Ms. Adams brings 27 years of in-depth program, analytics and technology experience in Health Plan Quality measurement, having held individual contributor and leadership positions within a myriad of health plans and EQROs.
Aurora is focused on increasing the education around quality measurement systems (e.g., HEDIS) and the implementation of Best-In-Class processes and systems, through consulting and HEDIS auditing.
Ms. Adams holds a B.S. in Information Technology Management, an M.S. in Industrial & Organizational Psychology.
Jessica Assefa leads efforts to maximize outcomes for government regulated, Quality focused programs including Star Ratings, rewards & incentives, provider experience, value-based contracting, HEDIS, CAHPS, and HOS for ATRIO Health Plans’ multiple Medicare Advantage contracts in collaboration with key internal and external stakeholders.
Prior to joining ATRIO Health Plans, Jessica served as the Senior Director over the Star Ratings consulting divisions for Gorman Health Group and Healthscope Advisors. She brings over 20 years of diverse experience and achievement in managed care, quality improvement and clinical operations. She has strong Medicare, Medicaid, Marketplace, and dual eligible programs knowledge. Jessica is also an experienced national conference presenter on the topics of heath care quality improvement and Medicare Star Ratings. She brings over 10 years of direct managed care experience including delegated case management oversight and quality ratings program leadership, in addition to her years of nursing experience in the states of MN, IN and NY, primarily focused on geriatric, disabled and dual-eligible populations.
Ryan has a master’s degree in public health with a concentration in epidemiology and biostatistics. He has 5 years of experience supporting Medicare Star Ratings. Prior to joining Rex Wallace Consulting, LLC he worked at a multi-state 4 Star plan in both leadership and analytic roles. Ryan is passionate about leveraging data to inform decision making in support of vulnerable populations.
Amy Blackledge, MBA-HC, MSN, RN, CSSBB is the Director of Clinical Quality at Blue Cross of Idaho where she has oversight of HEDIS, NCQA accreditation, and quality improvement. Her previous experience includes leading quality reporting, population health, and value-based performance for large health systems. She has a passion for transformational work through collaboration, quality integration, and using data to drive improved outcomes.
Cory Busse is Vice President, Strategic Solutions at Icario. With 25 years of healthcare industry experience working for payers, PBMs, pharmaceutical and medical device companies, Cory helps health plans optimize (and maximize) engagement with hard-to-reach member populations to improve quality, enhance member satisfaction and manage costs.
Prior to Icario, Cory was a senior leader at health tech firm DrFirst, where he helped make patient health data more available and actionable for practitioners. He has also held senior leadership positions at Prime Therapeutics, Blue Cross Blue Shield of Minnesota, ARKRAY and MGI Pharma.
Joe has been serving the senior population for the last four years in various leadership roles with in Blue Cross Blue Shield of Michigan. He was specifically recruited in 2019 to help re gain the 4 star rating for BCBSM. He was instrumental in establishing the strategy, infrastructure and operational approach to help transform our CAHPS strategy and score, both in investment and execution. He continues to support that execution across CAHPS, HOS and other critical member engagement areas in one the largest Medicare Advantage plans in the country.
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.
Matthew Dinh Sr. Director, Quality Care & Experience
SCAN Health Plan
Dr. Dinh received his Doctor of Pharmacy at the University of Southern California. He started his career in community pharmacy, but quickly transitioned to managed care in a quality-driven path in various settings inclusive of a medical group, PBM, and health plans.
At SCAN Health Plan, he oversees clinical programs geared towards medication adherence as well as the reduction of inappropriate medications. He and his team also strive to ensure that pharmacy care is equitable among all and that every member has an unparalleled pharmacy experience.
Dr. Dinh maintains an unwavering commitment to enhancing the quality and efficiency of healthcare and continues to collaborate with providers and pharmacies to optimize care such that all SCAN members get the medications they need to remain healthy and independent.
