Medicaid Innovations Forum
2017 SPEAKERS
ADVISORY BOARD MEMBERS
SPEAKERS
ADVISORY BOARD MEMBERS BIOGRAPHIES
Medicaid Innovations Forum
Bill Clark
Managed Care Compliance Director
Department of Vermont Health Access

Bill Clark is the Managed Care Compliance Director at the Department of Vermont Health Access (DVHA, the department responsible for Vermont's publicly administered health insurance programs). Mr. Clark is responsible for maintaining the department’s compliance with federal and state managed care regulations and policies and he coordinates all programmatic audits and compliance corrective action plans. He also provides leadership and supervision to the Provider and Member Relations Unit which is responsible for managing DVHA's provider network and enrollment processes, member support and the Non-Emergency Medical Transportation benefit.

Prior to working in Compliance and Provider and Member Relations, Mr. Clark was a Financial Director at DVHA where he managed audits, accounting practices, grants/contracts and other fiscal management duties. Before entering the Medicaid world, Mr. Clark served in various roles within the Vermont Department of Health, including: terrorism preparedness, death investigation and emergency medical services.

Medicaid Innovations Forum
Clay Farris
Director of Operations
Mostly Medicaid

Clay has advised CMS administrators, state Medicaid Directors and a wide range of other clients in the healthcare industry. His unique blend of management consulting, project management, policy making and analytics help deliver on-time, actionable results for a wide array of business challenges.

His experience includes policy making at both the federal and state levels, management consulting for large organizational change initiatives, big data solution sales and implementation and cutting-edge analytics. He currently serves as the Director of Operations for Mostly Medicaid, where he leads key project components related to consultation design, Medicaid subject matter expertise and project management. He has a masters in Health Policy from the Johns Hopkins Bloomberg of School of Public Health and is also a Certified Internal Auditor.

Medicaid Innovations Forum
Jim Milanowski
President and CEO
Genesee Health Plan
Jim Milanowski has over 22 years experience in the management of mental health, substance abuse, behavioral health managed care and medical care coverage programs. Mr. Milanowski currently serves as the President and Chief Executive Officer of the Genesee Health Plan (GHP), administering a community based indigent health care plan. The health plan has covered over 70,000 Genesee County residents since 2001. Since the start of enrollment into Affordable Care Act in 2013, GHP has conducted outreach and enrollment sessions with over 15,000 Genesee County residents. The health plan received the 2015 Pinnacle Award from the Michigan Association of Health Plans for this effort.

As a strong advocate, his expertise includes working to reduce racial disparities, uncompensated care, and the impact of chronic disease. During his leadership, Genesee Health Plan has received the national quality award from URAC for Best Practices in Patient Empowerment and Protection, the Greater Flint Labor Council's Community Partnership Award and the Robert M. Pestronk Excellence in Public Health Award. He is a founding member of the Health Net Collaborative, and a member of the Greater Flint Health Coalition Access, Dental and Medical Group Visit Committees. He is the Treasurer of the Michigan Association of County Health Plans and is on the Board of Directors for the Genesee Community Health Center.

Mr. Milanowski received his Bachelor of Arts degree in Psychology from Spring Arbor University and his Master's of Science degree in Clinical Psychology from Eastern Michigan University. He is a limited-licensed psychologist in the state of Michigan, and has extensive counseling experience with adult, child, and adolescent populations.

Medicaid Innovations Forum
Beth B. Nelson
Director, Medicaid Programs
Blue Cross Blue Shield of Minnesota
Beth Nelson has over 30 years of experience in program development, implementation and management within the fields of Medicaid managed care, dual eligibles and home and community based service. She is currently the Director of Medicaid Services at Blue Cross Blue Shield of Minnesota and oversees a managed care Medicaid product that serves over 300,000 members.

Medicaid Innovations Forum

Henry W. Osowski
Managing Director
Strategic Health Group LLC

Hank Osowski, a Founding Member of Strategic Health Group, is an experienced health care executive and strategist who has provided leadership to commercial, Medicare and Medicaid health plans for more than 30 years. He currently is the Managing Director of Strategic Health Group, a new boutique strategic and financial advisory firm dedicated to bringing seasoned leadership to enable health care organizations to succeed in a challenging and changing environment. He is an expert in Medicare Advantage and Medicaid long-term care strategies.

Formerly, as Senior Vice President Corporate Development, he was a key member of the senior leadership team that the company from a near death experience to an exceptionally strong financial position. He led SCAN Group's efforts to expand into seven additional California counties. Hank also led SCAN's entry into Arizona and served as the initial President of SCAN Health Plan Arizona and SCAN Long Term Care. The service area expansions represent approximately a quarter of SCAN's membership and added nearly $450 million to SCAN's revenue. He also led the organization's strategic planning efforts and initiated an innovation development regimen to seek improvements in care coordination practices and future care outcome protocols.

Prior to SCAN, Hank served as a Principal in a national health care consulting organization providing a range of strategic, financial and development services for health plans, physician groups and hospitals. He began his California career as a member of the senior management team responsible for the turnaround and financial survival of Blue Cross of California. In this capacity, Hank led the financial turnaround of the Individual and Small Group Division and provided leadership to the organization's strategic planning efforts.

Earlier he served as Vice President International Operations for American Family Life Assurance Corporation where he directed the activities of the company's Canadian and European operations. In this role he directed the development of start-up operations in the United Kingdom, Germany and Italy, as well as the financial turnaround of the company's Canadian operations. Earlier, Hank also served as Director of Insurance Consulting Services for Coopers and Lybrand, a predecessor to PriceWaterhouse Coopers.

Throughout his career, he has been a frequent speaker on critical issues and challenges facing the Medicare and Medicaid programs. In 2011, Hank spoke to the Managed Medicaid Congress about principles for structuring effective long term care programs, to the Medicare Market Innovations conference about opportunities for strengthening a plan's five star quality rating and offered his strategic projections for the future of Medicare. He also spoke to a diverse health care and technology audience at the Healthcare Unbound conference about leveraging the power of technology to improve the quality of health outcomes and care interventions.

Medicaid Innovations Forum
Sheila Wilson, BSN, RN, CCM
Director of Care Management, Medicaid
Priority Health
Sheila is a Registered Nurse with over 31 years' experience in both clinical and managed care environments. She has extensive experience in case management, and is especially knowledgeable about the challenges facing the Medicaid population. Currently Sheila serves as the Director of Care Management for Medicaid at Priority Health, a Michigan based company serving HMO, PPO, Medicare and Medicaid members across the State of Michigan. Her responsibilities include the development, implementation and administration of programs to achieve medical cost goals for the Medicaid Business Unit. She directly oversees case and disease management, as well as medical utilization operations. Sheila and her team recently received two prestigious Pinnacle Awards from the Michigan Association of Health Plans for work done to incorporate children with special health care needs into managed care, and for spearheading a pilot project with the use of a medical mobile application for children with asthma.

