Pat is a manager in the Clinical Strategy and Innovation Department for Gateway Health, an MCO based in Pittsburgh. Pat brings over 35 years nursing and management experience to Gateway Health. The last twenty four years have been devoted to managed care focusing primarily on quality improvement and disease management. Her area of expertise is the development and evaluation of chronic disease management programs directed at vulnerable populations receiving Medicaid or Medicare. Pat also manages a team of Wellness Coaches with focus on behavioral change and motivational interviewing to guide members in improving their overall health.
As Director of Development for Trusted Health Plan, Robin Barclay provides visionary leadership to the executive team to assure continued growth in the managed care arena. She is also responsible for developing and implementing innovative programming to enhance the health care outcomes for Trusted members. Barclay continues to create paths to strengthen Trusted's market position. Barclay brings nearly thirty years of executive Medicaid managed care experience to Trusted Health Plan.
Henry W. Osowski
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.
Lisa Holden is the Vice President of Accountable Care for Independent Health Care Plan (iCare) located in Milwaukee, Wisconsin. In her role, Holden is responsible for developing and implementing strategies and programs to obtain measured care management performance levels and for the on-going management of the iCare’s member experience within its model of care.
Holden has extensive and varied experience in nonprofit management, government affairs, public policy, coalition building and leadership.
Prior to joining iCare in 2014, Holden was the Senior Director of Organizational Development and Education at Visiting Nurse and Hospice Care of Santa Barbara.
Holden's public policy and government affairs experience includes eight years serving as the Executive Director of the Connecticut Coalition Against Domestic Violence (CCADV) and Board Member for the National Network to End Domestic Violence. Under her leadership CCADV became a state and national leader on addressing the needs of domestic violence victims within the criminal justice system.
Holden's nursing leadership career included serving as the Regional Manager for Ambulatory and Community Women’s Health Services for Aurora Health Care in Milwaukee, WI. In that position, Holden led efforts to improve health care services for women and children and foster reform and improvements in government agencies and community organizations to reduce infant mortality. From 1983 to 2000, Holden was extensively involved in both the March of Dimes and the Wisconsin Association of Perinatal Care (WAPC), chairing the joint Public Policy committee.
Marcy G. Carty, M.D. M.P.H.
Dr. Carty is Vice President, Network Performance Improvement and Innovation at Blue Cross Blue Shield of Massachusetts (BCBSMA). In this role, she leads the company's initiatives with Massachusetts based physician groups to measure and improve healthcare quality, safety and efficiency outcomes.
Prior to this role, she co-led a physician consulting team at Evolent Health. While there, Dr. Carty developed value based strategies with health care system executive leadership and engaged physician leadership in starting the change management necessary for a successful system transformation under new payment methodologies. In addition, she led the development and implementation of the Advanced Illness Care (AIC) care management program that aimed to identify patients in their last year of life via predictive stratification modeling and then improve their quality of life. Dr. Carty previously held the positions of Vice President of Medical Affairs/CMO at Good Samaritan Hospital, the largest hospital in the Steward Healthcare network and an original Pioneer ACO, and Director of Clinical Operations Improvement at Brigham and Women’s Hospital in Boston.
Dr. Carty graduated from Harvard College and earned her MD from Columbia University College of Physicians and Surgeons. She completed an internal medicine residency and palliative care training at Brigham and Women's / Dana Farber Cancer Institute. She currently practices palliative care and hospice medicine.
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.
Ken Eimers joined Care Wisconsin in 2002 as the Senior Manager of Information Systems. Ken has managed technologies and provided system solutions to a wide variety of organizations for over 20 years. As an outcome of working in the health care industry for over 15 years, he has developed a broad base of health care expertise, both from the insurance and clinical perspectives.
After managing key IS functions for a large commercial insurance carrier in the Madison area, Ken moved into the managed care environment with Dean Health System. Over the next 10 years Ken was engaged in a number of roles with Dean Health System including IS management, business office management, project leadership activities and consulting.
As Chief Operating and Information Officer at Care Wisconsin, Ken has primary responsibility for the overall program operations including Family Care and Partnership. In addition, Ken provides leadership and oversight for the Information Technology Department. Ken received a Bachelor Degree in Management Information Systems from the University of Wisconsin-Whitewater.