Tina Dueringer Vice President Clinical and Quality
Rebellis Group
Tina is the Vice President of Clinical and Quality at Rebellis Group, a consulting firm that specializes in health plan operations, pharmacy benefit management, government consulting and technology. Tina has extensive experience in Medicare, Medicaid, SNP, Marketplace and commercial business. Her expertise includes case management, medical management, utilization management, clinical quality, Stars, HEDIS and accreditation including NCQA and URAC. She has health plan experience in strategic planning, joint ventures, partnerships, delegated relationships, value-based care including development and implementation.
Tina previously served as the Head of Health Plan Operations for Cityblock Health, a value-based care, risk-based startup serving underprivileged populations. She was also the Director of Clinical Quality, Accreditation, Appeals and Grievances at Blue Cross Blue Shield of Arizona. Previously she held leadership positions with both the payer and provider. She holds a bachelor’s degree in nursing and a post graduate certification from Duke University in Population Care Coordination and is a Board-Certified Case Manager (CCM).
Julianne Eckert is the Senior Director of Clinical Quality Programs at Clover Health, a physician enablement company focused on seniors who have historically lacked access to affordable, high-quality healthcare. She is responsible for developing innovative leading strategies which break the traditional model of healthcare to make it easier for providers and patients to deliver and receive healthcare across the health continuum.
A recognized Star ratings and quality improvement leader, she has spent her life using her personal and clinical career experiences to drive patient advocacy and optimized health outcomes by developing forward thinking national and international programs. She has sweeping subject matter expertise and has led multiple health plans in achieving significant rating improvements across all lines of business with emphasis in Star Ratings, NCQA/URAC accreditation, CMS Innovation Models, health equity and HEDIS/CAHPS/HOS.
Julianne recently served on the Board of Advisors for Pace University, Lubin School of Business Design Thinking Executive Program charged with curriculum development preparing top executives to solve real-world challenges in designing innovative practices. She is a RN and has a BS in Nursing from Barnes-Jewish College of Nursing. She is currently earning her MBA with a focus in Healthcare Management at the University of Texas. She holds multiple board certifications in Organizational Change Management, Case Management and also Managed Care. She is an avid mentor and career coach focused on developing our next generation of leaders.
As Managing Partner of Engagys, Kathleen Ellmore brings the best of consumer marketing and data-driven methodologies to healthcare to motivate better health decisions. Prior to founding Engagys, Kathleen led the consumer engagement consulting practice for Silverlink for 12 years leveraging Silverlink's data repository of over a billion consumer health interactions, the best of behavioral economics and the latest in clinical research to help health plans and PBMs close the last mile of consumer engagement.
Kathleen is an award-winning engagement expert who speaks regularly on the national stage on many topics including: driving consumer health engagement, creating better consumer experience in healthcare, motivating and inspiring consumers, and using data to drive consumer behavior. She has been recently named as a consultant to the first ever FDA Patient Engagement Advisory Committee (PEAC).
Kathleen has an undergraduate degree from the University of New Hampshire and an MBA from the Kellogg School at Northwestern.
Eden Anne Encarnacion Sr. Manager, HEDIS – Medicare Stars Program
Blue Shield of California
Eden Encarnacion, MHA is currently the Sr. Manager, HEDIS for Medicare Stars Program at Blue Shield CA. She manages the member and provider-facing engagement programs to drive improvements in HEDIS performance. She has 8 plus years of experience leading Quality Improvement programs across multiple Lines of Business in both provider and payer settings. Her experience includes Risk Adjustment, Encounter Data Submission, and Member Experience (CAHPS, HOS). In her previous role as Director, Quality and Medicare Stars for Clever Care Health Plan, she led the development and implementation of the provider incentive program, transitions of care program, and multiple initiatives across HEDIS, Pharmacy, and CAHPS measures. Her previous roles also include Director of Quality Improvement and Physician Operations at Tenet Healthcare. In this capacity, she worked directly with multiple provider groups as well as with various health plans to manage end-to-end efforts and oversee performance on value-based care programs focused on Quality and Risk Adjustment improvement.