Sheila obtained her Bachelor of Science degree in Nursing from Alverno College, and has held her Certification in Case Management (CCM) since 1994. She has completed the first year of a 2 year Executive MBA Program with Grand Valley State University. She currently lives in Grand Rapids, Michigan with her husband Bill and daughter Ashley.
SPEAKER BIOGRAPHIES
Medicaid Innovations Forum
Chris Barrott
Contract Manager,
Idaho Department of Health and Welfare
Chris Barrott has worked in program development and implementation for over 15 years in both the private and public sector. Currently she is working for Idaho Medicaid as the Contract Manager for the Duals Special Needs Plan. Her expertise is in building programs that improve healthcare for beneficiaries.

Medicaid Innovations Forum

John E. Burich
Vice President, Strategy and Business Development
Passport Health Plan

As Vice President, Strategy and Business Development for Passport Health Plan, John is responsible for helping to position Passport Health Plan to as a state-wide Medicaid health plan.

John's focus is on Passport Growth with emphasis on statewide expansion, growth within our existing market and the upcoming health insurance exchange.

John is highly accomplished with over thirty years of experience in health and human services working with a variety of public and private sector models including managed care, fee-for-service, ACOs, VA and Tricare along with direct experience with hospitals and providers. Most recently, John was Vice President of Business Development for Magellan Health Services, a publically-traded company that provides behavioral health, specialty care management and pharmacy benefits to managed care companies, state Medicaid departments and provider systems across the United States. He has also served in leadership roles with United Healthcare.

Medicaid Innovations Forum
James Bush, MD, FACP
State Medicaid Medical Officer
Office of Health Care Financing
State of Wyoming
Dr. Bush joined the Wyoming Department of Health in March 2007 as Staff Physician and Medicaid Medical Director. In this role, he oversees the Health Management and Utilization Management contract, and provides clinical oversight throughout the Dept. of Health. Currently he provides clinical input to the development of the Statewide Superutilizer Program. Prior to that he had a solo practice on Internal Medicine in Fort Collins, CO. Interested in Medical Policy and Organization, he has filled many roles including that of Chief of Staff at Poudre Valley Hospital, President of the Colorado Society of Internal Medicine, and President of the Fort Collins IPA . Enjoying teaching as well he has been on the Clinical faculty of the U of Colorado for 23 years, and has also been involved with teaching Residents in Family Practice in Fort Collins.

In 2010 he was elected to be Governor of the Wyoming Chapter of the American College of Physicians for 2012-2016. He is Chairman of the Wyoming Telehealth Consortium and oversees the State of Wyoming’s Telehealth contract. Special interests include developing Wyoming’s Patient Centered Medical Home model, and Value Based Purchasing.
Medicaid Innovations Forum

John Cole
Chief Executive Officer
Shared Health

John Cole is Chief Executive Officer of Shared Health, a subsidiary of BlueCross BlueShield of Tennessee that was established to help managed care organizations improve the services they provide to their members. Shared Health specializes in managed care solutions for the underserved, chronically ill, and long-term services and supports populations.

Mr. Cole has more than 20 years of experience in working with organizations to implement challenging projects and has focused on the healthcare financing/managed care industry his entire career. Mr. Cole has worked with many organizations that included managed care organizations, state governments, and health systems. He has managed and performed key roles in the implementation of large management information systems, financial operations, network development, and managed care start-up project management.

Mr. Cole is a Certified Public Accountant that graduated from the University of Tennessee at Knoxville with a Bachelor of Science degree in Accounting and a Masters in Accounting.

Medicaid Innovations Forum
Erin Collins
Utilization Management & Client Appeals Unit Manager
Colorado Department of Health Care Policy & Financing
Erin Collins is the Utilization Management and Client Appeals Unit Manager for the Colorado Department of Health Care Policy and Financing. She oversees the Utilization Management contract for the ColoradoPAR Program, Nurse Advice Line, and the Department’s Client Appeals. Her focus is to modernize programs by incorporating state of the art system processes designed to improve provider and client experience, as well increase Medicaid client’s access to care.

Erin received her master’s degree in Public Policy from the University of Colorado in 2006. Prior to coming to the Department, for 6 years Erin was the Director of Programs for Dental Lifeline Network, a national organization providing no-cost dental care to disabled adults, low-income children, and seniors. Her background includes extensive work with children and adults with developmental and intellectual disabilities, low-income populations, seniors, and advocating for access to care for all.
Medicaid Innovations Forum
Alison L. Croke, MHA
Vice President of Medicare-Medicaid Integration
Neighborhood Health Plan of Rhode Island
Alison Croke is the Vice President of Medicare-Medicaid Integration at Neighborhood Health Plan of Rhode Island. She has responsibility for Neighborhood’s managed Long-Term Services and Supports (LTSS) product, and the future Medicare-Medicaid Plan (MMP) duals demonstration product. Prior to her current role she was with Xerox State Healthcare, working with the Rhode Island Executive Office of Health and Human Services (EOHHS/Medicaid) for approximately 10 years. In this capacity she worked with senior Medicaid agency staff to create new managed care programs for Medicaid clients, including RIte Smiles, Rhody HealthPartners, and Rhody Health Options. Prior to joining EOHHS, Alison worked as a Senior Project Manager at Neighborhood Health Plan of Rhode Island, from 2002-2005 and at the Center for Health Care Strategies (CHCS) in Princeton, New Jersey (1998-2002) on several Robert Wood Johnson Foundation funded national programs focused on developing health care delivery systems for vulnerable populations. Alison has a Bachelor of Science in Biological Sciences from the University of Vermont, and a Master of Health Administration from the Medical College of Virginia, Virginia Commonwealth University.
Medicaid Innovations Forum
Jeremy Cunningham, FSA, MAAA
Consulting Actuary
Milliman
Medicaid Innovations Forum
Scott W. Dahl
Senior Director, Healthy Communities Institute
Conduent Community Health Solutions
Scott Dahl is Senior Director of Business Development with Conduent Healthy Communities Institute, where he works with hospitals and health systems, health departments and coalitions on community- and population-health improvement. He has worked in the healthcare field for over 25 years with organizations such as VHA and Kimberly-Clark in clinical quality improvement, continuing education, patient engagement, packaged pricing and medical devise development. Scott holds a master’s degree from the University of Houston and a bachelor of science degree from the University of Texas at Austin.
Medicaid Innovations Forum
Kathleen Dougherty
Chief of Managed Care Operations, Diamond State Health Plan, DSHP Plus, Division of Medicaid and Medical Assistance
Delaware Health and Social Services
Kathleen Dougherty began her career with the State of Delaware in 2000 working in the Long Term Care unit of Medicaid. She has held increasing positions of responsibility and has moved from being on the front lines of the State’s fee-for- service delivery system to the Chief of Managed Care Operations with oversight responsibility for the State’s Medicaid Managed Care program. As the Chief of Managed Care Kathleen oversees the Diamond State Health Plan, Managed Medicaid/CHIP and Long Term Care contractors, the External Quality Review vendor, the Transportation Vendor, and the State’s Health Benefit Manager.

