulfill their needs. She holds an MBA in Health Care Management and Policy from Boston University and a BA in Psychology from Duke University.

Jenn Kerfoot Chief Strategy & Growth Officer

DUOS

Jenn brings her deep understanding of the complexities and nuances within the Medicare Advantage & Value-Based Care landscape to their work at DUOS, where they lead business development, go-to-market strategy, and marketing. By leveraging data-driven insights and market intelligence, they spearhead the development of tailored products and services that cater to the unique needs of Medicare Advantage plans and deliver unparalleled value to clients and beneficiaries alike; previous leadership roles include FarmboxRx, Excelera Health, and NationsBenefits. Beyond her role at DUOS, Jenn actively contributes to the industry's progress as a thought leader leveraging expertise and advocacy for innovative healthcare practices to enhance healthcare accessibility and quality.

Anna Kimelfeld, DNP , ANP , PMHNP , RN AVP of I/IE-SNP & Geriatric Complex Cre Clinical Services

MJHS Medical Associates PC

     Anna Kimelfeld DNP, PMHNP-BC, ANP-BC, WCC, RN is an Assistant Vice-President of Clinical Services for Elderplan - Metropolitan Jewish Health System, a large health care organization in the greater NY region. She obtained RN, BSN degree from NYU, have two master’s degrees from Hunter College (CUNY) and dual ANCC board certification as an adult nurse practitioner (ANP) and psychiatric nurse practitioner (PMHNP), as well as a doctoral degree (DNP) from the Rutgers University, NJ. As a part of her doctoral training, Anna authored a research study that focused on dementia care and the mental health needs of family caregivers.

   An accomplished clinician with over 20 years of practical experience as a nurse practitioner caring for patients with complex medical and psychosocial needs, in her leadership role Ms. Kimelfeld is providing operational and clinical oversight of special needs programs in over 25 Long Term Care and Assisted Living facilities in NYS as well as programs for the most vulnerable community dwelling Elderplan members with multiple medical and psychiatric co-morbidities. Using evidence-based practice guidelines Anna worked with her instrumental clinical management team on implementing numerous practice innovations and clinical protocols which have improved the ability to identify the highest risk individuals and then enact patient-specific interventions for these patients who are at jeopardy for possible catastrophic health decline, avoidable hospitalizations, and hospital readmissions .

   As a Psychiatric NP, Anna provides services in outpatient/telehealth practice where she follows adult patients with variety of mental health needs including substance use disorder. Anna Kimelfeld is also passionate about helping health care professionals and people in leadership positions to manage the stresses of a highly charged work environment and reduce the risk of burnout. Ms. Kimelfeld’ s background and experiences as an adult nurse practitioner (ANP) caring for adult and geriatric clients in primary care and extensive experiences in health care leadership roles have afforded her an ability to appreciate the interconnectedness of medical, psychiatric, and life-style aspects of her patient’s health and wellbeing.

  Ms. Kimelfeld has presented the results of the successful initiatives that focused on improving care for patients in the long term care and community settings at multiple national and international meetings including Care Coordination and Technology Congress, Atlanta January 2019, Annual NP NYS Conference, Saratoga Springs October 2018, Annual  Special Needs Plan Leadership Summit ,Dallas June 2018 ,Annual National NP Conference (Las Vegas October 2017, Orlando May 2016, Philadelphia May 2015, and Chicago April 2014). She has also presented at the Mental Health and Psychiatric Congress (Orlando September 2014) and the National American Conference for Nursing Leadership (Washington DC March 2014).

Mindi Knebel Chief Executive Officer

Kaizen Health

Mindi Knebel is the Founder & CEO of Kaizen Health, as well as Chair of the company’s Board of Directors. A startup junkie who is passionate about social entrepreneurship, Mindi has worked across several industries and has seen companies from inception through successful exit.