Myra Enloe has over 30 years of nursing experience in clinical and administrative roles. She currently works as the Vice President of Performance Excellence and is responsible for quality management, utilization management, and pharmacy services. Care Wisconsin is a nonprofit managed care organization specializing in the integration of health and long-term care services. For over 35 years, Care Wisconsin has been filling gaps in community services and providing innovative solutions for seniors and adults with intellectual/ developmental disabilities and/or physical disabilities. Today, Care Wisconsin manages three of the State's public health and long- term care programs: Family Care, Partnership, and SSI Managed Care. CW operates these programs through contracts with the Wisconsin Department of Health Services (DHS) and the Centers for Medicare and Medicaid (CMS), assuming the financial risk for the populations served. Myra has been with Care Wisconsin for 10 years, and spent 15 years before that at the University of Wisconsin Hospital and Clinics. She has extensive experience in quality and systems improvement and is a student of the Baldrige Criteria. Myra earned a Master of Science degree in nursing at the University of Wisconsin-Madison.
RACHEL ANDREW, MS, LMFT, CCM
Rachel Andrew has a master's degree and licensure as a Marriage and Family Therapist and is a Certified Case Manager. Her prior experience includes 11 years in the insurance industry, including director of Clinical Programs for three years, where she oversaw case, disease, and care transition management and wellness coaching. She also served as case management manager, including medical and behavioral case management, disease management, inpatient utilization for medical/surgical and behavioral health; and care transition management for medical/surgical and behavioral health. In her role as behavioral health services manager, she oversaw case management, behavioral health prospective review, and medical and behavioral health inpatient management. She also worked as a case manager and as a case management team lead. Ms. Andrew's experience also includes more than 20 years' teaching bachelor's and graduate behavioral health and education courses and working three years in utilization management at an inpatient psychiatric hospital and over 10 years of community mental health experience as therapist, manager and director as well as working as a social work in a hospital (e.g. transplant, pediatrics, oncology).
Andrea Gogel, BSN, RN, CCM
CareSource is a nonprofit health plan and national leader in Managed Care with a long history of serving the low-income populations across multiple states and insurance products. Andrea is the clinical lead for the design and implementation of clinical care management for the Ohio Home Care Waiver Program and a consultant for the Specialized Recovery Services Program. Andrea participated in the implementation of duals demonstration with a large national health plan. She has twenty four years of experience of nursing experience in Long Term Services and Support settings, including home health care and home and community based waivers. Andrea is a graduate of Ohio University with a BSN and has certification for case management (CCM).
Ernestine Johnson, RN, BSN, MPA
As Director of Utilization Management for Trusted Health Plan, Ernestine Johnson is responsible for the day to day management of both utilization review and case management. This involves oversight of both in-patient and out-patient authorizations as well as case management and care coordination of services needed before and after service utilization. Johnson has held leadership positions in acute and long-term care for more than twenty years.
Barbara Dusenberry BSN, RN
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.
Shelli Lara is the Founder and President of Innovative Healthcare Delivery. With over 20 years' experience in the healthcare industry, she founded the company with the vision of building an industry leading organization aimed to eliminate healthcare delivery barriers, reduce costs, while increasing patient engagement.
Prior to forming Innovative Healthcare Delivery, she served as the Director of Healthcare Delivery at the Culinary Health Fund, the largest Taft Hartley Fund in the country, where she had the opportunity to appreciate the complex components of the healthcare system. During her six year tenure, Shelli managed the $300 million dollar health fund which included oversight of strategic development, cost containment, program development, contract negotiations and staff development. Under her leadership, the Health Fund was continuously successful in lifting barriers to create healthcare value for their participants.
Patricia R. Miles
Ms. Miles provides executive level leadership for all quality functions, with full accountability for compliance with state and federal requirements relating to clinical quality for a startup managed care organization (launched July 2013). Serves as organizational lead and resource for NCQA, HEDIS, external quality review (EQRO) activities and other contractual requirements. Collaborates with Regulatory Compliance Officer/Legal Counsel to perform internal monitoring activities. Facilitates weekly Quality workgroup meetings and quarterly Quality Executive Committee meetings. Oversees the organization's Wellness and EPSDT program units as well as other quality department personnel. Represents the organization at external meetings hosted/facilitated by the District of Columbia Department of Healthcare Finance.
Ms. Miles, a certified Six Sigma Greenbelt, has over 23 years of healthcare experience, specifically within the Medicaid and Medicare markets. She is an innovative and performance- driven Sr. Managed Care leader with a solid and progressive career leading the development and delivery of policy, process, and operational improvements in highly competitive commercial and federally regulated programs. She has demonstrated expertise in the collection and analysis of performance data and the development of standards and practices that lead to increased productivity, customer satisfaction, and profitability. A natural leader with the proven ability to guide and mentor staff, work across functions and departments, and leverage resources to achieve organizational goals.
As Director of Pharmacy Therapeutics at Fallon Health, Karen implemented transitions of care and MTM programs for Medicare Advantage, Senior Care Options, Dual Eligible and PACE programs. These programs are integrated with the care and utilization management teams and preliminary data indicates a decreased 30-day admission rate for members enrolled into these programs.
Prior to her current role at Fallon Health, Karen developed and implemented medication management programs for medically complex Massachusetts Medicaid members to ensure access to medically necessary drugs and provide comprehensive medication reviews. At Health New England (HNE), in Springfield, MA, Karen implemented clinic and university based MTM programs for commercial, Medicare and Medicaid populations and a care transition program in collaboration with a PBM. Karen also managed the HNE Integrated Care Management Team.
Saeed founded Decision Point with the mission of improving health plan clinical, financial and operational performance through informed, data-driven predictions on strategic decisions. He has more than 25 years of health information technology experience, with a track record of developing innovative approaches to solve complex business problems. He has held key senior management positions at Eliza Corporation, Ingenix (currently Optum), IHCIS and ProVentive, where led high-performing teams focused creative uses of technology for practical problem- solving. Saeed is a graduate of The Johns Hopkins University with a BA in Economics.
Leonard J. Kirschner M.D. M.P.H.
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 Scottsdale 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.
Trista Pfeiffenberger, PharmD, MS
The core - and essential - components of CPESN USA are entrusted to Trista Pfeiffenberger, the company's Director of Quality and Operations. In her role, Trista leads the development and implementation of quality assurance and quality improvement processes among other duties.
Trista also serves Director of Network Pharmacy Programs for Community Care of North Carolina (CCNC). She is also the project coordinator for an award from the Centers for Medicare and Medicaid Innovation focused on connecting community-based pharmacy to the medical neighborhood.
Prior to joining CCNC, Trista held pharmacy leadership positions at both Duke University Hospital and University of North Carolina Hospitals. She obtained her Doctor of Pharmacy degree from West Virginia University and then completed a Pharmacy Practice Management Residency with Master of Science in Pharmacy Practice at the University of Kansas.
Trista's impact to health care has been recognized recently when she was honored by the North Carolina Association of Pharmacists with the Don Blanton award for contributing significantly to the advancement of pharmacy practice in North Carolina and by Triangle Business Journal as a "Health Care Hero" in the category of Health Care Innovation.
Bradley Marks serves as Chief Growth Officer at Vheda Health, bringing 17 years of health care experience. In this role, Bradley holds the responsibility for ensuring targeted growth for market dynamics, client needs and preferences while ultimately delivering on member satisfaction.
Previously, as the General Manager of Risk Adjustment Products at Inovalon, Bradley held the responsibility for planning, design, modeling, coordination and oversight of the retrospective risk adjustment solutions for Medicare, Medicaid and commercial risk adjustment products.
Prior to joining Inovalon, Bradley served as Vice President of HouseCalls Operations for the Medicare and Retirement division of UnitedHealthcare. In this role he led operational activities for both the prospective and retrospective functions. Prior to UnitedHealthcare’s acquisition of XLHealth in 2012, Bradley helped construct both the HouseCalls and Retrospective Review programs at XLHealth, leading the creation of operational functions for each program, including the scheduling and escalation center, project coordination, practitioner helpdesk, and travel, and supply management support. Bradley began his tenure at XLHealth as a Project Manager for disease management operations across several clients. Prior to XLHealth Bradley worked for Mid-Atlantic Health Plans and American WholeHealth, Inc.
Bradley received his bachelor’s degree in writing and communications from Lakeland College.
Mindy Smith, BSPharm, RPh
Smith joined PrescribeWellness as the Vice President of Pharmacy Practice Innovation in August 2015 where she works to drive the adaption of pharmacist patient care services. PrescribeWellness offers innovative technological solutions designed to make it easier for pharmacists to manage patient care services by improving patient adherence, building customer loyalty and providing extended services via the appointment-based model. PrescribeWellness solutions have been proven to improve a patient's adherence to their medication and the pharmacy's ratings in various performance measures.
Prior to joining PrescribeWellness in August 2015, Mindy Smith served as the Executive Director of the American Pharmacists Association Foundation from 2011 to 2015. Smith was appointed as chief executive officer of the Arizona Pharmacy Alliance in 2006 and served in that role for five years. Previous to her service in Arizona, Smith served as the executive director of the Wyoming Pharmacy Association from 2003-2006.
The first seven years of her career, Smith practiced in community pharmacy settings as well as spend six years practicing in health systems where she was awarded the Health-System Clinical Pharmacist of the Year in 2001 for helping establish an anticoagulation patient care service through collaborative practice. She holds two clinical certificates in diabetes and anticoagulation, and was ACLS (Advanced Cardiac Life Support) certified during her tenure at the hospital. She also holds a certificate in Professional Fundraising from Boston University's Center for Professional Education.
Mindy Smith earned both a Bachelor of Science in Zoology-Physiology from the University of Wyoming in 1995 and a Bachelor of Science in Pharmacy in 1998 from the University of Wyoming School of Pharmacy. Smith serves on the National Alliance of State Pharmacy Associations (NASPA) associate board and the Alliance for Patient Medication Safety. Smith also serves on the board the Alliance for Integrated Medication Management.
Cynthia Knorr-Mulder MSN, BCNP, NP-C
Cynthia is the Administrative Director of Pain Management & Palliative Medicine at Englewood Hospital and Medical Center where she has successfully implemented pain management initiatives that have enhanced the quality of care, improved patient satisfaction while reducing cost of care and length of stay for Medicare patients. Cynthia is recognized nationally for her contributions to pain management and the development of multi-modal integrative medicine programs, she opened one of the first private nurse practitioner pain management practices in New Jersey, which focused on the therapeutic relationship, self-care, stress management and health promotion for patients with acute and chronic pain.
As lecturer and keynote speaker, she has given many national presentations on pain management and integrative medicine including the annual PAINWeek Conferences. She believes that healthcare providers must first recognize that the therapeutic relationship they provide for the patient is the primary foundation for optimal health and healing. Educating and engaging patients to become active participants in healthcare helps to reduce the overall cost of healthcare, improve patient's function and overall quality of life.
Affiliated with various colleges and universities, she received the annual excellence award given by New York University for her contributions as a faculty member, and the first National Nurse Practitioner Award for Clinical Excellence given by the National Conference in Chicago.
Cynthia's goal is to continue to implement innovative initiatives in pain management that meet the needs of the Medicare, Medicaid and underserved population by providing high quality care in a cost-effective environment. She believes that the success of healthcare in the future will be achieved by integrating research-based medicine within a caring humanistic therapeutic model that engages patients and promote self-care.
As a healthcare provider and lecturer her philosophy and style is humanistic and supportive. She believes that at any given moment we are all teachers, learners and doers. At any given moment we all have the ability to influence the health and healing of another soul.
Parag Bharadwaj is the Chief of Palliative Care Medicine at Sentara Healthcare and oversees Palliative Care Programs for the system. He is also Assistant Professor of Medicine at Eastern Virginia Medical School. Prior to joining Sentara, he was Medical Director of Palliative Care at Cedars- Sinai Medical Center and Associate Clinical Professor of Medicine at UCLA. He went to medical school at Kasturba Medical College in India. Subsequently, he completed his residency in Internal Medicine from Texas Tech University. Following residency, he proceeded to do a fellowship in Geriatrics at UCLA and then in Hospice and Palliative Medicine at San Diego Hospice.
Dr. Bharadwaj has presented at various national and international conferences and has multiple publications to his credit. He currently serves as Editor in Chief of the journal Palliative Care: Research and Treatment. He has served as a leader in multiple national and international initiatives and is a Fellow of the American Academy of Hospice and Palliative Medicine. He is an avid proponent of early involvement of palliative care.
Manik Bhat is Co-Founder and CEO of Healthify, a New York based company on a mission to build a world where no one's health is hindered by their need. Healthify supports large healthcare organizations better address the social determinants of health by helping care teams find services, track referrals, and coordinate with community partners. Their platform is used across the country by thousands of staff and has been featured by TEDMED, the Center for Healthcare Strategies, KPMG, the Robert Wood Johnson Foundation, and Forbes.