Mark Enders has over 25 years of STARS, HEDIS®, data management, analytics, and data warehousing expertise. He has extensive experience leading HEDIS® submissions for Medicare, Special Needs Plans, Commercial and Medicaid plans.
Mark specializes in HEDIS® and STARS rate improvement through advanced data governance, deep measure analytics and strategic medical record pursuit and review strategies. Additionally, he has specific proficiency in the Medicare STARS Part D measures and the NCQA HEDIS® measure certification program.
Mark has worked for medium to large size health plans and HEDIS® certified and abstraction software vendors integrating health care analytics with quality improvement business functions. He has held numerous leadership roles directing software development, quality and project teams to improve and streamline processes and improve quality scores.
Mark currently owns and operates a software development company and consulting company that works with Health Plans and software companies to assist them with their HEDIS® and STARs initiatives.
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.
Savannah Gonsalves, RN, BSN, MHA is the Director of Quality for Hometown Health. Savannah specializes is government regulatory quality programs and has a passion for population health. In her role at Hometown Health, she oversees the HEDIS and Stars as well as Appeals and Grievances. Previous experience includes ACO/MIPS quality reporting, clinical informatics, and provider practice management. She enjoys hiking and camping with her family in the paradise that is Lake Tahoe.
"People who say it cannot be done should not interrupt those who are doing it." George Bernard Shaw.
Dean Gutridge is an accomplished sales executive specializing in managed care enterprise solutions for the healthcare industry. With more than a decade of experience, Dean has a proven track record of driving growth and improving operations for healthcare organizations. Currently serving as the Vice President of Sales for The Helper Bees, Dean brings a wealth of expertise and a deep understanding of the managed care industry.
Previously, Dean held senior positions at UnitedHealth Group, where he played a critical role in driving private label business growth and establishing strategic partnerships.
In his role at The Helper Bees, Dean focuses on working closely with health plans to identify their unique needs and develop tailored solutions that deliver exceptional results. He has a passion for helping healthcare organizations enhance the quality of care they provide and is committed to delivering value and outstanding service to every client. Dean’s extensive experience working with health plans is a key asset to his role at The Helper Bees.
Bryan Hall has been involved with HEDIS as part of a major benefits consulting firm, a health plan underwriting and data manager, a HEDIS programmer, an auditor, a troubleshooter for a HEDIS vendor, a project manager, and as a consultant.
As a HEDIS programmer, he twice helped a small, non-profit health plan make the U.S. News & World Report list of America's Best Health Plans.
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.
Kent Holdcroft is the Chief Growth Officer 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.
Nikki Hungate, a long-time resident of the Western New York region, currently serves as the Senior Leader of Medicare & Government Programs Product Strategy at MVP Health Care. Utilizing the 17 years of experience in the health plan industry she is accountable for leading a team of product innovators that create and deliver a suite of high-quality government products that address the needs of the community in a customer-centric fashion, placing emphasis on those populations that are most vulnerable and underserved. Nikki holds a Bachelor and Master of Science in Health Administration from Roberts Wesleyan College. She is currently an Executive Leadership doctoral candidate at the University of Charleston. Nikki has a passion for sharing knowledge, and also serves as an adjunct professor in the health sciences degree programs at Monroe Community College and Roberts Wesleyan College. In her free time, she volunteers as fundraising coordinator for the local Vietnam Veterans of America chapter in Rochester, NY.
Katharine is the President of Healthy People, an NCQA-licensed HEDIS audit firm and CMS Data Validation firm. She is a member of the NCQA Audit Methodology Panel, NCQA’s HEDIS Data Collection Advisory Panel, and NCQA’s Digital Quality Measures Panel. She is also featured on a 2020 NCQA ECDS podcast. Katharine has been a Certified HEDIS® Compliance Auditor since 1998 and has directed more than two thousand HEDIS audits.
