Payer Analytics Optimization for Care Transformation

Health Plan Innovations to Optimize Data, AI, and Technology to Enhance Care Delivery and
the Member Experience

Speakers

Speaker 6

Chris Esguerra, MD

Chief Medical Officer

Speaker 6

Jim Milanowski

CEO

Speaker 6

Janine Angel

Senior Director, Medicare Strategic Business Operations & Compliance

Speaker 6

Lucy Marrero MA LMFT CPHQ

Director of Behavioral Health & Social Programs

Speaker 6

Alan Rice

Population Health Specialist

Speaker 6

Jennifer D’ Angelo

COO & EVP

Speaker 6

Robert Millette

CEO

Speaker 6

Mina Chang

Senior Policy Adviser

Speaker 6

Marcela Ruiz

Director, Value Based Purchasing

Speaker 6

Shannon Smith

Director, Care Transformation

Speaker Details

Speaker 1

Chris Esguerra, MD

Chief Medical Officer

Health Plan of San Mateo

An experienced healthcare leader, Chris Esguerra, MD, MBA, FAPA, CHCQM has led systems transformation, program evolution, and public/private partnerships leading to outcomes meeting the quadruple aim of improving health, cost effectiveness, enhancing patient experience, and supporting provider well- being. He serves as Chief Medical Officer for Health Plan of San Mateo, a local community plan serving Medicaid and dually eligible Medicare and Medicaid beneficiaries. He also advises nonprofits partnering in healthcare delivery, healthcare startups, and provider groups.

His experience encompasses health care provider and systems leadership, managed care operations, novel payment models, public-private partnerships, and health care transformation. He has led significant efforts around integration of care and services for a variety of populations, holistically addressing social determinants of health in healthcare delivery, and helping people remain and age in the community with appropriate long-term services and supports. He most recently served on a National Academy of Science, Engineering, and Medicine committee that published Integrating Social Needs Care into the Delivery of Health Care to Improve the Nation's Health.

Dr. Esguerra is board certified in both Psychiatry and Health Care and Quality Management and is a Fellow of the American Psychiatric Association and the American Board of Quality Assurance and Utilization Review Physicians. He received his BS in Chemistry and Medical Degree from the University of Southern California. He completed his residency training in Psychiatry at San Mateo County Behavioral Health and Recovery Services Psychiatry Residency Training Program. He also received his MBA in business management from the Isenberg School of Management at the University of Massachusetts at Amherst

Speaker 1

Jim Milanowski

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.

Speaker 1

Janine Angel

Senior Director, