Linda S. Ellis, MD, MJ, MA, VP
Dr. Linda Ellis is Chief Medical Officer at Independent Care Health Plan in Milwaukee, WI, serving dually eligible Medicare and Medicaid beneficiaries, all of whom are at or below 100% of the federal poverty level. Dr. Ellis is responsible for utilization and disease management, population health initiatives, and oversight of medical and pharmacy services. Dr. Ellis is board certified in Anatomic, Clinical, and Pediatric Pathology, and has served as an academic pathologist for over 20 years. While in practice, Dr. Ellis completed a master’s of jurisprudence degree in health law and policy at Loyola University Chicago School of Law and a master’s of arts degree in bioethics and health policy, also at Loyola University Chicago, at the Neiswanger Institute for Bioethics and Health Policy. The unique interrelationship of medicine, law, and ethics fuels her passion in promoting access opportunities and ethical health care delivery and practice for vulnerable populations, including dual eligibles.
Puneet Budhiraja ASA MAAA
Puneet has been working in healthcare industry as an actuary for last 9 years. He has experience working for both the consulting and insurance side of the business. Puneet is currently working as Medicare / Chief Actuary for CDPHP (Capital District Physicians' Health Plan) as the lead actuary for Medicare and Medicaid business. Puneet has worked on wide variety of projects including pricing, reserving, product development, market surveys, and predictive modeling.
Puneet holds an Electrical Engineering degree and went to New Mexico State University to do his masters in Electrical engineering. In NMSU he became aware of Actuarial profession and decided to be an actuary
Rajesh Munjuluri ASA MAAA
Raj is a Member of the American Academy of Actuaries with over 12 years of health actuarial experience working with insurers as well as with consulting firms. During the course of his actuarial career, he has consulted with insurers on Medicare bid development and on risk adjustment. Additionally, he has consulted with providers in the development of risk sharing arrangements, alternative payment design and evaluation of bundled payment contracts.
Raj has an MBA from New Mexico State University and a Bachelor of Science in Mechanical Engineering from Bangalore University, India.
Jeff Bedenbaugh is Director of Advanced Analytics for Florida Blue. In this role, he is responsible for leading analytics to drive and enable Place-of-Delivery (POD) medical management, core medical management and pharmacy solutions. Prior to his current role, he was responsible for leading the analytics of medical cost and trends for the commercial group, individual and Medicare Advantage segments.
Bedenbaugh joined the company in 2011, having previously served as Director of Medical Economics and Decision Support for the Florida Department of Corrections where he was responsible for leading the creation of an analytics department for the Office of Health Services. In that role, he had responsibility over financial analysis, operational analysis of the state’s prison delivery system including the prison-based clinics for dental, mental and physical health, the prison-based hospital, and the internal pharmacies. Prior to that, he was Senior Analyst Manager for Capital Health Plan where he led the medical economics and decision support team accountable for financial and operational analysis of a mixed-model HMO including Medicare Advantage risk adjustment and PDE processes. He also has experience in public accounting, corporate accounting and accounting system development.
Bedenbaugh holds a bachelor’s degree in accounting and a master’s degree in business administration from the University of West Florida. He was also licensed as a Certified Public Accountant in 1995.
Angela Lappin is a believer in humanity and the inherent good in all people.
She is inspired by the opportunity to impact chronic disease, metal health, preventive health and underserved populations by combing technology and human touch.
Always desiring to make a positive impact, she started her career as a registered nurse, providing physical and emotional support to the most vulnerable populations. She continued to ask how she could impact more lives, which led her to serve hundreds of patients as a Care Manager at SSM Health, then thousands of patients as Director, Population Health at St. Luke’s Hospital.
As Director, Population Health she provides direct management to St. Luke’s nurse care management and care coordination team, develops and implements interventions to improve the health of attributed populations and is responsible for healthcare reform strategy and population health data analytics.
Angela received her Bachelor of Science in Nursing from Western Governor’s University and is currently working towards a Master of Business Administration from Maryville University in St. Louis, MO. She is also a board-certified case manager and a member of the American College of Healthcare Executives.
Melissa Smith is Vice President of Stars at Gorman Health Group. In this role, she helps health plans, providers, PBMs, and industry vendors improve their performance within quality ratings systems such as Star Ratings within Medicare Advantage, Quality Rating System (QRS) within the Health Insurance Marketplace, Healthcare Effectiveness Data and Information Set (HEDIS®), Consumer Assessment of Healthcare Providers and Systems (CAHPS®), etc. She brings more than 20 years of healthcare experience to GHG, with more than five years at Cigna-HealthSpring working with Star Ratings among national MA and Part D plans. Melissa has extensive experience developing strategic and tactical solutions to maximize performance on the full spectrum of quality measures. Melissa also has a strong background of building productive partnerships across internal teams and with external vendors to improve performance on clinical, medication, patient survey, and administrative quality measures.
Before working with quality ratings systems, Melissa was an Associate Director at Vanderbilt University Medical Center. Melissa received her degree from Purdue University and began her career at KPMG, LLP. Melissa’s unique background of business process, regulatory compliance, and healthcare quality offers our clients the opportunity to maximize quality performance and revenues.