Over the past several years Kathleen has focused on Delaware’s transition away from the traditional FFS delivery model to a more robust Managed Care program incorporating a fully integrated model for delivering physical and behavioral health care to Medicaid enrollees as well as, inclusion of the long term services and supports program; DSHP Plus. She lead the competitive re-procurement process for the State’s Managed Care vendors which has included a re-design of the State’s Managed Care Organization Contract to reflect the changing health services delivery landscape and to focus on improving care and outcomes for all Medicaid Managed Care enrollees. Most recently her major focus has been on gap analysis and operational planning for Delaware's compliance with the Managed Care Rule.
Medicaid Innovations Forum

John Dow
President and CEO
South Florida Behavioral Health Network, Inc.

Mr. Dow is responsible for administrative oversight and system of care integration of a multi-million dollar Behavioral Health Care system in South Florida. South Florida Behavioral Health Network, Inc. (SFBHN) is a nonprofit, managing entity that funds and oversees a network of providers in Miami-Dade and Monroe Counties on behalf of the State of Florida. SFBHN’s responsibilities includes planning and contracting for a comprehensive system of mental health, substance abuse treatment and prevention services, at a community level resulting in 65,000 individuals receiving care annually.

Medicaid Innovations Forum

Barbara Dusenberry, BSN, RN
Manager of Care Management, Medicaid
Priority Health

Barbara Dusenberry is a Registered Nurse with 30 years’ experience in both clinical and managed care environments. She has extensive experience in care management has worked exclusively with the Medicaid population since 2008 and understands the challenges, including the social determinants of health impacting the Medicaid population.

Currently Barb serves as the Manager of Care Management for Medicaid at Priority Health. Priority Health is a Michigan based Health Plan serving HMO, PPO, Medicare Advantage and Medicaid members across the State of Michigan. Her responsibilities include the development, implementation and administration of programs to improve the member experience of care, improve health outcomes for the Medicaid population and achieve medical cost goals for the Medicaid Business Unit. She directly oversees the care management department. She also has experience working in Critical Care, Post-Acute Recovery Care, and has held leadership roles in Home Health Care and Long Term Acute Care Hospital and Hospital Administration.

Barb obtained her Bachelor of Science degree in Nursing from Ferris State University. Barb lives in Montague, Michigan with her husband David and their 5 children.

Medicaid Innovations Forum
Anthony Evans
SVP Integrated Care and Home Health Services
CareSource
Anthony Evans serves as Senior Vice President of Integrated Care and Home Health Services at CareSource, one of the largest non-profit MCOs in the United States, serving nearly 1.5 million total enrollees in several states. Mr. Evans holds a degree in Registered Nursing with clinical and executive management experience in a wide variety of acute and LTSS settings. Prior to his current role with CareSource, he owned and operated a Medicare-certified home health and hospice agency in central Ohio, and more recently served as Chief Operations Officer for the largest State-administered 1915c HCBS Waiver Program in Ohio, overseeing case management for more than 13,000 waiver recipients and performance/quality oversight of more than 10,000 direct and ancillary service providers in the Ohio Department of Medicaid network. His current responsibilities at CareSource include clinical and operational oversight of the MyCare Ohio MMP program serving over 22,000 dual eligible enrollees, and the strategic development and implementation of integrated care delivery systems for the management of chronic/complex, HCBS, LTSS, and dual eligible participants.
Medicaid Innovations Forum

Gregory S. Everett
President & CEO
Payer Compass

Greg is the President & CEO of Payer Compass, LLC. With over 25 years in the managed care and healthcare software business, Greg brings vast knowledge and experience to provider and payer organizations.

Greg and his team support comprehensive Medicaid pricing and are well versed in the complexities of pricing from state to state, as well as confidently navigate the rules of dual eligibility. Payer Compass positions themselves as the reimbursement experts, charting a course to reduce reimbursement costs, improve repricing, increase efficiencies and lower administrative costs.

Greg is a proud alumni of Oklahoma State University.

Medicaid Innovations Forum
Clay Farris
Director of Operations
Mostly Medicaid

Clay has advised CMS administrators, state Medicaid Directors and a wide range of other clients in the healthcare industry. His unique blend of management consulting, project management, policy making and analytics help deliver on-time, actionable results for a wide array of business challenges.

His experience includes policy making at both the federal and state levels, management consulting for large organizational change initiatives, big data solution sales and implementation and cutting-edge analytics. He currently serves as the Director of Operations for Mostly Medicaid, where he leads key project components related to consultation design, Medicaid subject matter expertise and project management. He has a masters in Health Policy from the Johns Hopkins Bloomberg of School of Public Health and is also a Certified Internal Auditor.

Medicaid Innovations Forum

Holly Michaels Fisher
Managing Director
PricewaterhouseCoopers, LLP


Medicaid Innovations Forum
William E. Golden, M.D.
Professor of Medicine and Public Health at the University of Arkansas for Medical Sciences
Medical Director
Arkansas Medicaid
William E. Golden, M.D. is Professor of Medicine and Public Health at the University of Arkansas for Medical Sciences and Medical Director of Arkansas Medicaid where he is the clinical lead for the program’s nationally recognized multipayer payment reform initiative. Previously, he served as the Vice President for Clinical Quality Improvement of the Arkansas QIO and designed numerous statewide quality improvement projects. A past Chair the Board of Regents of the American College of Physicians, Dr. Golden served 4 years on the Board of Directors of the National Quality Forum and is a past President of the American Health Quality Association. He is currently on the Guiding Committee of the CMS Health Care Payment Learning Action Network and co-chair of its Primary Care workgroup. Dr. Golden received an AB from Brown University, an MD from Baylor College of Medicine, and internal medicine training at Rush Medical Center in Chicago.
Medicaid Innovations Forum
Sara Hall
HIP Link Director
Office of Medicaid Policy and Planning
Indiana Family and Social Services Administration
Sara Hall is the HIP Link Director at the Office of Medicaid Policy and Planning at Indiana’s Family and Social Services Administration. Prior to working for Indiana Medicaid, Sara was a federally licensed Navigator assisting clients with Marketplace and Medicaid plans. [Additional information is on my LinkedIn profile: www.linkedin.com/in/sara-hall-8aab7057]
Medicaid Innovations Forum
Paul R. Houchens, FSA, MAAA
Principal, Consulting Actuary
Milliman
Paul Houchens is a Principal & Consulting Actuary in Milliman’s Indianapolis office. He has consulted on a wide array of topics for state Medicaid agencies, including capitation rate development, financial projections, risk adjustment, financial reporting, and encounter data quality improvement. In addition to his work in the Medicaid industry, Paul has provided consulting services to multiple states related to analyzing the changes that have occurred in the commercial health insurance market as a result of the Affordable Care Act. He has written several publicly available white papers on Medicaid and healthcare reform issues, including the individual mandate, health insurer financial results, and encounter data requirements.

Jeremy Cunningham is an Actuary with Milliman's Indianapolis Health Practice. He joined the firm in 2011, and has over 5 years of experience providing actuarial support to state Medicaid agencies including capitation rate-settings, financial impacts of policy and program changes, and other Medicaid functions. He has gained a great deal of technical expertise including raw data processing and manipulation, cleaning, and quality review. He also has led the development of a web-based application that evaluates the quality of the underlying encounter data supporting the capitation rate development. He has written several publicly available white papers on Medicaid issues, including Autism and encounter data requirements in the new Medicaid managed care regulations released by the federal government.
Medicaid Innovations Forum
R. Cyrus Huffman
Senior Medical Director, BlueCare Tennessee
Dr. "Cy" Huffman is a Senior Medical Director for BlueCare Tennessee which serves over 600,000 low- income Tennesseans. Dr. Huffman provides medical leadership to BlueCare Plus (a Medicare Advantage plan for low-income seniors and low-income disabled individuals), BlueCare CHOICES (long term home and community-based services to a similar population) and Select Community (comprehensive integrated care for adults with intellectual disabilities). Dr. Huffman is quite passionate about high quality care for all, particularly those with complex medical and social challenges.

Dr. Huffman is an internal medicine physician who has served in senior executive leadership for health systems in Alabama, Florida and Tennessee. He received his medical degree from the University of Alabama in Birmingham and also holds a degree in Health Care Management from the University of Alabama Tuscaloosa.

Dr. Huffman serves on the Regional Health Council for Chattanooga/Hamilton County Tennessee and the Council for Inclusion and Health Equity of the Tennessee Hospital Association. He helped found the Chief Medical Officer Society of Tennessee and previously served on the Board of QSource, the Quality Improvement Organization (QIO) for the state of Tennessee. Dr. Huffman has led a number of regional and statewide quality improvement initiatives.
Medicaid Innovations Forum

Justin Hyde
Director, Market Planning
LexisNexis Risk Solutions

Mr. Hyde has been instrumental in LexisNexis Government Sector specifically in the strategy, design, and implementation of identity solutions focused on health and human services agencies nationwide.
  • Experienced program manager who directed the implementation of the Florida Department of Children and Families Customer Authentication project as part of their integrated eligibility system. Additionally, managed numerous successful implementations across various State and Federal HHS programs.
  • Directs the design and deploy solutions focused at preventing, detecting, and deterring fraud, waste, and abuse in Medicaid and other programs as well as manage a team of solution architects.
  • Active Certified Fraud Examiner (CFE) and Project Management Professional(PMP) certifications


Medicaid Innovations Forum
Amanda James, MSN, FNP-C
Director, Utilization Management
Blue Cross of Idaho
As Director of Utilization Management at Blue Cross of Idaho, Amanda leads a dynamic team of clinical and administrative staff who serve the inpatient and outpatient needs of its members. Additionally, she possesses experience developing clinical NCQA accredited programs that support the commercial and government membership at Blue Cross of Idaho.

Amanda's experience as an Emergency Room and Family Nurse Practitioner are invaluable to her innovative and member-centric focused approach. Her passion for serving the needs of complex populations such as the Medicare Medicaid Coordinated Program at Blue Cross of Idaho is energizing.

Medicaid Innovations Forum

Michael Jarjour
President and CEO
ODH, Inc.

Michael Jarjour is president and CEO at ODH, Inc., a leading provider of behavioral health technology solutions and services. In this role, he oversees ODH’s overall operations and drives strategy for its flagship product, Mentrics, the leading-edge healthcare data analytics platform designed to transform behavioral healthcare systems. With more than 20 years of experience in pharmaceutical and healthcare technology, Mr. Jarjour has a proven track record of growing businesses, maximizing operations and building highly motivated and effective management teams on a global scale.

An entrepreneur, investor and advisor, Mr. Jarjour’s extensive experience leading healthcare and technology companies to significant growth makes him the ideal executive to launch ODH. His leadership, strategic and operational strengths for steering companies and franchises toward greater growth and profitability have been recognized by his employers, peers and analysts.

Prior to leading ODH, Mr. Jarjour served as vice president, global commercialization and portfolio management at Otsuka Pharmaceutical and led the company’s global digital strategy. Before that, he led Kinematik, a company focused on developing scientific R&D solutions, as president and CEO. Throughout his career, he has held key leadership positions at Bristol-Myers, Pharmacia/Pfizer, Warner-Lambert/Pfizer and Wyeth with particular focus on executive management, marketing, operations, strategy and business development.

Mr. Jarjour’s long career has afforded him unique expertise in many areas, from pharmaceutical and managed care sales, to product marketing – from discovery to launch to generics – to portfolio management, business development and therapeutic area leadership. His strong entrepreneurial spirit stemmed from the first company he co-founded, Logonhealth Corporation, a provider of wireless handheld and web-based prescription solutions for physicians, pharmacists and patients, which was rated “best in class” by McKinsey & Co.

Furthermore, Mr. Jarjour is committed to serving the tech and healthcare community. He is a venture partner and advisor at Mansa Capital. Mr. Jarjour earned his undergraduate degree in finance from Florida International University and his MBA from Rutgers University.

Medicaid Innovations Forum
Leornard J. Kirschner M.D. M.P.H.,
Immediate Past President
AARP Arizona
Dr. Kirschner is Immediate Past President of AARP Arizona. He is a member of the AHA Committee on Research and was a member of the 2010 Long Range Policy Committee. He is on the Board of Directors of Wickenburg Community Hospital. He is a member of the National Advisory Board on Improving Health Care Services for Seniors and People with Disabilities. He is a Trustee of the Arizona Perinatal Trust, a member of the Arizona State Medicaid Advisory Committee, the State Trauma Advisory Board, and Fighter Country Partnership. He was a member of the Harvard School of Public Health Leadership Council, 2003 to 2006, and the 2003 Citizens' Task Force on the Maricopa County Health Care System. He is a past President of the Veterans Medical Leadership Council of the Carl T. Hayden VA Medical Center, and he served on the Board of the AzHHA from 1998 to 2005. He was a member of the AHA Regional Policy Board from 2000-2003 and 2007-2009 and was on the Board of the PMH Health Systems Strategy Group, 1994-2001; Del E. Webb Hospital, 2002-2008; and Sun Health, 2004-2008.

He retired as a Principal with William M. Mercer Inc., a global consulting firm, in 2001. During his tenure with the company, he provided consulting services to such diverse Medicaid programs as TennCare, MediCal and AHCCCS. Dr. Kirschner was Vice President, Health Care Initiatives, State Health Care, EDS, 1993 to 1999. During his 6 years with EDS, he provided consulting services to Medicaid programs across the United States, including business trips to all 50 states. Dr. Kirschner was Director of the Arizona Health Care Cost Containment System (AHCCCS) from February, 1987 until July, 1993. This program provides health care to over 1 million residents of the state. The prepaid model pioneered by Arizona is considered to be the most cost effective means of providing quality health care to Medicaid beneficiaries. During his 6 years as AHCCCS Director, he represented the western states and Pacific territories on the Executive Committee of the State Medicaid Directors Association and chaired the Medicaid Managed Care Technical Advisory Group.