Mindi was part of the founding team of MATTER, a healthcare technology incubator formed through a public-private partnership in the city of Chicago. Prior to that, she lead operations and corporate development initiatives for growth stage companies in service, veterinary and technology industries.

Mindi holds a bachelor’s degree from the University of Iowa and a master’s in business from Colorado Technical University. She enjoys spending time with family & friends, running, yoga and is a proud Packers shareholder and also an avid fan of the Iowa Hawkeyes, Cubs, Bulls and Blackhawks.

Karen Mason MBA, Director of Client Services

BluePeak Advisors

Karen Mason, MBA, is Director, Client Services at BluePeak Advisors, a division of Gallagher Benefits Services, Inc. Karen has been in the health care industry for over 20 years with experience in Medicare, Medicaid, Individual and Employer plans. Karen has extensive experience in CMS and other government requirements, specifically related to Contact Center and Appeals and Grievances. Within those areas, she has implemented new plans, assisted plans in turnaround efforts, and functioned as an operational leader.

At BluePeak, Karen is responsible for partnering with clients to find solutions to meet their key objectives and goals. Her firsthand experience leading health plan operations coupled with her knowledge in plan implementations, project management and process improvement allow Karen the ability to support a client from different angles to develop strong solutions and drive results.

Prior to BluePeak Advisors, Karen worked as a director supporting various clients with building new government health plans. Karen’s primary focus was implementing infrastructure and ensuring regulatory compliance for the plan Contact Center and Appeals and Grievances departments. In this role Karen also served as a consultant to existing plans who were not within regulatory requirements and assisted with remediation and the successful passing of validation audits.  As a Senior Director Karen took over running TPA operations of Appeals and Grievances and Contact Center for numerous health plans, overseeing over 400 employees who supported over 1 million plan members. Karen demonstrated a successful model of meeting or exceeding operational metrics, driving process improvements and staying on top of changing regulations. Karen successfully led her departments through numerous government audits and supported NCQA accreditation for the organization. She has worked as a Black Belt Six Sigma Project Specialist, driving process improvement in various parts of the health plan space including Utilization Management, Population Health and Case Management.

Karen holds a master’s in business administration from the University of Maryland.

Steven Merahn Medical Director

Partners Health Plan & Care Design New York

Dr. Steven Merahn is the Medical Director at Partners Health Plan (PHP) and Care Design NY both exclusively dedicated to supporting individuals with intellectual and developmental disabilities and their circles of support.  He is an experienced physician-executive focused on care delivery redesign and clinical operations for person-centered care, and systems-based practice with special focus on clinical integration for special needs communities.

Before joining PHP Dr. Merahn was a consultant to a multi-state Institutional Special Needs Plan focused on implementing a multi-disciplinary model of care. Prior to that he was Chief Medical Officer at Centria Autism Services, a national autism services provider, where supported clinical policy and program development and clinical operations management and grew their operations from 500 to 3,000 children and families

Before joining Centria, Dr. Merahn was the Chief Medical Officer at US Medical Management (USMM), a Centene Company, where he led a 14-state 42-office primary care network delivering home-based primary care to complex/fragile and disabled patients based on a intensive continuum of care model to extraordinary Triple Aim results and top tier performance in value-based contracting as a Medicare Shared Savings ACO and with commercial payers. 

Previously, Dr. Merahn was a Senior Vice President and Senior Medical Director at Aetna’s Active Health Management Unit, where he led clinical program teams focused on accountable care, providing clinical analytics, care management and patient engagement initiatives for both provider networks, health systems and employer plan sponsors. 

Dr. Merahn is an established thought leader and national speaker on the healthcare transformation and a vocal advocate for health equity and the power of human-factors in care delivery and health status improvement for both patients and communities, rooted in collaboration, systems innovation, and healthcare interaction design. He is the author of Care Evolution: Essays on Health Care as a Social Imperative which advocates for health as a social imperative and for healthcare as a fundamentally human endeavor and is the only physician on the national Autism Commissioner on Quality.

