Rise

Jessica Assefa President and Senior Consultant

Ameropia Advisors, LLC

Raheleh Barznia Senior Manager, Clinical Quality Member Experience

Blue Shield of California

Raheleh Barznia currently serves as the Senior Manager of Clinical Quality Member Experience at Blue Shield of California. In her role, she is responsible for the end-to-end CAHPS reporting and performance improvement strategies across Blue Shield’s Medicare line of business. With over 13 years of experience in the health care industry, Raheleh is deeply committed to understanding and enhancing interactions, services, and value that members receive from their Health Plan. In her spare time, Raheleh enjoys traveling, exploring new restaurants, and spending quality time with her husband, daughter, and their teacup yorkie.

Ryan Bernstein Consultant

Rex Wallace Consulting

Ryan is a proficient Star Ratings expert with over five years of dedicated experience in the Medicare field. As a consultant with Rex Wallace Consulting, LLC, his expertise covers data analysis, program management, and strategic planning, ensuring that clients achieve substantial improvements. Before joining RWC, Ryan was the Program Director for Medicare Star Ratings at a regional health plan in the Pacific Northwest, where he led initiatives to improve quality of care, health outcomes, and member experience for the Medicare Advantage population across multiple states. Ryan is deeply committed to leveraging data to inform decision-making processes and enhance outcomes for vulnerable populations, consistently driving operational efficiencies and performance improvements.

Ana Berridge Executive Advisor, Consulting and Professional Services

Healthmine

Ana brings more than 20 years of healthcare and health plan experience. The last two years she has been a consultant with Healthmine and has helped health plans and companies improve their quality programs. In her prior positions she had oversight of work related to Stars, HEDIS®, NCQA, Quality Rating System, External Quality Review Organization, population health programs, new product implementation, value-based care programs, policy advocacy and health equity programs.  

Ana developed multiple innovative member and provider interventions that were integral in the successful improvement of key HEDIS and Consumer Asessment of Healthcare Providers and Systems (CAHPS) quality measures and meeting corporate and contractual goals. She has experience with successfully identifying and implementing new to industry initiatives, such as texting, with proven quality and financial improvement. Ana is bilingual in English and Spanish and has used this in community initiatives to help engage members and improve the quality of care for the Medicaid, Medicare, Affordable Care Act, and Commercial populations. 

Dave Burianek Senior Vice President

MedOrion

Dave is a  national leader in the healthcare industry and managed care organizations.  His experience comprises a comprehensive blend of healthcare, quality, information technology and operations.  He has been an executive leader at GE, GE Capital, Humana, and Anthem as well as several venture capital / private equity funded companies.  While at Humana, he stood up and led their Stars Program which is widely recognized as best in class. Dave contributes to setting the national direction/policy for healthcare quality by being on NCQA's Standards Committee and a member of the Pharmacy Quality Alliance (PQA).  Dave was inducted into the University of Kentucky's Hall of Distinction for his outstanding contributions in improving healthcare (given to less than 1% of alumni). 

Dave currently serves as Senior Vice President - US for MedOrion Technologies, Inc. 

Christina Byrne Consulting Actuary

Wakely

A consulting actuary with Wakely Consulting Group, an HMA Company, Christina Byrne specializes in Medicare Advantage and Prescription Drug Plan (MA-PD) bid submissions. Since joining Wakely in 2015, Christina has mastered projecting medical and pharmacy expenses, forecasting revenue, and developing product strategies for a range of service areas and plan types to support clients’ submissions. She is also well-versed in the Plan Benefit Package (PBP) submission process, ensuring compliance with Medicare standards while optimizing offerings to meet member needs.

Christina is skilled in data analysis and trend forecasting, leveraging detailed claims data to inform financial strategies. Her expertise extends to financial modeling, demonstrated by her work as the consultant lead for Wakely’s Part C pricing model, overseeing annual updates, maintenance, and model enhancements. She was also named a co-lead on Wakely’s quality improvement strategic initiative, responsible for managing the development of Wakely's Healthcare Effectiveness Data and Information Set (HEDIS) engine and other quality-focused products. Her contributions in the quality space affirm her commitment to providing data-driven insights to clients within the Medicare Advantage landscape to improve health outcomes.

With Wakely, Christina has also worked on pro forma financial projections, Employer Group Waiver Plan (EGWP) pricing, and evaluation of unpaid claim liabilities. She is familiar with preparing financial statement filings for Medicare and commercial lines, covering actuarial liabilities, risk adjustment estimates, and Medicare Part D payables and receivables.

Christina earned her bachelor's degree in actuarial science from Florida State University. She is an associate of the Society of Actuaries and a member of the American Academy of Actuaries.

Paige Caprara Quality Improvement Consultant

Rex Wallace Consulting

Paige holds a Master’s degree in English and Human Development. She has over 10 years of experience in healthcare management, specializing in Medicare strategy, population health, and value-based contracting. ​

​Previously, Paige supported Accountable Care Organizations at Collaborative Health Systems and led Quality Improvement at WellCare Health Plans. She also managed provider education at BayCare Health System, advancing healthcare outcomes and operational efficiency.

In her free time, Paige enjoys spending time with her daughters and two dogs, traveling, hiking and doing yoga.

Liz Carr VP of Product Delivery & Customer Experience

Ingenia

As VP of Product Delivery and Customer Experience at Ingenia Health, Liz directs the account management, operations and support teams for new client implementations and production clients. Liz is a trusted advisor to health plan leaders on all things related to Quality organization and analytics. She enjoys taking creative yet pragmatic approaches to problem solving in order to deliver the most value to clients.