Previously, as CEO of the company Acumetrics, Katharine provided consultancy services to NCQA which helped their initial development and eventual launch of the NCQA Measure Certification Program.
Katharine is a frequent speaker at HEDIS conferences, including NCQA’s most recent Healthcare Quality Congress. She received her BA from Columbia University and her MPH from UC Berkeley School of Public Health. She is a member of the National Association for Healthcare Quality and is published in the fields of healthcare and public health.
Yoona is the CEO and co-founder of Arine, a next-generation medication intelligence company with a mission to solve medication mismanagement across the healthcare continuum. Arine’s
proprietary platform pulls insights from a complex ecosystem of clinical, socioeconomic, and behavioral data to generate personalized care plans and deliver value-based care. Yoona previously led clinical and health economic activities at leading digital health and pharma companies including Novartis and Gilead. She also implemented innovative healthcare design and value-based insurance programs for large self-insured employers at Mercer Health and Benefits. She holds a bachelor’s degree from Stanford University, a PharmD with an emphasis in health policy and management from the University of California, San Francisco, and a PhD in health economics and outcomes from the University of Texas at Austin.
Since 2021, James has served as the chief commercial officer for Kroger Health. In this role, he is responsible for developing relationships with strategic partners, suppliers, providers and payers; generating alternative profit through innovative healthcare ventures; overseeing Kroger’s Prescription Benefit Manager; implementing a comprehensive Food as Medicine strategy; and creating an interprofessional, interoperable healthcare ecosystem to deliver population health solutions.
James has delivered more than 50 presentations and publications, led Kroger in becoming Top Chain for providing Medication Therapy Management and played an instrumental role in creating both PGY1 and combined PGY1/2 community pharmacy residency programs with the University of Cincinnati. He is a board-certified pharmacotherapy specialist, adjunct professor at the University of Cincinnati, Fellow of the American Pharmacists Association and a board member of the Pharmacy Quality Alliance and the Community Pharmacy Foundation.
James earned his pharmacy degree from the Ohio State University in 1998 and his Doctor of Pharmacy degree from the University of Cincinnati in 2002. He joined The Kroger Co. as a clinical coordinator in the Cincinnati division after graduation and then transitioned to the corporate office in 2013.
Varun Kumar
Vice President/Medical Director, Quality and Member Experience
Katie Lanza, Manager of the Medicare Star program at Blue Shield of California, has been in the Stars space for the last four years. In her current role, she focuses on governance and oversight of the program and supports measure owners and stakeholders in developing initiatives and mitigations to drive Star Rating improvement. She is known for her technical expertise down to the measure level and serves as the lead for Stars policy tracking, management, and advocacy. Katie's background includes a Master of Public Health, which provided her with skills for program evaluation and to address the emerging health equity priorities introduced by CMS.
Nate Lucena is a Senior Consultant for Rex Wallace Consulting, where he specializes in helping health plans achieve their Quality Improvement performance goals through data-driven and equity-focused strategies. He began his career spending over a decade in academic research, specializing in the neural bases of schizophrenia, brain aging, Alzheimer’s Disease and human cognition. Nate has been published in the Journal of Clinical and Experimental Neuropsychology and Frontiers in Integrative Neuroscience, and regularly presented research findings at industry conferences.
Nate shifted into a managed care career at Centene Corporation, where he built and led an Enterprise Quality Analytics and Data Science team specializing in data strategy, QI initiative outcomes studies, member-level predictive modeling of experience and clinical outcomes, and performance forecasting. Additionally, he was the key analytics lead in the development of an award-winning QI Health Equity Analysis Model, incorporating stratified reporting and advanced statistical modeling to help health plans identify health disparities and drivers in HEDIS and CAHPS. He went on to lead Ratings Improvement Strategy, National Vendor Management, and Quality RFP/Business Development for Medicare, Medicaid, and Marketplace lines of business.