Dennis Mihale Chief Medical Officer

Upward Health

Dennis P.H. Mihale, MD, MBA, CHCQM, FABQAURP is a physician executive with over 30 years of experience in technology, value-based care, telehealth, managed care and clinical medicine creating and leading teams from start-ups to large-scale organizations. A pioneer in new technologies and Value Based Reimbursement (VBR), he has built programs and taught physicians about VBR, including documentation, coding and compliance. He founded two HMOs and several healthcare tech companies and served in executive leadership roles for IBM, McKesson, CHP (Berkshire Hathaway), Upward Health, CareSync, PatientKeeper, Anthem/Freedom and as the CMS Physician Champion for ICD-10 in Florida. He is a retired Major from the US Army Reserve MC and assistant professor at the USF Morsani College of Medicine.

Ja-Nee’ Mooney Director of Care Management

Belong Health

Ja-Nee has over 17 years of experience improving the healthcare experiences and outcomes of the most vulnerable populations by ensuring they receive the right care at the right time and in the right setting.

Before Belong, Ja-Nee worked directly with delegated partners who were responsible for SNP care coordination activities on behalf of Humana. Under her scope were all aspects of the delegated SNP program for Humana, including compliance, Model of Care development, policy and procedures, reporting, and audit readiness. She began her career as a Registered Nurse delivering care in a community hospital in Clarkston, Washington.

At Belong Health, Ja-Nee is responsible for delivering high-quality and personalized care for members with complex and chronic conditions. She moved to her current role in clinical operations to utilize her compliance expertise and directly impact member care.

Ja-Nee’ leads a diverse team of care managers, nurses, social workers, and others who work collaboratively with providers, caregivers, and community partners to coordinate and manage member care. As part of this role, she utilizes data, analytics, and evidence-based practices to monitor and evaluate the quality and effectiveness of care management programs to remain audit-ready and proactively identify and address any gaps or opportunities for improvement.

Ja-Nee’ has a BSN-RN from Spalding University in Louisville, Kentucky.

Kimberly Moran AVP of Facility Based Products,

Elderplan, MJHS

Ms. Moran develops and implements Centers for Medicare & Medicaid services’ patient and revenue growth strategies, with a principal focus on managed care market share, payer, and provider relationships.

Ms. Moran comes from Elderplan, Inc., the health plan arm of Metropolitan Jewish Health systems, a premier non-profit health system integrating health plans with the full continuum of post-acute services (nursing homes, medical practice, homecare, housing, care management & hospice) with over $1.6B in annual revenues, where she has led key strategic efforts across Elderplan ‘s Medicare lines of business, with a focus on institutionalized Medicare beneficiaries , and leading planning for and response to changes in federal policy. Throughout her career Ms. Moran has overseen over $500M in health care transactions, She is a national expert in Medicare Advantage Special Needs Plans focused on the frail elderly population. As member of the team responsible for all operations of the health plan, she has responsibility for developing and executing medium and long-term strategy for institutionalized Medicare beneficiaries. Ms. Moran has also worked as a product expansion, reimbursement, and compliance consultant.

Laura Paduano, DNP-ANP-BC, CDEO Director of ISNP Clinical Services & Quality Management

MJHS Medical Associates PC

Laura Paduano graduated in 1983 from SUNY Farmingdale and then continued her education at SUNY Stony brook obtaining a Bachelor of Science degree in Nursing and a Master of Science Degree in Nursing obtaining certification as an Adult Health Nurse Practitioner.

She was awarded an overall excellence award for academic and clinical achievements. Dr. Paduano was also given the opportunity to do an additional internship through the Veterans Administration, where she practiced primary care, and was afforded the opportunity to rotate through all specialty clinics.

In 2014 Dr Paduano graduated from the George Washington University with a Doctorate in Nursing Practice, completing a clinical research project: Improving Care Transitions for CHF Patients in Post-acute Care Settings.”