Liz began her career at MedVentive, a startup acquired by McKesson, and was on the product team for a Quality & Med Econ tool. She was a Certified Scaled Agile scrum master for the product development team and supported new client implementations. Liz made the transition to consulting, joining a boutique firm that focused on Quality and Risk Adjustment optimization for health plans. She led client accounts ranging from small Duals payers to national multi-state managed care organizations and worked with vendor partners to design new specialized software. Her projects ranged from new Quality tool implementations and multi-year HEDIS and STARS projects to organizational strategy consulting.

Liz has a BA in Neuroscience from Johns Hopkins University

Phil Collins Director, Customer Success

Hyperlift

Jessica Columbus VP, Value Based Care Operations

Memorial Herman Health Plan/Apex Health Solutions

Jessica Columbus, LVN, CCS-P, CRC, CPHQ is currently the Vice President of Value Based Care for Apex Health Solutions. Her expertise in physician performance engagement and value-based care best practices are built on a foundation of more than 18 years’ experience in managed care focusing on end-to-end health plan operations related to Risk Adjustment and the CMS Star Rating Program. 

She began her healthcare career in direct patient care as a Pediatric/NICU nurse and in 2005 took an opportunity at a managed care company in their Referral/Pre-Cert Department where she was first exposed to quality and risk adjustment concepts. Once promoted into a leadership role that allowed her to own and create both risk adjustment and HEDIS programs from scratch she discovered those to be her true passion.

For 15 years her career has concentrated on innovative provider engagement strategies and implementing real world solutions that positively impact provider and contract performance. Her enterprise-wide physician education programs that aim to improve understanding of clinical documentation requirements have proven successful through accuracy of HCC recapture, increased year-round closure of HEDIS gaps in care and strengthened positive health plan experiences among both providers and members. 

Prior to joining Apex in August of 2020, Jessica worked at Universal American/WellCare for 6 years as the Sr. Director of Quality Improvement directly overseeing all quality improvement programs, HEDIS, Stars operations and prospective risk adjustment activities for their Texas and Louisiana markets. During her tenure at WellCare she was able to consistently deliver solid Star Ratings for all contracts under her responsibility, including achieving a 4.5 STAR in 2019 for their flagship MAPD plan in Texas.  Jessica’s continued career journey is centered on improving clinical outcomes for patients through advancing provider and payer partnerships that will revolutionize value-based care. 

Jessica enjoys spending her free time traveling with her husband Brandon and their 3 daughters (Gabriella, Alexis and Jordan) in Houston Texas. 

Scott Cummings CEO

NexTalk

Scott Cummings is the CEO of NexTalk, an accessibility software and services company transforming communication for the Deaf, hard of hearing, speech-impaired, and non-English speaking communities. Under his leadership, NexTalk has advanced its mission by focusing on innovation and accessibility access in contact center environments.

Scott is dedicated to helping health plans improve their member and employee experiences by providing direct, reliable channels for those who are communication-challenged.  To date, he has enhanced NexTalk's proprietary TTY/RTT software by creating native API-driven agent experiences within leading contact center platforms, and is working on improvements in transcription and remote interpreting services.

Before joining NexTalk, Scott held leadership roles at SAP, where he shaped business development, customer-focused outcomes and operational excellence.  His experience in enterprise software and leadership in large-scale organizations have equipped him with a deep understanding of how technology can address complex challenges and create sustainable, positive impacts.

U. Michael Currie Former Chief Health Equity Officer

National Health Plan

Hailing from Washington, DC, U. Michael Currie served as the Chief Health Equity Officer at National Health Plan. In this role, Michael led the coordination of health equity efforts from June of 2010 to October of 2023. He was responsible for the development and execution of enterprise efforts, initiatives, and interventions to identify health disparities, as well as the enhancement or implementation of programs, services, and strategies to address identified health disparities.

Michael has held roles in both the public and private sectors with responsibilities related to disease prevention, wellness, and health benefits, and has spent nearly 30 years focused on population health management. Michael has contributed to numerous health equity and health disparities related articles and publications, been a guest lecturer at public and private organizations, as well as numerous academic institutions.

He currently serves on various local and national boards and committees focused on addressing barriers to health care and improving health outcomes including the Maryland Department of Health Advisory Comm on Minority Health, American Telemedicine Association Advisory Board on Eliminating Health Disparities, the Health Care Payment Learning & Action Network Health Equity Advisory Team, the Howard Community College Educational Foundation Board, the Creating Healthier Communities Board of Directors and the Johns Hopkins Howard County Medical Center Foundation Board.

Michael holds a bachelor’s degree from Morehouse College, a Master of Public Health (MPH) degree from George Washington University and a Master of Business Administration (MBA) degree from Johns Hopkins University.

Shannon I. Decker Founder & CEO

VBC One

Dr. Shannon Decker is Founder & CEO 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 25 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 25 years of experience in healthcare--17 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 in the social and behavioral sciences 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 social and behavioral theories may be brought to bear in value based care and population health management as a whole.