During the past 40 years, he has been an invited speaker at numerous conferences across the country speaking on the subjects of Medicaid, Medicare, managed care, behavioral health and health care reform. He was on the Advisory Committee of the National Managed Health Care Congress, a featured speaker of the Medical Leadership Forum and co-author of "Medicaid Managed Care" in the Managed Health Care Handbook. He was the recipient of the 1994 Arizona Hospital and Healthcare Association's Salisbury Award and the 1997 Arizona Department of Health Services and Arizona Medical Association's Public Health Service Award. In 2006, he was awarded the Healthcare Lifetime Achievement Award by the Phoenix Business Journal and the Individual Leadership Award by WESTMARC. Dr. Kirschner is a graduate of Williams College, Albany Medical College, and the Harvard University School of Public Health. He is board certified by the American Board of Preventive Medicine and is a Fellow of the American College of Preventive Medicine and the Aerospace Medical Association.

Dr. Kirschner served on active duty in the United States Air Force for 22 years commanding five Air Force hospitals before retiring in 1985 as Commanding Officer of the USAF Hospital, Luke Air Force Base with the rank of Colonel. He spent ten years at military medical facilities outside the United States, including assignments in Turkey, Japan, Vietnam, Thailand and Spain, and served four years as Director, Cadet Health Services at the USAF Academy. His military awards include the Legion of Merit, Bronze Star, Air Medal and Vietnam Service.

Medicaid Innovations Forum
Lawrence J. Kissner
Chief Executive Officer
Aetna Better Health
Lawrence was most recently the Commissioner of Medicaid for the Commonwealth of Kentucky and was instrumental in leading the state to a position of national prominence by smoothing out the transition from fee-for- service (FFS) to managed care, expanding Medicaid, and building a fully functional health benefit exchange.

Previously, Mr. Kissner was CEO of Magnolia Health Plan in Mississippi, Vice President of National Accounts and Large employers at Independence Blue Cross, and President and CEO of UnitedHealthcare in Kentucky. He also was selected to participate in UnitedHealth Group’s prestigious Presidents Leadership Development Program where 30 students from throughout the company tackle a difficult assignment from the Board and attend Wharton’s Executive Development Program.
Medicaid Innovations Forum
Steve Konsin, RPh
Principal
Syrtis Solutions
Steve Konsin is responsible for Syrtis Solutions' leadership direction. Before founding Syrtis, Steve, a licensed pharmacist, has held executive leadership positions at several fortune 500 companies and operational management positions in leading retail and mail service pharmacies, pharmacy benefit managers, MMIS and specialty pharmacy organizations.

Steve has spent his career dedicated to the business of pharmacy, which includes expertise in management of operations, information technology, clinical programs, third party liability, sales, reporting, network management, specialty and mail service distribution, formulary design, and rebate management.

Medicaid Innovations Forum
Jordan Mauer
EVP of Marketing & Engagement
NovuHealth
Jordan develops and leads NovuHealth's marketing and brand initiatives, as well as the end-to-end management of member-facing operations. Jordan brings a passion for analytics, loyalty operations and engagement, as well as strategic energy to NovuHealth.

Medicaid Innovations Forum

Dr. Srinivas Merugu
Medical Director
United Healthcare Community Plan of Ohio

Dr. Srinivas Merugu is an Internist with over 10 years of clinical practice and 10 years of hospital administration and health plan experience. He obtained his medical degree from Osmania Medical College in Hyderabad, India and completed his Internal Medicine residency at St. Vincent Charity Hospital in Cleveland, Ohio. He was part of a multispecialty group practice in Cleveland until September 2014. At St. Vincent Charity Medical Center, he served in several leadership positions including Associate Residency Program Director, Chair of Hospital Performance Improvement and Patient Safety and as the hospital’s first Chief Medical Informatics Officer. Dr. Merugu also served as Physician Advisor for Utilization Management and Chief Medical Advisor for Clinical Strategy at Medical Mutual of Ohio. His passion for innovation, management of complex populations and health policy leadership drew him to his current position as Medical Director for United Healthcare Community Plan of Ohio with a primary focus on the MyCare Ohio (Medicare-Medicaid demonstration) product. He works closely with the Quality team in Ohio on setting and delivering on strategic quality goals. He lives in Cleveland and enjoys travel, reading, jazz and playing tennis.

Medicaid Innovations Forum
Tom Meyer
Chief Program Integrity Officer
HHAeXchange
As Chief Program Integrity Officer, Tom Meyer ensures HHAX’s platform helps all home care stakeholders comply with state regulations and prevent fraud, waste and abuse. His responsibilities include working with Managed Care Organizations (MCOs), state Medicaid professionals and HHAX customers to demonstrate the value of and need for a robust and collaborative platform in home care. With more than 30 years in the information technology and healthcare industries, Tom brings decades of public sector and leadership experience to the role. He previously served as New York State’s Acting Medicaid Inspector General, where he was responsible for monitoring fraud, waste and abuse in the healthcare system, with a specific focus on home care, and managed a staff of more than 300.

Medicaid Innovations Forum
Jim Milanowski
President and CEO
Genesee Health Plan
Jim Milanowski has over 22 years experience in the management of mental health, substance abuse, behavioral health managed care and medical care coverage programs. Mr. Milanowski currently serves as the President and Chief Executive Officer of the Genesee Health Plan (GHP), administering a community based indigent health care plan. The health plan has covered over 70,000 Genesee County residents since 2001. Since the start of enrollment into Affordable Care Act in 2013, GHP has conducted outreach and enrollment sessions with over 15,000 Genesee County residents. The health plan received the 2015 Pinnacle Award from the Michigan Association of Health Plans for this effort.

As a strong advocate, his expertise includes working to reduce racial disparities, uncompensated care, and the impact of chronic disease. During his leadership, Genesee Health Plan has received the national quality award from URAC for Best Practices in Patient Empowerment and Protection, the Greater Flint Labor Council's Community Partnership Award and the Robert M. Pestronk Excellence in Public Health Award. He is a founding member of the Health Net Collaborative, and a member of the Greater Flint Health Coalition Access, Dental and Medical Group Visit Committees. He is the Treasurer of the Michigan Association of County Health Plans and is on the Board of Directors for the Genesee Community Health Center.

Mr. Milanowski received his Bachelor of Arts degree in Psychology from Spring Arbor University and his Master's of Science degree in Clinical Psychology from Eastern Michigan University. He is a limited-licensed psychologist in the state of Michigan, and has extensive counseling experience with adult, child, and adolescent populations.