Fernando Arbelaez serves as the Senior Director of Population Health and Analytics at Gateway Health Plan®. He oversees advanced analytics programs and medical excellence initiatives, and makes recommendations to executives regarding financial position, quality ratings, clinical stratification and market decisions. Fernando is an Economist, holds a Doctoral degree in Economic Development. He has worked at Gateway Health Plan® for over ten years, his experience has given him comprehensive knowledge of the organizations and the markets that the Health Plan serves.
Frances Martini is the director of government clinical programs for BlueCare Tennessee, the Medicaid subsidiary of BlueCross BlueShield of Tennessee. She is responsible for overseeing integrated population health management and utilization management. Prior to joining BlueCare, she was the senior director of medical management at Emblem Health in New York and the Vice President of Medical Management for Health Net. She has extensive experience in medical management in multiple states and for multiple lines of business. Ms Martini is an RN with a Bachelor’s degree in Nursing and a Master’s Degree in Business Administration. She is a member of the American Society for Quality, the America’s Health Insurance Plans (AHIP), the Case Management Society of America and the Association of Managed Care Nursing. She is a board member and past board chair of the A Step Ahead Foundation, Chattanooga. She Lives in Chattanooga, Tennessee.
Charlie Steinhice has been with BlueCross BlueShield of Tennessee since 1996. He is currently Manager of Internal Analytics and Reporting in Information Delivery, leading a department that provides research and analysis for key leadership and medical management. His team’s primary focus is on BCBST’s Medicaid subsidiary, BlueCare Tennessee. Charlie’s areas of prior experience within BCBST include health care cost reporting/analysis, health economics research, and market research.
Charlie has a Master’s in Library and Information Science from the University of Tennessee and a Graduate Certificate in Biomedical Informatics from the University of Tennessee at Chattanooga, where he also earned a Bachelor’s in History. He is also a Fellow of the Academy of Healthcare Management. Outside of work, Charlie is an active volunteer for the Pancreatic Cancer Action Network, serving as Advocacy Chair for the Chattanooga affiliate.
Lauren K. Hampshire, RN, BSN
Lauren Hampshire is the Director, Corporate Clinical Quality at CareSource. Lauren has more than 35 years of experience in health care, including organizational health care quality. In her role, she provides leadership and strategy for corporate quality programs and is responsible for new market launches for the CareSource Corporate Quality Improvement Department. Lauren has responsibility for the oversight of the CareSource Medicare Advantage Stars Program. Lauren earned a Bachelor of Science in Nursing from Wright State University.
Suzanne (Sue) Brown, RN, MS, MPA is Director II of Quality Management at Amerigroup Iowa where she has responsibility for clinical process improvement, NCQA Accreditation, Grievance and Appeals, Quality of Care, Critical Incidents, and quality-related member and provider outreach and interventions for members in traditional Medicaid, waiver programs, Long Term Services and Supports, Integrated Health Homes and those who are Dual eligible. Before joining Anthem, she was the Director of the Medicare Stars Quality Improvement Program at Excellus Health Plan in Rochester, New York. Sue has been a nurse for more than 30 years and has worked in a variety of settings. Over the years, Sue has managed programs, people and projects in health plans (Medicare and Medicaid Managed Care, quality improvement, care management, software implementation and medical policy implementation), Home Health and Hospice (responsible for compliance, quality and education), academic research (psychosocial research and clinical trials), and hospitals (cross-continuum critical pathway implementation). In addition to Bachelor and Masters Degrees in nursing, Sue has a Master's in Public Administration, is a certified Project Management Professional (PMP) and a Lean Six Sigma Black Belt.
James Schuster, MD, MBA
In his role at the Insurance Division, Dr. Schuster has led development of multiple programs designed to address wellness and physical health concerns for individuals with serious mental illness and other disabilities. He is currently a principal investigator on a contract from the Patient Centered Outcomes Research Institute (PCORI) focused on health homes in behavioral health settings, and an investigator on another PCORI contract focused on shared decision making.
Dr. Schuster is board certified in psychiatry and in the subspecialties of geriatric and addiction psychiatry. He obtained his medical degree from the University of Louisville and completed his psychiatric residency at the University of Pittsburgh. He also received an MBA from the University of Pittsburgh. He is currently a Clinical Professor of Psychiatry at the University of Pittsburgh and has published numerous articles and book chapters.
Jeff Myers is the president and CEO at Medicaid Health Plans of America (MHPA), the leading national trade association for Medicaid managed care organizations. Mr. Myers serves as the primary spokesperson for the Medicaid health plan industry before Congress, the executive branch, state governments, and the media. Mr. Myers is responsible for demonstrating the value of Medicaid managed care to these audiences as well as opening new markets for Medicaid health plan business. He also leads advocacy efforts in advancing an aggressive policy agenda on behalf of the industry.