Nick DiMauro Director of Sales

Medline

Ryan Dodson Chief Operating Officer/Co-Founder

New Vision Healthcare Solutions

His background is in management and operational processes for 15 years, and began working in the Risk Adjustment arena 12 years ago. Ryan has proven himself by helping Medical Groups raise their RAF scores to their proper levels. He directed the movement of a 10,000 member group up 43% over a two year period, and an 1800 member group up 53% in the first year. Ryan achieves these results through chart documentation audits, provider and staff documentation training, and provider relationship building. In his most current role Ryan works with multiple groups to optimize their RAF score, while at the same time achieving CMS 5 Star quality. Ryan explains to these groups that getting their RAF score to the correct level will not only drive revenue, but it will also lead to better patient care with improved documentation habits. Ryan is a Certified Risk Adjustment Coder (CRC) credential through the AAPC.

Tina Dueringer CEO, Principal Advisor

Dueringer Advisors, Inc

Tina Dueringer, BSN, RN, CCM, PCC, is the CEO and Principal Advisor at Dueringer Advisors Inc., a distinguished consulting firm dedicated to supporting health plans, vendors, and leaders in the health insurance and provider sectors. With a robust background spanning Medicare Advantage, Medicaid, Duals, ACA, and commercial markets, Tina brings extensive expertise in care management, utilization management, clinical quality, Model of Care development, Stars ratings, HEDIS measures, and accreditation standards such as NCQA and URAC.

Tina's career is marked by strategic insights into health plan operations, including strategic planning, joint ventures, partnerships, delegated relationships, and the advancement of value-based care models. She is deeply committed to advancing Health Equity, Population Health, and integrated care initiatives across the industry.

Previously, Tina served as Vice President of Clinical Quality and Stars at Rebellis Group, specializing in Medicare Advantage and government consulting. Her leadership journey includes pivotal roles at Cityblock, Blue Cross Blue Shield of Arizona, and the Wisconsin Department of Health Services, Medicaid Policy Division.

Tina earned her Bachelor of Science in Nursing and holds a post-graduate certification in Population Care Coordination from Duke University. She is also a Board-Certified Case Manager (CCM), underscoring her dedication to enhancing healthcare delivery and outcomes through comprehensive care coordination strategies.

Rhonda Farrar Clinical HEDIS Supervisor

Healthy People, Inc.

Rhonda Farrar, RN, BSN, CHCA, is Healthy People's Clinical HEDIS Supervisor, as well as a Lead HEDIS Auditor. Prior to joining Healthy People, Rhonda was Advantmed’s HEDIS and Quality Principal Program Manager and served as the Senior Manager of HEDIS Data Analytics. Prior to working at Advantmed, Rhonda led HEDIS and NCQA Accreditation programs at a health plan. Across her seven years of HEDIS work at the health plan, Rhonda developed a provider-based incentive program including quality and pharmacy measures. Rhonda also created health care integrated delivery network (IDN) system-wide initiatives and education to support HEDIS population health improvements. She is currently based in Marion County, FL and spends her free time with her husband, family, and their precious dogs, Creek and River.

Arlene Godinez Sr. Program Manager

VBC One

Arlene Godinez is a Senior Program Manager at VBC One, specializing in Clinical Documentation Improvement (CDI) and quality/risk adjustment programs. Drawing on her hands-on experience as a former medical assistant in family practice, Arlene brings a unique perspective to healthcare documentation that bridges clinical practice with operational excellence.

In her current role, Arlene develops and oversees customized CDI training programs focused on retrospective chart reviews, helping healthcare providers optimize their documentation for both quality care and regulatory compliance. Her expertise spans financial accuracy, quality measure validation, and population health management strategies.

Currently pursuing a Bachelor's degree in Healthcare Administration with a focus in Leadership, Arlene combines practical experience with emerging best practices in healthcare management to deliver comprehensive solutions for medical practices of all sizes.

Savannah Gonsalves Director of Quality Improvement

Hometown Health

Savannah Gonsalves, RN, BSN, MHA is the Director of Quality for Hometown Health. Savannah specializes is regulatory quality programs, including MIPS, ACO, and HEDIS and has a passion for population health.  She has an extensive background in clinical informatics as well and uses this to integrate quality into clinician workflows effectively and efficiently. In her role at Hometown Health, she oversees the Stars and Accreditation Programs. 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.

Ana Handshuh Principal

CAT5 Strategies

Ana Handshuh, Principal at CAT5 Strategies, is a government programs executive with expertise in creating and implementing corporate programs for the healthcare industry. Her background includes Quality, Core Measures, Care Management, Benefit Design and Bid Submission, Accreditation, Regulatory Compliance, Revenue Management, Communications, Community-based Care Management Programs and Technology Integration. Ms. Handshuh currently serves on the Board of the Resource Initiative and Society for Education (RISE), the preeminent national professional association dedicated to managed and accountable care financing and delivery. She is a sought after speaker on the national healthcare circuit in the areas of Quality, Star Ratings, Care Management, Member and Provider Engagement, and Revenue Management. Her recent consultancy roles have included assisting organizations create programs to address the unmet care management needs in the highest risk strata of membership, document their processes and procedures, achieve accreditation status, design and submit government program bids, institute corporate-wide programs and create communications strategies and materials. She possesses sophisticated business acumen with the ability to build consensus with cross-functional groups to accomplish corporate goals. Ms. Handshuh served as the Vice President of Managed Care Services at Central Florida Inpatient Medicine (CFIM). In this role, she provided leadership and strategy on CFIM projects and collaborations with physicians, risk entities, hospital health care systems, and health plans. CFIM is the largest Hospitalist group in Central Florida, with 70 providers discharging over 50,000 patients annually from multiple hospitals across two health care delivery systems and 24 skilled nursing facilities. At CFIM Ms. Handshuh previously served as the Vice President of Operations. Prior to those assignments, she worked with Precision Healthcare Systems as their Vice President of Quality Improvement. In that capacity, she led the IPA’s Quality efforts and collaborated with payers on implementing programs to move the needle on Quality and Star Rating initiatives. Ms. Handshuh also served as the Director of Corporate Program Development at Physicians United Plan. In this role, she led the Quality Management and Corporate Communications departments and spearheaded the development of innovative integrated technology solutions to drive business excellence and Star Rating achievement initiatives. For the past fifteen years Ms. Handshuh has taken an active role in redefining and implementing changes that have led to improvements and greater efficiency within Government programs and healthcare delivery. Prior to joining Physicians United Plan Ms. Handshuh was the founder of I-Six Creative. Under Ms. Handshuh’s vision and leadership, I-Six Creative provided expertise in the areas of managed Medicare benefit design, MSO/IPA operations, provider network strategy, new market launches, technology integration, corporate communications and quality improvement.