Medicaid Innovations Forum
Michelle Miller, MS, RN, PMP
Chief Nursing Officer
Colorado Department of Health Care Policy & Financing
Michelle received her nursing degree in 1994 from Augustana College in Sioux Falls, South Dakota. She worked until 2004 as a Pediatric and Pediatric Intensive Care Unit (PICU) Registered Nurse, specializing in respiratory disorders, children with special needs, and acute trauma services. Michelle moved to Colorado in 2003 and soon turned her focus to the outpatient clinical setting. She became a nationally certified Organ Recovery Coordinator for Colorado’s Organ Procurement Organization, Donor Alliance Inc., where she focused on increasing successful multi-organ donations in infants and children. In 2006, she accepted a position as a Liver Transplant Coordinator at the University of Colorado Hospital.

Michelle received her Master’s degree in Leadership in Health Care Systems at Regis University prior to joining the Colorado Medicaid team in 2013 as the Pediatric Assessment Tool (PAT) Revision Project Manager. She successfully designed and implemented a PAT pilot study. Michelle transitioned into the Utilization Management (UM) Contract Manager position and made significant contributions to the modernization of the ColoradoPAR Program, the Medicaid Nurse Advice Line, and the Client Over Utilization Program over the past 3 years. Michelle was recently promoted to the Chief Nursing Officer position.

Michelle lives in Larkspur, Colorado where she enjoys gourmet cooking, all forms of exercise, and spending time on her deck with her husband, dogs, and the local wildlife.
Medicaid Innovations Forum
Jeff Myers
President and CEO
Medicaid Health Plans of America
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.

Medicaid Innovations Forum
Laura M. Naredo, MS, CHC, CHPC
Vice President CQI
South Florida Behavioral Health Network
Laura is a dedicated professional in the social services field with experience at both the clinical and management level. Laura has also worked with both State agencies and nonprofits in the behavioral health care sector. Amongst her accomplishments she has:

  • Experience in Substance Abuse and Mental Health Service Administration including Contract Management, Monitoring, Continuous Quality Improvement, Compliance and Strategic Planning.
  • Provided technical assistance and training regarding management, programmatic and client issues and assisted in interpreting rules, policies, and standards.
  • Reviewed and conducted clinical assessments for Substance Abuse, Mental Health and Co-occurring populations.
  • Collected data and generated statistical reports on consumers in need of behavioral health services analyzing trends and benchmarks.
  • Supervised System of Care, CQI, and IT including: Supervised the day-to-day operations and employees and supervised the funding and funds allocation to community agencies.
She has worked for both The Village and the Department of Children’s and Families. As the Vice President of CQI of South Florida Behavioral Health Network, Laura is responsible for the Quality Assurance, Quality Improvement, Compliance, and Data Units. She is a critical member of the management team; helping guide and set the course for the next phase of SFBHN’s growth. Laura received her undergraduate degree in Psychology and her master’s degree in Mental Health Counseling from Florida International University. She is also certified in health care compliance and privacy

Medicaid Innovations Forum
Beth B. Nelson
Director, Medicaid Programs
Blue Cross Blue Shield of Minnesota
Beth Nelson has over 30 years of experience in program development, implementation and management within the fields of Medicaid managed care, dual eligibles and home and community based service. She is currently the Director of Medicaid Services at Blue Cross Blue Shield of Minnesota and oversees a managed care Medicaid product that serves over 300,000 members.

Medicaid Innovations Forum

Henry W. Osowski
Managing Director
Strategic Health Group LLC

Hank Osowski, a Founding Member of Strategic Health Group, is an experienced health care executive and strategist who has provided leadership to commercial, Medicare and Medicaid health plans for more than 30 years. He currently is the Managing Director of Strategic Health Group, a new boutique strategic and financial advisory firm dedicated to bringing seasoned leadership to enable health care organizations to succeed in a challenging and changing environment. He is an expert in Medicare Advantage and Medicaid long-term care strategies.

Formerly, as Senior Vice President Corporate Development, he was a key member of the senior leadership team that the company from a near death experience to an exceptionally strong financial position. He led SCAN Group's efforts to expand into seven additional California counties. Hank also led SCAN's entry into Arizona and served as the initial President of SCAN Health Plan Arizona and SCAN Long Term Care. The service area expansions represent approximately a quarter of SCAN's membership and added nearly $450 million to SCAN's revenue. He also led the organization's strategic planning efforts and initiated an innovation development regimen to seek improvements in care coordination practices and future care outcome protocols.

Prior to SCAN, Hank served as a Principal in a national health care consulting organization providing a range of strategic, financial and development services for health plans, physician groups and hospitals. He began his California career as a member of the senior management team responsible for the turnaround and financial survival of Blue Cross of California. In this capacity, Hank led the financial turnaround of the Individual and Small Group Division and provided leadership to the organization's strategic planning efforts.

Earlier he served as Vice President International Operations for American Family Life Assurance Corporation where he directed the activities of the company's Canadian and European operations. In this role he directed the development of start-up operations in the United Kingdom, Germany and Italy, as well as the financial turnaround of the company's Canadian operations. Earlier, Hank also served as Director of Insurance Consulting Services for Coopers and Lybrand, a predecessor to PriceWaterhouse Coopers.

Throughout his career, he has been a frequent speaker on critical issues and challenges facing the Medicare and Medicaid programs. In 2011, Hank spoke to the Managed Medicaid Congress about principles for structuring effective long term care programs, to the Medicare Market Innovations conference about opportunities for strengthening a plan's five star quality rating and offered his strategic projections for the future of Medicare. He also spoke to a diverse health care and technology audience at the Healthcare Unbound conference about leveraging the power of technology to improve the quality of health outcomes and care interventions.

Medicaid Innovations Forum

Caroline R. Piselli, RN, DNP. MBA, FACHE
Health Industries Advisory Managing Director
Price Waterhouse Management Consultants

Caroline is a clinician and business executive with extensive senior executive leadership and global strategy experience within a large academic IDN and Fortune 50 corporation working with most US providers, payers, and vendors; and many ministries of health around the world. She specialized in global strategy; VBC clinical, payment, and information transformation; new company development and commercialization. She also worked under contract to CMS, DoD and international ministries of health re: clinical/ payment models. Her current focus is Presidential transition, innovative CIN design/implementation across full continuum of care and payment.

Areas of expertise include Global strategy/marketing, population health/VBC, software commercialization, clinical/financial outcomes, research and critical care practice.

Select Experience
  • Designing and implementing transformation of one of the largest US payer/ provider systems and associated Presidential transition
  • Designed CIN/population health strategy, clinical, economic/ payment, analytic, operating/capability/ competency model for large payer/providers + physician practices NewCo, DSRIP and some of the largest health systems, payers and clinically integrated networks.
  • Co-developed and implemented payment models under contract to CMS (e.g., MS DRGs, episodes, APR DRGs, ICD-10) as well as state reporting/payment models (e.g., NY, TX, MD, CA, FL preventables for in- and out-patient models), bundles/ episodes working with most US payers and providers
  • Managed AMC’s critical care, transplant and electrophysiology units, care and national research
Education and certifications
  • Doctorate in Nursing (DNP) from Yale University; BSN;
  • MBA from Rensselaer Polytechnic Institute (RPI), The Lally School of Management and Technology
  • Six Sigma Black Belt and Lean professional


Medicaid Innovations Forum
Jan Reed
Director, Health Plan Services
RelayHealth Pharmacy Solutions
In her role as Director, Health Plan Services at RelayHealth Pharmacy Solutions, Jan is responsible for bridging collaboration between health plans and retail pharmacies that ultimately drives measurable improvements in a plan’s quality measures. Prior to joining RelayHealth, Jan worked for Molina Healthcare with oversight for outreach efforts designed to improve HEDIS and CAHPS measures. Previous to this role, she held leadership positions with Aetna, Ohio Health Group and CVS Caremark.