Core to Nate’s work across the academic and corporate sectors is a deep commitment to creating diverse workplaces rooted in equity and inclusion through measurable action. His commitment is evidenced by leadership roles in the Washington University LGBT Advisory Board, co-creator and leader of the SafeZones training program for faculty and staff departments, co-Presidency of Centene’s cPRIDE employee inclusion group, and participation in numerous equity-focused community groups. This equity focus is the primary lens through which he helps managed care organizations bring disparity reduction to the forefront of their QI strategic focus.
Nate has Master’s degrees in Experimental Psychology and Cognitive Neuroscience/Aging from the College of William & Mary and Washington University in St. Louis.
Katie Martin Vice President of Quality and Clinical Analytics
Baylor Scott & White Health Plan
Katie Martin (she/her) received her Masters of Healthcare Informatics from the University of San Diego. She is currently Vice President, Quality and Clinical Analytics with Baylor Scott & White Health Plan. Katie is passionate about developing integrated quality programs; collaborating with population health, wellness, care management, member engagement and analytics to drive improvement. Some of her achievements involve leading plans to achieving CMS 5 Stars, improved overall quality ratings, and focused programs to guide member engagement and satisfaction.
Crystal Mata Principal Program Manager, Clinical Quaity
Blue Shield of California
Crystal Mata, Principal Program Manager in Clinical Quality at Blue Shield of CA, brings over 17 years of leadership in the healthcare industry. Her experience encompasses a wide range of pivotal roles, showcasing her versatility and commitment to advancing healthcare quality. Beyond her current focus on HEDIS and Stars Measures, Crystal previously spearheaded health trend solutions to enhance affordability and accessibility. Notably, she played a pivotal role in implementing the COVID Vaccines Tiger team, demonstrating her agility in responding to critical healthcare challenges and her ability to lead high-profile, cross-functional projects successfully. Crystal's dedication to driving improved health outcomes aligns seamlessly with the fundamental principles of Healthcare Quality. As a certified professional in Lean Six Sigma and SAFe Agile, her qualifications emphasize a commitment to excellence and a proactive approach to addressing the evolving challenges in healthcare.
Traco Matthews is the Chief Health Equity Officer (CHEO) for Kern Health Systems (KHS). Working with the Executive team, he provides leadership in the design and implementation of KHS’s business strategies, stakeholder relationships, and community programs to ensure health equity is prioritized and sustainably addressed. Traco brings extensive leadership skills, a strong vision for diversity, equity, and inclusion (DEI), and deep community connections to this critical position in Kern County’s local Medi-Cal managed care plan.
His efforts to improve communities have been recognized via multiple awards and appointments. He serves as a Gubernatorial Appointee for both the California Office of the Small Business Advocate (CalOSBA) and the state’s new Racial Equity Commission.
Tamara is the Director of Quality Management for Health Alliance, a subsidiary of Carle Health. Carle, a Vertically Integrated Health System, encompasses hospitals, physicians, outpatient and wellness divisions, as well as the health plan. She has been in her role since 2019. In Tamara’s role, she has oversight of the Health Alliance quality improvement program, HEDIS data collection and reporting, and Member/Provider Resolutions.
She brings over 23 years of experience in the healthcare field at Carle Health with focus on patient/member experience, data collection and analytics, and process improvement.
In addition to her Bachelor of Science degree in Pharmacy from Midwestern University Chicago College of Pharmacy, Tamara is also a Certified Professional in Healthcare Quality from the Healthcare Quality Certification Commission.