Dr Paduano’ s clinical experience includes, primary care, internal medicine, occupational medicine and developing a medical home within a private practice providing care for patients in the home setting through SNF care. She holds national certification through ANCC, and AANP; she is a Certified Medical Examiner for the Department of Transportation, wound care certified and is a certified documentation specialist for the outpatient setting.

Dr Paduano has been working in the ISNP field since 2005 as a practicing NP, clinical manager and is presently the Director of Clinical Services and Quality Management for The Metropolitan Jewish Health Systems, Medical Associates PC.

In addition, Dr Paduano has a private Nurse Practitioner Practice, where she makes medical house calls to the vulnerable population for elderly, chronically ill patients. She carries her passion of treating in place and avoiding unnecessary hospitalizations in the home and assisted living settings.

Dr Paduano presented her clinical research project: Improving Care Transitions for CHF Patients in Post-acute Care Settings.” At the American Academy of Nurse Practitioners Annual Conference June 2015, New Orleans, LA, and Sigma Theta Tau International Honor Society Las Vegas, NV November 2015.

Additional presentations include Stop DWI: NYS Program Evaluation Presented at The George Washington University, 2013. Using Analytical Methods to clinically appraise existing literature and other evidence to develop and implement the best evidence for practice, The George Washington University, 2012.

Identify Acute Change in Condition in Long Term Care setting. Presented to DNP students at The George Washington University 2011. Presented to staff CNAs at Smithtown Health Care Facility 2012.

Clinical Significance of Hypodermoclysis in Treating Dehydration in the Elderly presented to RN and LPN staff at numerous long term care facilities as a facility in service to teach staff competency in administration methods.

Dr Paduano and her colleagues presented the results of several successful initiatives in the improvement of patient care in long term and community settings at the Annual NP NYS Conference, Saratoga Springs October 2018, and the Annual National NP Conference (Las Vegas October 2017).

Siena Ruggeri Community Engagement Consultant

Community Catalyst

Siena Ruggeri is a Community Engagement Consultant for the Center for Community Engagement in Health Innovation at Community Catalyst. In this role, she supports organizations as they meaningfully engage with their communities, with the goal of improving health care services and overall health of people with complex needs, particularly those from systemically excluded communities.

Siena is passionate about health justice. At the Center, Siena provides consulting services to a range of organizations, including health plans and providers, hospitals, state agencies, and organizations serving older adults, people with disabilities, and people with complex health care needs. Siena offers facilitation, training, and other services to assist with developing and implementing programs to better serve members/patients, with a particular emphasis on beneficiaries of Medicare and Medicaid. At the same time, Siena seeks to advance opportunities that address social drivers of health, and promote health equity.

Previously, Siena worked as a government relations associate at NETWORK Lobby for Catholic Social Justice, where her portfolio included health care, housing, labor, and paid leave federal policy. Siena received a bachelor’s degree in politics from Regis University and a minor in peace and justice studies.

Laura Sheriff RN, MSN, CPC, CRC, Risk Adjustment Consultant, Vice President, Risk Adjustment

Southwestern Health Resources tern Health

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.

Jill Sumner Principal

Lyle Health LLC

Jill Sumner, Principal at Lyle Health, possesses over two decades of experience in the healthcare industry. Throughout her career, she has held various positions in payer and provider organizations, with a primary focus on enhancing the delivery and financing of healthcare services for complex and underserved populations. Jill has specialized in establishing partnerships between providers and payers through population health management models, aiming to enhance quality and streamline healthcare spending.

Her ability to identify gaps in the industry and naturally connect the dots to develop innovative solutions has established her as a thought leader in the field. With prominent positions in the two largest professional associations for long-term care providers, she developed multiple successful initiatives to foster productive partnerships between managed care organizations and providers.  Jill has been instrumental in the development of special needs plans including ISNPs, DSNPs, CSNPs and one of the first MMPs in the nation.

Jill has held positions within the Blue Cross Blue Shield Association, Trigon Blue Cross Blue Shield (now Anthem) and Virginia Premier Health plan.  As the VP of Strategy and Business Development at Virginia Premier Health Plan she successfully led the organization in being one of three health plans awarded a contract to develop one of the first Medicare-Medicaid plans in the country.

Jill’s educational background includes two Master’s degrees from the University of Illinois at Chicago. She holds a Master’s degree in Public Health with a concentration in gerontology, as well as a Master’s degree in Business Administration.

As Principal at Lyle Health, Jill helps organizations and individuals navigate the complex healthcare system. Understanding that every situation and organization is unique Lyle Health takes an individualistic approach to identifying the end goals and crafting a strategy to attain them.

Elizabeth Sutton MPH, Risk Management Lead | GRO – Quality, Care Management & CMU Care Management – Risk

Humana

Elizabeth Sutton, MPH, is a Risk Management Lead with Humana, where she focuses on oversight and governance of Humana’s Special Needs Plan (SNP) products. Through the establishment of appropriate controls, oversight, and governance, Humana is able to identify risks and push to align on finding compliant data-driven solutions. Elizabeth has held various positions within the SNP division since joining the enterprise in 2013. She is actively involved in improving the health outcomes of Humana’s SNP members by leading quality improvement program requirements for Humana SNP products and ensuring the group is “audit ready every day.” Prior to joining Humana, she worked for an Institutional Special Needs Plan in New York City. Her passion to improve the care of older adults in rural areas led her to Quinnipiac University in Hamden, CT where she earned her bachelor’s degree in Gerontology. Elizabeth also holds a Master’s degree in Public Health from the University of Connecticut. She grew up in rural Maine and now lives in New York with her partner James and their two canine rescues, Maggie and Mota.

Jason Synakowski Director of Facility Based Products

Elderplan, MJHS

Jason Synakowski has worked for Elderplan for 8 years, serving in a variety of capacities. He began his career in SNP sales, progressed to SNP Product Manager, and currently serves as Director of Facility Based Product.  

 Jason Synakowski has been instrumental in Elderplan’s effort of ongoing Facility Based Product growth and expansion across upstate NY.   His ability to network with likeminded industry experts has afforded him the opportunity to introduce Elderplan products into new service areas, fostering new partnerships and membership growth.  Jason is forward thinking and an innovator in the SNP space.  His responsibilities include oversight of the Elderplan Facility Based Products team, SNP Product Sales, SNP Product Development, SNP Product Marketing, Network Build, and Financials.

Jason resides in Rochester, NY with his wife Audrey and their 9-month-old daughter Quinn.  He is a graduate of the University of Michigan and enjoys golfing, gardening, and the beach.

Dave Thimons MD, President and CEO

Personal Care Medical Associates

Dr. David Thimons is the co-founder and CEO of Personal Care Medical Associates and The Rose Program, specializing in Geriatric and Palliative Medicine in the post-acute setting. He is board certified in Family Medicine and Hospice and Palliative Medicine. His career passion focuses on providing cost effective, best in class care for patients living with serious illness across the country.

Dr. Thimons began his career in private practice. He held the position of Family Medicine residency director from 2013-2018. He was instrumental in obtaining the CMS RAVEN Grant for UPMC where he functioned as a medical director. This grant was given to 7 sites across the country with the goal of reducing unwanted hospitalizations among long term nursing home residents.

In 2012, his daughter Kaelyn Rose was diagnosed with Metastatic Ewings Sarcoma, a rare bone cancer. After a year of intensive treatments, she was miraculously cured. During this challenging time, she often spoke of the palliative medicine clinicians that supported her and assisted in saving her life. This led Dr. Thimons on a journey to better understand palliative medicine, redefine what it means, and to make it more available to all patients suffering from advanced illnesses. He soon thereafter became board certified in Palliative Medicine and started several inpatient and outpatient palliative medicine programs.