Through her 20+ years of leadership experience, Jan has an intimate understanding of the challenges and regulatory requirements faced by Payers to improve population health and manage chronic diseases. It’s with this experience that she is adept at aligning customized services with Payer organizations’ strategic goals to improve member health.

Medicaid Innovations Forum
Rob Robidou
Vice President, Operations
Children’s Medical Center Health Plan
Mr. Robidou has over 22 years of Managed Care experience. He is currently the Vice President of Operations for Children’s Medical Center Health Plan (CMCHP) in Dallas which involves working with all areas of operations within CMCHP management including supervision of network development, credentialing, claims, system configuration, member and provider services and network administration. He is involved in the strategic planning, initiatives, and administration of CMCHP in order to ensure compliance with the agreement between CMCHP and the Health and Human Services Commission (HHSC). This also encompasses leading and working with health plan staff in the implementation of programs, chairing committees and serving on projects within all areas of the health plan. He has been part of the establishment of two start up HMO’s, the development of other POS programs, PPO networks and transplant programs in various parts of the United States.
Medicaid Innovations Forum
Peter Rodes
Senior Vice President, Strategic Planning
Wunderman Health
Peter is an experienced managed care executive with more than 20 years of industry, technology and marketing experience. Peter leads the Strategy and Consulting team in developing winning solutions that accelerate profitable growth for clients. Recent areas of emphasis have been Health Care Reform go-to-market strategies, customer experience improvement and Medicare Star strategies.

Before joining Wunderman, Peter was the Vice President of Marketing for Health Care Service Corporation (HCSC) and the BlueCross and BlueShield of Illinois Consumer Market division. Peter was responsible for all marketing operations, distribution and customer experience for more than 1 million members in the individual market segments including Under 65, Medicare Supplement and Medicare Advantage. He was responsible for all aspects of the consumer lines including the introduction of both the Part D benefit and the Medicare Advantage platforms.

Prior to joining HCSC, Peter worked for BENU as a Vice President of Marketing. BENU is a venture backed healthcare startup focused on delivering defined contribution, choice-based solutions for carriers, brokers and employers. In addition, Peter also worked for ChannelPoint, an internet exchange company, as both a product and business development executive.

Before these entrepreneurial ventures, Peter worked as an account director and marketing manager for Health Net in Northern California and as a consultant for the BlueCross BlueShield Association.

Peter has earned both an MBA and MHSA from the University of Michigan and an undergraduate degree from Wake Forest University.

Medicaid Innovations Forum

Candace T. Saldarini, M.D.
Director, Medical Strategy
ODH, Inc.

Candace T. Saldarini is the director for Medical Strategy for ODH, Inc., a leading provider of behavioral health technology solutions and services. In this role, she provides content expertise for its flagship product Mentrics, the leading edge comprehensive population health management platform designed to transform the management of behavioral healthcare systems.

Dr. Saldarini earned her undergraduate degree in biological sciences from Stanford University and her medical degree from St. George’s University School of Medicine. She also received adult psychiatry training at Yale University and obtained her child and adolescent psychiatry fellowship training at the University of California, Los Angeles.

Medicaid Innovations Forum
Diane Sargent
Senior Director, Dual Eligible Product Management & Program Implementation
Health Net
Diane Sargent is the Senior Director of Dual Eligible Product Management & Program Implementation for Health Net, a wholly owned subsidiary of Centene Corp. In this capacity she is responsible for managing all aspects of the implementation and transition work for Health Net's duals demonstrations ensuring all operational units execute on their responsibilities necessary to ensure a smooth roll out of the contract on time and to required specifications. Ms. Sargent is also responsible for leading product strategy and overseeing functional areas that deliver dual demonstration outreach, marketing, and communications.

Ms. Sargent has more than 25 years of experience in the health care industry – 12 of them with Health Net in a variety of strategic and operational roles. Prior to joining Health Net, Ms. Sargent worked as a physical therapist, in medical device sales for Johnson and Johnson, and as a management consultant at a company which has since been acquired by PwC.

Ms. Sargent earned a bachelor's degree in physical therapy and a master's degree in allied health administration from the University of Connecticut, and a master's in business administration degree from the Anderson School at the University of California, Los Angeles.

Medicaid Innovations Forum
Stanton Sipes
EVP, Business Development
Veyo
Stan is an entrepreneur and sales executive with more than 35 years of successful executive experience in consultative sales and business development management, as a CEO, an entrepreneur, and in senior-level leadership. He has experience with a global Fortune 50 company as a turnaround specialist, he founded a successful software company, and he has worked as consultant and advisor to over 300 companies, assisting them in growth strategies. He provides direction to Veyo’s overall go-to-market strategy, business development, and customer support efforts. He has a proven track record in the design and implementation of innovative customer advocacy models that add value to each touch point with our valued customers. His passion lies in understanding our customers’ goals, and in building relationships that are based on trust, transparency and integrity.
Medicaid Innovations Forum
Jill Spencer
Executive Vice President, Business Development and Client Relations
Human Arc
Jill Spencer holds overall responsibility for new business sales, cross-selling, client retention and strategic partnerships for all three major Hospital Business product groups – Eligibility Enrollment Solutionssm, PayerLogicsm Solutions and Disproportionate Share Solutionssm– as well as the company's two main Health Plan Business product groups – PremiumAssistsmDual Eligibility Outreachand Enrollment Services and Best Benefitssm for the Aged, Blind and Disabled. Prior to promotion to this position in 2011, she had responsibilities over the firm's Health Plan Business sales and strategic initiatives. She joined Human Arc in 2001 with responsibility for the firm's Dual Eligibility Services, including P&L functions, internal operations, product development, compliance requirements, sales, new client implementation and ongoing process improvement. In 24 months, Ms. Spencer grew her service line's revenues over threefold.