Jessica Muratore has a master’s degree in public administration and bachelor’s degrees in political science and psychology. She spent the first half of her career in the legal field focused on civil litigation where she became skilled in the interpretation of federal and state laws before entering managed care. Currently, she is a senior consultant with Rex Wallace Consulting, LLC (RWC) focusing on quality improvement across all lines of business with both health plan and vendor clients. Before joining RWC, Jessica spent 10 years on the payer side. Jessica worked for MVP Health Care and Centene Corporation in executive leadership positions. She was responsible for national market performance and execution, governance, quality improvement organizational structure, NCQA health plan accreditation, delegation oversight, quality compliance and program operations, federal and state audits (Quality, Utilization Management, Appeals, Complaints), quality improvement strategy, and quality Medicaid RFPs and new health plan implementations. She has extensive experience working with the Medicare, Medicaid, Marketplace, Commercial and the Basic Health Program populations. In 2014, she also started as an adjunct professor at SUNY Brockport’s Public Administration Master’s Program teaching classes on healthcare focusing on government programs (Medicare, Medicaid), global health care systems and the Patient Protection and the Affordable Care Act. Jessica enjoys serving her community through board leadership positions and spending time with her husband and daughter, traveling, reading and being outdoors.
Previously, Jay was Washington correspondent for TIME Magazine, where she remains a contributor. At TIME she covered politics as well as stories on five continents from conflicts in the Middle East to the earthquake in Haiti and the November 2015 Paris terror attacks. She has written nearly a dozen TIME cover stories and interviewed numerous heads of state, including Presidents Barack Obama and George W. Bush.
She authored the 2016 best-selling book, Broad Influence: How Women Are Changing the Way America Works.
Before TIME, Jay was a reporter for Bloomberg News, where she covered the White House and politics.
Jay received an M.S. in journalism from Columbia University and undergraduate degrees in International Relations and Art History from Tufts University. She is a 2017 Halcyon Incubator fellow, a 2016-2017 New America fellow and a 2015 Harvard Institute of Politics fellow. She is the 2016 winner of the prestigious Dirksen Award for congressional reporting and the 2016 Deadline Club award for community service reporting.
LeAnna Pierson Director of Member Engagement & Communications
Blue Cross Minnesota
LeAnna is the Director of Member Engagement at Blue Cross Blue Shield of Minnesota. In her role, she is responsible for member engagement and communications. She also oversees the development of member experience programs needed for the Medicare Stars program.
Prior to Blue Cross Blue Shield of Minnesota, she spent most of her career in retail marketing, leading large national campaigns and developing long-term brand marketing strategies. Her expertise is centered on building best-in-class consumer experiences and insights-driven marketing communications.
LeAnna holds a Master of Business Administration from the University of Minnesota, Carlson School of Management, and a dual Bachelor of Science degree in Marketing and Nutrition from the University of Minnesota
Bert Rico is a healthcare analytics and quality improvement expert with a wealth of experience spanning prominent roles at Baylor Scott & White Health, UnitedHealth Group, and Optum. He is passionate about transforming healthcare outcomes through data science and interoperability. With a background in Computer Software Engineering and certifications in areas such as Certified Scrum Product Owner (CSPO), Bert possesses a unique blend of technical prowess and leadership skills that have consistently delivered measurable results in improving quality of care. With an unwavering commitment to data-driven insights, he has expertly closed gaps in care, enhanced member experiences, improved gap reporting accuracy & actionability, and streamlined healthcare operations.
A serial successful brand builder, Daryl has long recognized the health care industry as ideal for engineering disruptive strategies in the development of successful products, services and organizations. At Walmart, Daryl was the Chief Growth Officer for Health & Wellness and one of the architects of Walmart Health. Under his leadership, Walmart built the supplemental benefits business, going from $0 to $2B in revenues in 3 years.
Prior to Walmart, his nearly 30 years of health care expertise has included Fortune 100 and start-up organizations within the pharmaceutical, medical device, hospital and outpatient services industries. What has been most consistent throughout his career is an innate ability to understand market needs, identify existing gaps and build the teams required to deliver market-leading solutions.
Heidi has deep expertise in helping health plans improve their Member Experience. Prior to joining RWC, she led the CAHPS and HOS national strategy for Cigna.