A government affairs veteran, Mr. Myers comes to MHPA from the American Health Care Association (AHCA), where he was senior vice president of policy and government relations. Prior to AHCA he represented pharmaceutical companies like Cephalon, Biogen Idec, Pharmacia, and Hoffman-LaRoche before the legislative and executive branches. His time on Capitol Hill included serving as U.S. Representative Fred Upton’s legislative director and health staff for the Energy and Commerce Health Subcommittee, and working for U.S. Representatives Don Sundquist and Alex McMillan. While at McMillan’s office, Mr. Myers led McMillan’s health staff during the attempt at health reform in 1994. Mr. Myers received his MBA from the Fuqua School of Business at Duke and his bachelor’s degree from Rhodes College in Memphis. He lives in McLean, Virginia with his wife and three children.
Dr. Concetta L. Zak, DNP, MBA, FNP-BC
Dr. Connie Zak is the Vice President of Healthcare Management for the Community Care Alliance of Illinois and Family Health Network. In the past five years, Dr. Zak has led the successful development and implementation of an innovative model of care for the health care management and care coordination of adults and seniors with disabilities. In addition, she led the establishment of eight Nurse Practitioner-led Anchor Health Homes. Her department's work has been featured on the front page of the Chicago Tribune, and they have received a Platinum Award from URAC for the work Community Care Alliance of Illinois has done with the psychiatric population the organization serves.
In addition to her successful administrative career, she has had a long and successful academic career both as Associate Dean for Graduate Studies at Lewis University and Director of the DNP program at the University of Illinois at Chicago. She has been a Family Nurse Practitioner for the past 15 years, and she has practiced in a variety of settings from Cardiology Research to Primary Care and retail clinics.
Saeed founded Decision Point with the mission of improving health plan clinical, financial and operational performance through informed, data-driven predictions on strategic decisions. He has more than 25 years of health information technology experience, with a track record of developing innovative approaches to solve complex business problems. He has held key senior management positions at Eliza Corporation, Ingenix (currently Optum), IHCIS and ProVentive, where led high-performing teams focused creative uses of technology for practical problem-solving. Saeed is a graduate of The Johns Hopkins University with a BA in Economics.
Paul Rosenthal, VP
Paul Rosenthal leads Indegene's Engagement Business Unit. His responsibility is to leverage a full portfolio of engagement solutions to help drive improved health outcomes in patient populations across Indegene's healthcare business. Mr. Rosenthal is a 20-year healthcare industry veteran and consumer marketing strategist with experience developing innovative, health communication campaigns. Prior to Indegene, he was at Healthways where he led the first-of- its-kind behavioral economics based engagement strategy and incentive design. Previously, he was Director of Market Strategy at Blue Cross Blue Shield of Massachusetts. He has also held positions at Health Dialog and Arrco Medical Art and Design, where he spent 14 years running a health communication agency managing operations and driving the strategic vision. Rosenthal holds a BA in Psychology from Brandies University and a Masters in Health Communication from Emerson College in collaboration with Tufts University School of Medicine.
Steve is a Director, Digital Strategy at HealthCrowd, specializing in Managed Care. He actively advises health plans on digital outreach, either assisting in the development of a digital communications strategy or optimizing current efforts with innovative technology. He is intimately familiar with the outreach needs of health plans and is highly outcomes-driven. In his role, he regularly conducts webinars and speaking engagements on improving and sustaining HEDIS scores through effective outreach. Steve works with health plans and partner organizations all over the country. He is a fan of the outdoors, music and fine bourbon. Steve holds a BS from Virginia Tech.
Robb Cohen, Vice President, Government Affairs, has spent his career dedicated to helping high-risk populations for payers and providers. Previously, Robb was a Co-Founder & Senior Executive of XLHealth, which was founded as a diabetes disease management company, became the nation's leading Medicare Advantage Chronic Special Needs Plan, and was acquired by UnitedHealthcare. Robb is also the former / founding CEO of Advanced Health Collaborative, a network that includes seven health systems with ten hospitals. Robb has an MBA from The Wharton School in Finance and Healthcare Management, is a regular speaker at industry conferences, and is a board member for many not-for-profit organizations.
Dr. Don Casey
Dr. Casey is currently holds faculty appointments at Rush Medical College and the Jefferson College of Population Health and is also president-elect of the American College of Medical Quality. He joins Medecision with extensive clinical experience serving in various clinical quality-focused leadership roles at some of the nation's most well-known providers, including Catholic Healthcare Partners, NYU Langone Medical Center and the Atlantic Health System. During his tenure, Dr. Casey focused on building successful population health programs, including pioneering performance measurement and improvement systems, researching clinical quality improvement efforts and reducing readmissions. Dr. Casey earned an AB degree from Dartmouth College, an MD degree from the University of Cincinnati College of Medicine, an MPH from Johns Hopkins Bloomberg School of Public Health and an MBA from the Wharton School at the University of Pennsylvania - See more at: https://www.medecision.com/seasoned-population-health-pioneers-expand-medecision-clinical-data-consulting-disciplines/#sthash.XhrW7HlR.dpuf