Adam Higman Partner, Strategic Consulting

Press Ganey

Adam leads the Payer Solutions team and brings extensive management and consulting experience to his role. He is passionate about improving our experiences navigating complex health decisions to ultimately improve the quality of life for members, patients and communities. He has carried this work out leading data-driven experience improvement initiatives to identify the moments that most impact both our perception and the outcomes of care.

He has worked with large national payers, state and regional non-profits, provider sponsored health plans and directly with more than 75 health systems and independent provider organizations ranging from local specialty groups to large national and academic organizations throughout the United States.

In addition to leading a number of large-scale redesign projects requiring strategic planning, market analysis, and provider alignment, Adam has conducted assessments and overseen implementations focusing on quality, operational efficiency and growth planning; care
management/coordination; and structural/governance improvement. He also has analyzed staffing, redesigned scheduling and coordinated transformational engagements for medical practice and ambulatory services; has extensive experience in vendor management and in standardization of SLAs; and has led a number of model-of-care redesign projects to improve key moments of the member/patient journey.

During his career, Adam worked for a full-service strategic health and science communications agency advising health systems, health plans, advocacy groups, and life sciences companies.

Nikki Hungate Product & Quality Strategy Consultant

FarmboxRx

Nikki is an accomplished professional with over 17 years of experience in the healthcare industry, specializing in Medicare and Medicaid product strategy. With extensive knowledge and expertise in the field, Nikki is a trusted leader who has consistently contributed to the growth and success of various organizations.

Nikki holds a Master's degree in Health Administration. Additionally, she has pursued a Doctorate in Executive Leadership. 

As a passionate advocate for accessible and affordable healthcare, Nikki remains dedicated to driving innovation in the Medicare and Medicaid sectors.

Katharine Iskrant Practice Leader

Healthy People, Inc.

Katharine is the President of Healthy People, an NCQA-licensed HEDIS audit firm and CMS Data Validation firm. She is a member of NCQA’s Audit Methodology Panel and NCQA’s HEDIS Data Collection Advisory Panel. 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. 

She is featured on an NCQA podcast, discussing the HEDIS Electronic Clinical Data System Measures:
https://blog.ncqa.org/inside-h...

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.

David Kao Principal Program Manager, Clinical Quality

Blue Shield of California

David provides analytical support to the Blue Shield of California Medicare Stars Strategy team. He is responsible for building dashboards, setting goals, and calculating projections. His contributions help guide strategic decision-making and optimize quality improvement efforts. He is a Certified Six Sigma Black Belt and has previous experience in process engineering. David has a BS in Chemical Engineering from UC Berkeley and a MS in Materials Engineering from San Jose State University.

Jenn Kerfoot Chief Strategy and 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.

Katherine Lanza Manager, Medicare, Stars

Blue Shield of California

Katie has been working to improve Blue Shield of California’s Medicare Star Rating for over five years, and she is now the Manager of the Stars Strategy team. In this role she leads the team through the annual and monthly Stars process to ensure the performance engine is running smoothly. On a day-to-day basis, she works with enterprise leaders to evaluate their measures’ performance, review workplans, and implement mitigation strategies. Katie holds a Master of Public Health from the University of Michigan.

David Larsen Senior Advisor, Member Experience

Press Ganey

David L. Larsen has been the Director of Quality Improvement for SelectHealth in Salt La¬ke City, Utah for the past 31 years and has worked for Intermountain Healthcare for 38 years. SelectHealth is a mixed model HMO with more than 900,000 members in Utah, Idaho and Nevada. Intermountain Healthcare is an integrated health care delivery system with 23 hospitals and over 1500 employed physicians.

As the Director of Quality Improvement, David has responsibilities for oversight of the Medicare Advantage Stars program for which SelectHealth received a 4.5 Star rating in 2020 and 4 Star rating in 2021, maintaining NCQA accreditation; HEDIS performance measurement; CAHPS measurement and reporting, public reporting (transparency) and population health.

David has also been responsible for the oversight and development of chronic disease registries, performance measurement and web based reporting systems, quality improvement pay for performance incentives for providers, and direct patient improvement interventions related to chronic illnesses including patient adherence monitoring, reminders and incentive programs.

Nate Lucena Chief Strategy & Analytics Officer

Rex Wallace Consulting

Nate Lucena is the Chief Strategy & Analytics Officer 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.

Eddie Maria Head of Sales

Birdsong Hearing Benefits

Eddie Maria is the Head of Sales for Birdsong Hearing. In his role, Eddie provides leadership of Birdsong Hearing Benefits, LLC Sales while partnering with clients to make their plans more impactful, personal, and meaningful for members. He is passionate about improving peoples’ lives by bringing a whole health focus to hearing benefits that also helps health plans bring additional value to their members.

Eddie is a client-focused leader with extensive experience bringing solutions to Commercial, Medicare Advantage, and Managed Medicaid plans. He is passionate about the customer experience, focuses on nurturing relationships, and appreciates the importance of understanding the customer’s needs.

Eddie has 27 years of experience building client partnerships and leading sales teams in the healthcare industry, including the pharmaceutical, women’s healthcare, and hearing benefits sectors. He has a Bachelor of Arts in Communications Studies from California State University – Sacramento. Outside of work, Eddie volunteers with Blessings in a Backpack – an organization that provides children on a free-lunch program with food every Friday during the school year so that they have food for the weekend.

Katie Martin Vice President, Quality

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.

Carmen Martinez Product Manager

MedOrion

Carmen is a Certified Professional in Healthcare Quality Registered Nurse with over 10 years of experience in quality improvement. She led the implementation of multiple initiatives focused on improving quality, health equity, and star ratings at Humana for over 14 years. She recently joined MedOrion as a Product Manager to lead the clinical and health behavior management strategy for multiple solutions.

Traco Matthews Chief Health Equity Officer

Kern Health Systems

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.

Traco continually seeks to improve culture, processes, and outcomes through his work at KHS and in the community. He uses his experience in the private, public, and nonprofit sectors to contribute human-centered strategic analysis, effective leadership development, and expertise in building trust with Kern Family Health Care members and other important stakeholders including providers and community partners.

The passion that drives Traco in his work at Kern Heath Systems also shapes his commitment to the community in his personal life. He teaches business courses at California State University, Bakersfield, provides mentoring for leaders on justice, equity, diversity, and inclusion, and serves as a local pastor and community advocate. He graduated from the University of California, Davis with a bachelor’s degree in economics in 2001, and from California State University, Bakersfield, with an M.B.A. in 2017. He is happily married to his wife of over 20 years, Dr. Jessica Grimes, a community college district administrator. Bakersfield, CA serves as the home base for their frequent travels and life adventures.

Dr. Christie McMullen CEO

AIM...Analyze, Improve, Move

Dr. Christie McMullen is a seasoned educator turned entrepreneur, dedicated to infusing work with genuine fun. With 25 years of experience and expertise in educational leadership, she's impacted organizations like FAMP, ReMax, Aetna, Solaris, and RISE, enhancing human interactions.

With a master's and doctorate in Educational Leadership, Dr. McMullen connects with individuals across industries, from CEOs to educators to salespeople. As a coach, networking specialist, and keynote speaker, she offers transformative experiences, using her AIM approach: Analyze, Improve, Move towards extraordinary relationships.

Dr. McMullen's coaching is personalized, tailored to diverse needs, whether in the corporate world or personal relationships. She helps humans overcome mediocrity and unlock the potential for extraordinary connections.

LaShawn Moore Project Manager, Stars, Quality, and Risk Adjustment

CareFirst BlueCross BlueShield

LaShawn Moore has over 12 years of experience in healthcare operations and informatics working to drive excellence in quality metrics.

Mallory Mueller VP, Population Health & Equity

Healthmine

Mallory has over 15 years of leadership, quality and clinical experience delivering 5-Star quality care for senior populations in managed care plans and assisted living settings. She serves as Vice President of Population Health and Equity at Healthmine, guiding the brand's strategy in eliminating barriers to care, serving diverse populations and helping plans meet evolving health equity requirements. She previously served as the Director of Quality Health Integration at Network Health Plan where she oversaw all regulatory programs and led the plan to achieve 5-Star performance.

Jack Newsom Partner

Engagys

During a 25-year career in healthcare, Dr. Newsom has specialized in building teams focused on improving consumer engagement with an emphasis on integrating communications, analytics, and delivery. At Engagys, Dr. Newsom continues the practice of using analytics to drive better health outcomes and improve the results of consumer communications. Additionally, he has led the Healthcare Consumer Engagement Practices survey since its inception in 2017. As Chief Program Officer at Caravan Health, Dr. Newsom led a team of more than 40 professionals across analytics, quality, events, content management, and delivery to help practices succeed in accountable care frameworks. Prior to that, he created the analytics functions at Silverlink Communications and CenseoHealth. Dr. Newsom holds a bachelor’s degree in Economics, Master of Business Administration, and Master of Science in Clinical Evaluative Science from Dartmouth College, as well as a Doctor of Science in Health Services Research from Boston University where he taught at the School of Public Health for five years. He currently serves as an adjunct professor of public health at Cal State University East Bay.

Jennifer Nguyen Star Ratings Consultant

Rex Wallace Consulting

Jennifer has a Master's degree in Public Health and is a Certified Health Education Specialist. She has over ten years of experience in the payer field, healthcare industry, and non-profit sector. 

Jennifer previously led the Medicare Stars Program at a local Pacific Northwest carrier, where she developed and executed multi-year Stars strategies and chaired executive Stars committees. She also has experience in Medicare Operations and oversight. 

Deborah Paone Performance Evaluation Lead and Policy Consultant

SNP Alliance

Dr. Deborah Paone is an independent researcher/consultant and President of Paone & Associates, LLC, a firm she founded in 2002 (Minneapolis). Dr. Paone works with providers, health plans, communities, research centers, and government agencies to promote better systems of care, focusing on older adults, people with disabilities, and family caregivers. Deborah provides consultation to the Special Needs Plan Alliance where she has served as Performance Evaluation Lead and Policy Consultant since 2017. She is a subject matter expert in quality measurement, care coordination, integration, health equity, and implementation effectiveness (Leadership & Staff Bios | The SNP Alliance Team | SNPA). Dr. Paone serves on national technical expert committees such as the MA Stars TEP (CMS/RAND), Person-Centered Outcome Measure Advisory Panel (NCQA), Core Measure Collaborative on Health Equity (NQF), 2028 HCBS Quality Measure Set Review Workgroup (Mathematica), and as a researcher for the ACL Falls Prevention Innovation Lab. She also provides national technical assistance to organizations implementing the CAPABLE evidence-based program developed by Johns Hopkins University clinician-researchers (Deborah Paone - Johns Hopkins School of Nursing) Dr. Paone has worked with cities, states, and the federal government on demonstration and innovation initiatives such as the Minnesota Senior Health Options demonstration, ACT on Alzheimer’s, and the New York University Caregiver Intervention. Throughout her 30-year career, Deborah has worked across disciplines and settings—bridging policy, practice, and research—to bring disciplines and efforts together toward improvement.
Deborah has a Doctor of Public Health (UNC-Chapel Hill), a Master of Health Services Administration (University of Michigan), and a Bachelor in Gerontological Issues in Community Health (University of Rochester).

Claude Pinnock MD, MPH

Chief Medical Officer

Dr. Pinnock is a healthcare industry veteran with deep clinical strategy and digital health experience and brings a strong passion for improving access and quality to -elevate health for all with a focus on social determinants of health (SDOH).

As Chief Medical Officer at Wider Circle, Dr. Pinnock is responsible for crafting, directing, and overseeing the execution of the company’s clinical strategy for expanding its Medicare and Medicaid business. In addition, he leads research, business development and supports the senior leadership team in their efforts to further shape and grow the organization, including collaborating closely with Wider Circle’s product
development, marketing, and sales teams.

Dr. Pinnock began his clinical career in the United Kingdom, earning his Bachelor of Medicine, Bachelor of Surgery (BMBS) at the University of Nottingham and his master’s in public health from Cambridge University. While he began his career as a practicing physician in rural Cambridgeshire, a personal interest in driving the adoption of value-based healthcare in EMEA eventually led to a position at International Consortium for Health Outcomes Measurement (ICHOM). Following a move to the United States, he held leadership positions addressing service redesign, quality improvement, and strategy in public and private health sectors (Stanford University School of Medicine,
Clarify Health Solutions). Most recently, he managed global strategic partnerships in health at Meta, Facebook’s parent company, and led their health partnerships innovation team driving global adoption of vaccines.

Kempton Presley Chief Strategy Officer, Office of the President

AdhereHealth, Vanderbilt University

Kempton leads a multi-disciplinary analytics, product, and strategy team to meet current and future market needs using all enterprise data combined with a framework of subject matter intelligence. With 12 years of tenure at Adhere, he has also led account management and other operations teams for the company.

With two decades of healthcare payor experience, Kempton previously worked at Anthem (now Elevance) where he received the New York Presidents’ Award and participated in the Emerging Leader Program. He serves as an Adjunct Professor at Vanderbilt University, was a Lecturer at Columbia University, and has co-authored work published in the Journal of Biomedical Informatics. He holds a BA in Economics from Washington & Lee University, a Master’s in Public Health from Columbia University and a Master’s in Medical Informatics from Northwestern University.

Kempton currently serves on the Board of the Center for Living and Learning, the Board of the Blake McMeans Foundation, the Board of Elders at Woodmont Christian Church, and the Alumni Board of Montgomery Bell Academy. Previously, he served on the Board of United Cerebral Palsy of Middle TN, was Chair of the Board of Friends Life Community, was Treasurer of the Percy Priest Elementary PTO and was Alumni Chair for Montgomery Bell Academy’s Annual Fund giving campaign.

Amanda Rees Co-founder and CEO

Bold

Amanda Rees is co-founder and CEO of Bold, a digital health company focused on disease prevention and healthy aging. Bold partners with Medicare plans and provider groups to offer older adults personalized and science-based exercise programs that prevent falls, reduce musculoskeletal pain and disability, and increase physical activity levels. Before Bold, Amanda worked in energy and environmental justice, managing the renewable energy portfolio at The 11th Hour Project, a program of The Schmidt Family Foundation. Prior to that, she was a Dalai Lama Fellow, and she has conducted research at Stanford, Princeton and UCLA. Amanda has a BSE in Chemical & Biological Engineering from Princeton University. She has been a fitness instructor for over a decade, teaching dance, yoga, indoor cycling, and community tai chi for fall prevention. 

Joshua Renken President

Hyperlift

Josh is the President of Hyperlift, where he has been an integral part of the team since 2017. In his role, he oversees product development and implementation, while also managing customer relationships. With over 15 years of experience in technology leadership roles, Josh brings a developer's expertise to the company's strategic vision.