Sheehan is an experienced government programs subject matter expert with more than 15 years of industry experience ranging from long-term care and compound pharmacy management to health plan quality and operations, previously leading Medicare 5-Star Quality initiatives at Priority Health. She is tasked with enhancing mPulse’s support of government plans through technology, relationships, and subject matter expertise.
An expert in multiple aspects of CMS star ratings and quality and owner and Principal at Freedom Health Consulting, LLC, Kim is a strategic minded healthcare executive, committed to creativity and innovation in every aspect of health care.
Kim has almost 30 years of extensive experience focused on quality management and process improvement, inclusive of Six Sigma projects in the national health plan industry. Working for several of the largest US health plans, she has designed and implemented roadmaps and tactical strategies designed to improve performance, increase member engagement and yield greater returns. Her experience includes working in local, regional and national leadership roles and experience with Medicaid, Medicare and Commercial lines of business.
She has led efforts not only with health plans but also with other partners such as providers assisting in strategic design to maximize the efficiencies between payor and providers. Additionally, she has direct experience in 14 states/markets overseeing all aspects of quality, HEDIS/CAHPS/HOS as well as Risk Adjustment.
Kim has excelled in developing strategies to achieve outcomes on multiple aspects of quality, operations and network areas. Her outcomes have included being the recipient of the 5 Star Award for being the first plan in a national MCO to achieve the coveted 5-star rating, receiving the Executive Development Program nomination and completion (given to only 1% of national MCSO plan) and led rapid and sustainable Medicare Stars improvements at multiple national health plans, resulting in improved health care quality.
Melissa Smith is Chief Consulting Officer at Healthmine. She is a well-known thought leader and health care strategist with over 25 years of experience in Star ratings, strategy, sales, and marketing for health plans, providers, pharmacy benefit managers, and industry vendors. As head of Healthmine’s advisory division, she helps clients evaluate market dynamics and opportunities, optimize distribution channels, and fulfill strategic planning needs.
Jill Strassler, VP Solutions Management, Veradigm, is a dynamic healthcare executive focused on innovating the analytics and reporting solutions for Health Plans for Risk Adjustment, Quality and Value Based Care models. Jill brings expertise in developing novel solutions to address emerging and transformative change in the healthcare industry. Jill excels at delivering value across the ecosystem by increasing transparency and building connectivity among all stakeholders. Over her notable 20-year career, Jill has developed holistic member engagement and quality strategies for health plans. Prior to her focus in risk adjustment, she led solutions for molecular diagnostic utilization management and reimbursement. Jill received her BA in Psychology from The University of Chicago and received her MBA and MS in Management Information Systems from Boston University.
Suzanna-Grace Tritt, FSA, MAAA, CERA, is a Senior Consulting Actuary in the Denver office of Wakely Consulting Group, LLC, an HMA Company. Suzanna-Grace began working at Wakely in 2016 and has been an actuary since 2012. Although she has worked in various lines of business, including Medicare, Medicaid, small group, and individual, her areas of expertise are in Medicare Advantage Stars and Medicare/Medicaid risk-adjustment. She has developed impact analyses of various Medicare Star Rating policy reforms for multiple large health plan associations and several national Managed Care Organizations. Suzanna-Grace manages the Wakely tool for estimating and scenario testing contract-level Medicare Star Ratings. In addition, she supports Wakely clients on Star Rating improvement initiatives.
Mick Twomey is the founding Chief Operating Officer (COO) and current Chief Executive Officer, (CEO) of Hyperlift Logic, Inc. Coming from a management consulting background, Mick set his vision on redefining how plans approach Stars optimization. Out of that was bornStars Monitor, Hyperlift's SaaS technology platform.
Crafted by Stars professionals for their peers,Stars Monitoris the industry's leading Stars analytics solution that gives Stars teams time back while redefining how plans approach Stars optimization. Mick's dedication to creating a scalable and universally applicable model has helped establish Hyperlift's innovation-driven approach into a trusted partner in the healthcare sector.