In 2015, his love for the post-acute space and geriatric care led him to becoming a certified medical director. He also functioned as the Deputy CMO for a national home based palliative medicine company that contracted with health plans in 32 states. It was during this time that he had the opportunity to see how palliative medicine was being delivered across the country. He soon realized that people in this country deserved better, this led him to fully immerse himself in the hospice and palliative medicine space.

In 2019, he founded the Rose Program, named in honor of his daughter. The Rose Program redefines what Palliative Medicine means across the country and increases its availability to those in need. His goal and passion is to expand this program across the country, thus providing ethical, caring, cost effective care to all patients living with serious illness, making Palliative Care and essential component of health care.

Dr. Thimons lives in Western Pennsylvania and has 3 beautiful children. His passion is to continue to work with partners to create new models of care to increase access to the right services to those in need. He lectures locally and nationally advocating to redefine palliative care and effectively reduce cost and change the American healthcare system for the better.

Giselle Torralba Senior Analyst

ATI Advisory

Giselle Torralba focuses on issues related to Medicaid LTSS and dually eligible populations.

Most recently, Torralba was a Program Officer at the Center for Health Care Strategies where she supported initiatives related to dually eligible populations and those in need of LTSS. In this role, she provided technical assistance and project support for a broad portfolio of work, including the Integrated Care Resource Center in partnership with the Medicare and Medicaid Coordination Office. Torralba also supported several foundation-funded projects that engaged states in advancing innovations in policies and programs for individuals dually enrolled in Medicare and Medicaid, family caregivers, and Medicaid enrollees with behavioral health needs. She has previous experience engaging with stakeholders to develop a set of care standards for adults with intellectual and developmental disabilities so that their needs may be better met in clinical care settings.

Torralba received her Master of Public Health degree from Des Moines University and a bachelor’s degree from the University of Pittsburgh where she studied Psychology and Social Work.

Dominique Valentin, DNP, ANP-C, MSNE, BSN-C Assistant Director, IE-SNP & Geriatric Complex Cre Clinical Services

MJHS Medical Associates PC

Dominique Valentin DNP, ANP, RN is Assistant Director of IE-SNP and Geriatric Complex Clinical Services. In the past Dominique worked as a Manager of Community Programs built a strong team and streamlined MJHS Plus programs (Transition and Core) to meet high standards in decrease of avoidable hospitalizations and reduction in 30 days hospital readmission which surpass national averages.

Dominique ‘s Nursing and Nurse Practitioner professional career includes over 20years of caring for vulnerable population in multiple settings in different parts of the word. She has numerous extraordinary accomplishments, just to list a few: Dominique was in South Haiti during September 2021 Crises at the field mission with Church Of Scientology, Red Cross and Haitian American Association in 2010 led the group of volunteers who provided medical and psychological support services in Haiti after the tragic earthquake. Deputy and Medical Program Manager for J/P HRO -Haitian Relief Organization, managed USAID Artists for Haiti, Clinton Health Foundation, Digicel, NRG grants for community-based programs, and currently serves as a Senior Advisor/Consultant for Philanthropic organization Yvonne’s 100 wish.

She serves as a Board member for Kenscare Kids, a Philanthropic Organization, and currently Executive Coordinator and one of the sponsors of the Medical/Nursing Department of the Mayor’s Office of Port-au-Prince. Initiated enrollment of Haitian nurses and doctors to participate in Pri-Med CME sessions in (collaboration with Harvard and University of Miami) and was coordinated many International Vaccination campaigns.  Co-participant in Abstract Paper for World Association for Disaster and Emergency Medicine, April 2015- Which was presented in South Africa. Plus, Dominique was instrumental in establishing new programs that facilitate access to care of most vulnerable elderly such as CHHA oversight program, Telehealth Hospice Bridge Program and was involved in boarding of IE-SNP clinicians. 

Dominique received her Doctoral degree from Walden University where she was awarded a full scholarship, and she is committed to empower people with knowledge. Dominique holds Adult Nurse Practitioner degree and Masters in Nurse Executives from Long Island University. Dominique graduated with BSN-Summa Cum Lauder and Sigma Theta Tau nursing honors from Hunter College and is a member of the International Nurses Association; member of the Haitian Ladies Network – Based in Washington D.C.; Active member of the Haitian American Nurses Association of Greater New York.

Gretchen Wagner M.A., CIA, CRMA, Director, Home Compliance & Risk Management, Healthcare Services

Humana

Lisa Watkins Senior Director of Health Policy

Elevance Health

Lisa Watkins is a Senior Director of Health Policy at Elevance Health. In this role, she leads the development and execution of Elevance Health’s public policy agenda, focusing on federal policy strategies related to advancing health equity, addressing health-related social needs, and improving care for individuals who are dually eligible for Medicare and Medicaid.

Prior to joining Elevance Health, Lisa served as the Director of Low-Income Programs Analysis Group within the Centers for Medicare & Medicaid Services (CMS) Office of Legislation, and as a Senior Advisor to the CMS Chief of Staff & Chief Operating Officer, where she worked to improve care delivery and financing for individuals eligible for Medicaid, Medicare, and/or the Exchanges. She has also served as Professional Staff on the Committee on Ways and Means, Health Subcommittee, and in additional roles at the U.S. Department of Health and Human Services, including as a Policy Coordinator in the Immediate Office of the Secretary.

Lisa has a law degree (JD) from the University of Michigan and a bachelor’s degree with a focus on English, Spanish, and Latin American Studies from Haverford College.

Naomi Williams Patient Family Engagement Specialist

PFCCpartners

Naomi D. Williams joined PFCCpartners in 2021 and serves as a Patient and Family Engagement Specialist. Originally from Pennsylvania, Naomi has lived most of her life in Georgia. For over 20 years Naomi has served  families and communities as a community health educator and family support coordinator. Educational and professional experiences served her well, and in 2009, Naomi’s disability advocacy along with community and organization education efforts were enhanced when she became the parent to a 26 week micro-preemie and began the journey of raising a child with complex health and medical needs.

Naomi holds a Master’s in Public Health, from Walden University. She is also a certified grief specialist and yoga instructor.  Naomi is the author of And God Remembered Noah: A mother’s heart-opening journey through 22 weeks in the NICU (2018), and she and her son are principals in the6,000 Waiting documentary (2019).

When not advocating for her family or others, you can find Naomi getting lost exploring nature or taking a deep breath on her yoga mat.

Caroline Wilson McDonald Principal

Prizm Health Advisory

Caroline Wilson McDonald is the Founder and 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).

Duane Wisk Adjunct Assistant Professor of Medicine, The Warren Alpert Medical School, Brown University

Managing Partner, GlobalMed Physicians, PLLC

Dr. Duane F. Wisk is a double-board certified physician in Public Health and General Preventive Medicine, as well as Occupational Medicine. He is currently on staff at Holland Hospital, Holland, Michigan. He received his undergraduate and medical degrees from Michigan State University. He received his master’s degree in public health with an emphasis on Informatics from the University of Illinois Chicago. He is a fellow of the ACOEM, and a member of the American College of Preventive Medicine. He has been an actively practicing physician for 40 years. He has expertise in value-based medicine, quality assurance, patient safety, population health, public health, preventive medicine, emergency medicine, occupational medicine, toxicology, disability evaluation, worker's compensation injuries, and environmental health. He has been a national consultant in healthcare IT for over 30 years. He has been a researcher in value-based medicine, healthcare IT, quality, alternative delivery systems, and Transitions of Care. He is a retired Lt. Colonel and flight surgeon from the Air National Guard, where he served from 2003 until 2013. He is also currently an adjunct assistant professor of medicine at the Warren Alpert School of Medicine of Brown University in Transitions of Care.