Prior to joining Human Arc, Ms. Spencer was Vice President, Managed Care, for MemberHealth, a Cleveland, Ohio-based pharmacy benefits management firm. Before that, she served 15 years with Prudential HealthCare in its commercial health plan and Medicare+Choice operations. She holds a BA degree from Miami University (Oxford, OH) and a number of industry designations: Financial Life Management Institute (FLMI) membership, Associate of Customer Service of the Life Office Management Association (LOMA), and Professional, American Academy of Healthcare Management (PAHM). She also holds Ohio insurance agent licensure, has served on advisory boards focused on seniors, and is a recognized speaker around the industry.ncer

Medicaid Innovations Forum
Phil Stalboerger
Vice President Public Affairs
Medical Transportation Management, Inc
Phil Stalboerger is Vice President of Public Affairs at MTM (Medical Transportation Management) and has over 20 years of experience in health care and government relations. Phil began his career in the Minnesota legislature as staff for the Senate Commerce Committee. In 1999 he became the director of legislative affairs for the Department of Commerce during the Jesse Venture Administration. From there, Phil joined Blue Cross Blue Shield of Minnesota and became the Vice President of Legislative and Public Affairs for 12 years. Now as a Vice President at MTM, Mr. Stalboerger's responsibilities include managing public affairs efforts around the country, in conjunction with marketing and business development efforts. MTM is currently operating in 31 states, contracting with health plans, city, county, and state governments around the country.

Mr. Stalboerger holds a Bachelor of Arts degree in government and political science from St. John's University in Collegeville, MN and a Master of Arts degree in public administration from Hamline University in St. Paul MN.
Medicaid Innovations Forum
Sam Taylor
Director of Solutions, HHS and Public Sector
Eccovia Solutions
Sam Taylor serves as the Director of Solutions for Health and Human Services and Public Sector. His focus is on the development of programs and services that enable health and social service organizations to work together to address the social determinants of health. Sam is an accomplished project management professional and is the leading force at Eccovia Solutions for implementing technology and processes for public sector, nonprofit, and private health and human service organizations.

Prior to his current role, Sam was the Director of Product Management at Eccovia Solutions where he was responsible for the planning, organizing, and managing of the successful completion of all technology solutions.

Sam has a BA from Utah Valley University, a Masters in Philosophy and Social Policy from American University, and an Advanced Project Management Certificate from the Stanford University Center for Professional Development. In addition, he has obtained education certificates in HL7 Fundamentals, Data Analysis, Case-Based Introduction to Biostatistics, and Computing for Data Analysis.
Medicaid Innovations Forum
Wendy White Tiegreen
Director, Office of Medicaid Coordination and Health System Innovation
Georgia Department of Behavioral Health and Developmental Disabilities
Ms. Tiegreen has over 20 years of professional experience working in services delivery and administration in the public behavioral health sector. In various roles, she has managed the contract for the state's External Review Organization, as well as for the award-winning Georgia Crisis and Access Line. The majority of her career has been spent as liaison to the state Medicaid authority. In that role, she was the primary mental health negotiator with the Centers for Medicare and Medicaid Services in the original establishment of peer supports as a unique Medicaid-financed service, and has been a presenter at several national Medicaid and behavioral health management conferences. Recently, she has brokered with the Medicaid authority to expand Peer Support as provided by individuals with lived addiction experience and to allow health-trained Certified Peer Specialists to do health and wellness support. Additionally, she is the Principle Investigator for a CMS grant which is establishing a Parent and Youth Peer workforce in Georgia. She has also been a contractor for SAMHSA, NASMHPD, and many states related to behavioral health, Medicaid, and peer support.
Medicaid Innovations Forum
Sheila Wilson, BSN, RN, CCM
Director of Care Management, Medicaid
Priority Health
Sheila is a Registered Nurse with over 31 years' experience in both clinical and managed care environments. She has extensive experience in case management, and is especially knowledgeable about the challenges facing the Medicaid population. Currently Sheila serves as the Director of Care Management for Medicaid at Priority Health, a Michigan based company serving HMO, PPO, Medicare and Medicaid members across the State of Michigan. Her responsibilities include the development, implementation and administration of programs to achieve medical cost goals for the Medicaid Business Unit. She directly oversees case and disease management, as well as medical utilization operations. Sheila and her team recently received two prestigious Pinnacle Awards from the Michigan Association of Health Plans for work done to incorporate children with special health care needs into managed care, and for spearheading a pilot project with the use of a medical mobile application for children with asthma.

Sheila obtained her Bachelor of Science degree in Nursing from Alverno College, and has held her Certification in Case Management (CCM) since 1994. She has completed the first year of a 2 year Executive MBA Program with Grand Valley State University. She currently lives in Grand Rapids, Michigan with her husband Bill and daughter Ashley.
Medicaid Innovations Forum
Heidi Wold, MSN, ARNP, ANP-BC
Vice President, Chronic Care
Matrix Medical Network
Ms. Heidi Wold leads Matrix’s chronic care line of business (Care Direct), which includes the development and implementation of a suite of care coordination and medical management products aimed at improving outcomes for chronically ill health plan members in multiple states and residential settings.

Ms. Wold has more than 30 years of progressive leadership experience in the healthcare industry. Most recently, she served as the vice president of operations for Walgreens’ Take Care Health Systems, Consumer Solutions Group. At Walgreens, she oversaw national operations for the retail clinic business and worked to improve profitability/value, enhance provider engagement and expand patient care services including management of targeted chronic conditions.

Prior to joining Walgreens, Ms. Wold held a series of senior/executive leadership positions with United Healthcare. She ultimately served as vice president of clinical operations & chief nursing officer where she led innovative clinical solutions for Medicaid, Medicare Advantage, Commercial and Dual Special Needs populations across 32 states.

Ms. Wold holds a Master of Nursing Administration/Business from the University of Florida and a Post-Master’s certificate in Adult Nurse Practitioner from the University of Tampa. She is also an ANCC board certified adult nurse practitioner.

Medicaid Innovations Forum
Kijuana Wright
Manager, Innovation and New Product Development
Centene Corporation
Kijuana Wright is a Manager of Innovation & New Product Development at Centene Corporation. Her focus is the expanding national Managed Long-Term Services and Supports pipeline for the elderly, physically disabled and intellectually disabled populations. In her role, she brings together the necessary individuals and resources to develop and implement new enterprise-wide strategies, and assesses the performance of product launches to ensure they are meeting product objectives and market expectations.

By collaborating with the leadership of local markets on performance improvement, member quality of life and integration efforts, Kijuana endeavors to reduce care fragmentation and inefficiencies for members and providers. She oversees the entire life cycle of new product development from ideation to market launch; as well as strives to achieve a balance between cost effectiveness and quality care. Kijuana holds a master's degree in health administration and her career experience includes previous roles in state government, hospital, and non-profit settings.
Register-Now

Keep me inform

EDUCATIONAL UNDERWRITERS

 Medicaid Innovations Forum

 Medicaid Innovations Forum

 Medicaid Innovations Forum

 Medicaid Innovations Forum

 Medicaid Innovations Forum

SUPPORTING ORGANIZATIONS

Medicaid Innovations Forum

 Medicaid Innovations Forum

 Medicaid Innovations Forum

 Medicaid Innovations Forum

 Medicaid Innovations Forum

 Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

EXHIBITORS

Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

Medicaid Innovations Forum

MEDIA & ASSOCIATION PARTNERS

Medicaid Innovations Forum

Medicaid Innovations Forum