Angelo Rexach Medicare Star Ratings Policy and Analytics Consultant

Rex Wallace Consulting

Angelo Rexach is a highly skilled Medicare Star Ratings Consultant with a Master’s degree in Demography and six years of specialized experience in the Medicare Star Ratings Program. Since joining Rex Wallace Consulting, LLC in January 2024, he has utilized his expertise to assist clients in enhancing their Star Ratings through strategic data analysis and performance improvement initiatives. Previously, Angelo served as a Senior Data Scientist at MCS Puerto Rico, where he was instrumental in helping the organization become the first plan in Puerto Rico to achieve a 5-star rating. Over his seven-year tenure at MCS, he held various roles, including Data Scientist and Business Analyst, focusing on data-driven strategies to elevate Star Ratings performance.

Heidi Salerno Member Experience Consultant

Rex Wallace Consulting

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.

Daniela Simpson Senior Consultant

Wakely

Daniela Simpson, MA, MBA joined Wakely Consulting Group in 2022 as Senior Consultant in the Tempe Office. She has more than 20 years of healthcare experience, specializing in identifying data and analytics solutions and performance improvement strategies. She specializes in end-to-end HEDIS, QRS, and Stars data delivery solutions, spanning from operations and architecture to strategy design and adoption.

Ms. Simpson leads Wakely’s Quality Measurement and HEDIS Certification team, providing strategic leadership and subject matter expertise across multiple projects, including quality, population health, and value-based care initiatives. She evaluates client’s quality measurement processes through internally developed rule-tracing analytics, identifies improvement opportunities, and advises clients on how interoperability and digital transformation can enhance the efficiency, accuracy, and scalability of their operations. Additionally, Ms. Simpson collaborates closely with data aggregators, providing expert guidance to help them navigate the complex process of earning the NCQA Data Aggregator Validation certificate. This process involves assisting organizations in meeting stringent data quality standards and ensuring their data collection, integration, and reporting processes align with NCQA’s rigorous requirements and industry standards.

Prior to joining Wakely, Ms. Simpson worked for Blue Cross Blue Shield of Arizona in different leadership roles, operating at the intersection of business, analytics, and solution design. She served as an analytics translator on the senior leadership strategy team, collaborating closely with general managers and clinical quality leaders to identify and implement analytics solutions that would create the highest value for the business. She led cross-functional teams to implement the organization’s data and submission process for HEDIS and Marketplace QRS reporting, resulting in significantly improved data quality and delivery timelines. She later restructured the organizational processes and consolidated HEDIS submissions across the Commercial, Marketplace, and Medicare lines of business to one vendor, streamlining operations and improving data accuracy. As part of the consolidation, Ms. Simpson transitioned lab and other clinical data feeds to industry standards and integrated health information exchange feeds to replace manual chart abstraction, further enhancing efficiency and reducing reporting burdens.

Ms. Simpson earned a master’s degree in business administration and a master’s degree in political science from Arizona State University. She earned a bachelor’s degree from the Faculty of Law at Ss. Cyril and Methodius University of Skopje.

Melissa Skelton Duke Executive Director, Stars Strategy

Banner Medicare Advantage Health Plans

Missy Skelton Duke is the Executive Director of Medicare Stars Strategy at Banner Health. In this role, she builds the strategic vision and strategies that optimize Banner Health Plans’ Medicare Advantage Star Rating. In this role, she drives alignment across complex provider networks, provider aggregators, population health services organizations, and health plan departments to provide the highest quality health care and service to their Medicare Advantage HMO, PPO, and Dual-Eligible members. Prior to this role, Missy served as the Executive Director of Population Health Pharmacy Solutions and Ambulatory Pharmacy Services and Senior Director of Specialty and Home Delivery Pharmacy Services at Banner Health. She has also served as the Clinical Pharmacy Services Manager for Intermountain Healthcare, where she was responsible for the growth and development of clinical services, collaborative pharmacy practice agreements, and professional development and competency assessment.

Missy has been active in pharmacy advocacy issues throughout her entire pharmacy career. She has served in numerous pharmacy leadership and advocacy roles at the state and national level, most recently serving as APhA Speaker of the House of Delegates.

She received her Doctor of Pharmacy degree from the University Of New Mexico College Of Pharmacy in 2008, and a Master of Science degree in Health Policy and Pharmacotherapy Outcomes Research from the University of Utah. She completed a 24-month residency program in Health-System Pharmacy Administration from Intermountain Healthcare in June of 2010.

Melissa Smith Founder, Senior Advisor

Newton Smith Group

For more than a decade, Melissa Smith has been at the forefront of leading Medicare Advantage and Star Ratings teams. As the founder of Newton Smith Group and a Senior Advisor to Oliver Wyman, Melissa is a widely recognized thought leader and healthcare strategist. Her proven track record of success lies in developing comprehensive enterprise-wide solutions that enhance Star Ratings, quality performance, health outcomes, and the overall member experience.

Melissa excels in crafting strategic and tactical solutions to meet client needs, forging productive partnerships across internal teams and external vendors, and improving performance on various quality measures.  Her unique background in business, finance, regulatory compliance, and healthcare quality provides clients unparalleled access to healthcare strategy, quality performance, and revenue optimization.

As the former Chief Consulting Officer at Healthmine and Senior Vice President at Gorman Health Group, Melissa's leadership spans across prestigious organizations like Cigna-HealthSpring and Vanderbilt University Medical Center. Graduating from Purdue University, Melissa began her career at KPMG, LLP and is a Certified Public Accountant.

Elissa Toder VP of Quality Improvement Strategies

Reveleer

Elissa Toder, Vice President of Quality Improvement Strategy and Solutions has worked in managed care for over 16 years as a former Staff Vice President of Quality Improvement.

Mick Twomey Chief Executive Officer

Hyperlift

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 born Stars Monitor, Hyperlift's SaaS technology platform.

Crafted by Stars professionals for their peers, Stars Monitor is 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. 

Kyra Valdez-Shipp Founder & Principal

Peak Performance Solutions Group

Kyra Valdez-Shipp stands out as an esteemed healthcare executive and is the Founder & Principal of Peak Performance Solutions Group. Her mission is straightforward: to Inspire, Motivate, and Elevate individuals and organizations to infinite potential. Boasting two decades of experience in healthcare across various products, Kyra assists health plans, providers, and healthcare technology vendors in achieving peak performance with a focus on member-centric strategies. Her deep passion lies in pioneering healthcare solutions that cater to the dynamic and varied needs of populations managed by healthcare professionals daily.

Peet van Biljon Adjunct Professor

Georgetown University, McCourt School of Public Policy

Peet van Biljon serves as an adjunct professor at Georgetown University where he teaches a graduate course, Innovation & Public Policy, to students at the McCourt School of Public Policy. His recent research employs the Medicare Advantage program as a case study for exploring the ability of public-procurement spending to induce innovation in private firms.

He was formerly a management consultant and strategy expert at McKinsey & Company, where he also managed its global innovation practice. Subsequently, Peet founded BMNP Strategies LLC, an advisory firm, where he consults to clients on innovation management, R&D and business transformation, as well as on public policies to promote innovation and economic growth. Peet serves clients in all sectors, but has particularly deep expertise in the high-tech, electronics, software, and advanced manufacturing industries. He has held executive positions in several technology and advisory companies internationally. 

Peet’s book, Innovation for Value and Mission: An Introduction to Innovation Management and Policy (published by De Gruyter in 2022), covers innovation in both the public and private sectors, as well as public policy for innovation. Articles on innovation and R&D management that he coauthored have been published in MIT Sloan Management Review, Research-Technology Management, and mckinsey.com. 

Rex Wallace CEO

Rex Wallace Consulting, LLC

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.

Daniel Weaver SVP Stars and Quality

Zing Health

Daniel Weaver recently became the Senior Vice President of Stars and Quality at Zing Health. With over 25 years of experience in Operations and Star Ratings strategy, Daniel has previously served as VP, Government Quality Programs at Gateway Health and Director of Stars Programs at Highmark Health, helping both organizations achieve and maintain their first 4.5 Star Ratings. In his career, Dan has overseen the development and implementation of many analytics-driven and customer-focused programs, and he advocates for continuous improvement and operational excellence philosophies for sustained success. In his new role with Zing Health, Daniel will focus on implementing a high-performing Stars infrastructure to support the organization’s rapid growth with a focus on servicing special needs members in several states.

Darren Wethers CEO

Wethers Consulting, LLC

Darren Wethers is a board-certified internal medicine physician and certified physician executive.

He graduated from Morehouse College, Northwestern University Medical School and completed internal medicine training at Emory University School of Medicine before establishing himself in internal medicine practice in the St. Louis, Missouri area, becoming a “Top Doctor” honoree several years running. Dr. Wethers was the medical staff president at SSM St. Mary’s Health Center in 2006-07 and chaired the facility’s Credentials committee 2007-11.

In 2011, Dr. Wethers began a career in administrative medicine, servings as a medical director with Coventry Health Care and Aetna, vice president of clinical operations at Blue Cross Blue Shield of Arizona and at Atrio Health Plans, where he served as chief medical officer. He launched Wethers Consulting, LLC in 2023, which has clients including Rebellis Group, Toney Health and MetaDigital. Dr. Wethers is a strategic advisor to the Managed Care Resource Alliance (MCRA).

Dr. Wethers is a member of the American Association for Physician Leadership, Fellow of the American College of Physicians, member of Alpha Phi Alpha and Sigma Pi Phi fraternities; he is the immediate past chairman of the board for Gamma Mu Educational Services (GMES) and is a board member of Northwestern University Medical School Alumni Association, for which he serves as president-elect and co-chair of the Inclusion and Allyship committee.

Stephen P. Winn Senior Director, Quality

Permanente Medicine

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.

Kate Wolin Senior Advisor

Wellth

Dr. Kate Wolin is a behavioral epidemiologist, digital health entrepreneur, investor and professor. Following her academic medicine career at Washington University School of Medicine and Loyola University, Dr. Wolin co-founded and served as CEO of a digital health start-up that was acquired by Anthem, Inc. She then served as Chief Science Officer of a population health platform company and as head of product for Optum's direct-to-consumer business. Dr. Wolin is an advisor to start-ups and enterprise organizations on bridging clinical and behavioral science with commercial product strategy and execution. She is an investor in early-stage digital health companies. Kate earned her doctorate at the Harvard School of Public Health and completed her fellowship training at Northwestern Feinberg School of Medicine. She is currently on the entrepreneurship faculty at the Kellogg School of Management at Northwestern. She has been named as a Forbes Healthcare Innovator That You Should Know and a Notable Woman in STEM by Crains. Dr. Wolin is a Fellow of the Society of Behavioral Medicine and the American College of Sports Medicine.

Susan Yates Miller Director, Medicare Stars

CareOregon

Susan Yates Miller is the Director of Medicare Stars for CareOregon Advantage. Susan has worked in managed care and led HEDIS and quality improvement for over 20 years. In her role, Susan promotes system strategies to engage providers, build trust and activate members, and develops stakeholder relationships to ensure quality reporting systems.