Through a combination of leading-edge technology, Stars experts, and a year-round engagement framework, Hyperlift propels healthcare plans of all magnitudes to elevate their Stars performance management. Mick's leadership catalyzes these solutions, enabling healthcare plans to embark on a transformative Stars management journey that outperforms conventional performance management.
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.
Dr. Avantika Waring, MD, has over fifteen years of experience in the medical field, and as the Chief Medical Officer at 9amHealth, she is on a mission to treat diabetes with affordable solutions, focusing on the historically underserved. With experience in both traditional healthcare and start-up spaces, she brings your audience a unique perspective on forming a culturally inclusive approach to patient care: from diagnosis to treatment and beyond.
Stephen Winn is the Senior Director for Quality at the Mid-Atlantic Permanente Medical Group, a large multi-specialty medical group based in the Mid-Atlantic, and oversees Quality Program reporting, including HEDIS. With more than a decade of experience, he focuses on building programs, systems, and workflows that promote the delivery of high-quality care and accurate reporting.
Prior to working in Healthcare, he was an International Economist at the U.S. Department of Treasury.
Lisa Winters, ASA, MAAA, is a Consulting Actuary at Wakely Consulting Group, LLC, an HMA Company. Lisa began working at Wakely in 2019 and has been an actuary since 2021. She has experience in a variety of health care lines of business including Medicare, Medicaid, and Commercial/ACA. As an actuary in the Medicare Star Ratings space, she helps Wakely clients understand and project the financial implications of methodology and performance changes. She also maintains the Wakely Stars Calculation Tool, aiding clients in strategizing for Star Ratings improvement.
Leveraging a multidecade background in technology and healthcare, Glenn leads AdhereHealth’s Sales and Marketing operations, with a focus on high-value technology and clinical solutions for health plan and health system customers. In this role, Glenn is focused on delivering high-impact technology-driven solutions that improve value-based care outcomes, lower overall cost of care, and enhance patient experience. In addition to a lengthy technology business development background, Wirick has worked as a consultant helping organizations improve operations and performance outcomes. Glenn sits on the Board of Washington-based charity Heart and Homes Foundation, which provides housing and assistance to victims of domestic abuse.
Dr. Ashby Wolfe is a board-certified family physician and serves as Regional Chief Medical Officer for the Centers for Medicare & Medicaid Services (CMS) offices in Seattle and San Francisco. Dr. Wolfe has served as a CMS Regional Chief Medical Officer since 2015, focusing on the implementation of Medicare and Medicaid policy across the Western United States and the Pacific Territories (AK, ID, OR, WA, AZ, CA, HI, NV, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands). As a senior medical advisor for CMS programs in the West, she provides clinical expertise to the divisions of Medicare and Medicaid payment policy, quality improvement, survey operations, contracted health plans and serves as a principal liaison with the clinical community. Dr. Wolfe also serves as co-lead of the CMS Acute Hospital Care at Home Initiative, as extended by Congress, following the end of the COVID-19 Public Health Emergency.
Dr. Wolfe completed her medical degree at Stony Brook School of Medicine in New York, and her residency training at the UC Davis Medical Center in Sacramento, California. She also holds a Masters of Public Policy and a Masters of Public Health from the University of California, Berkeley. Dr. Wolfe has practiced broad-scope family medicine in academic, integrated and community clinical settings over the course of her career. She holds medical licenses in both the State of California and the State of Washington, and currently serves as a member of her local HHS medical reserve corps. She has a particular interest in improving the quality and equity of care for underserved and low-income populations. She has published on the CMS Acute Hospital Care at Home waiver experience as well as multiple articles on Medicare and Medicaid policy, and is a contributing author of the public health text Prevention is Primary (Jossey-Bass). In her free time, she enjoys hiking, swimming and traveling with her husband and two children.
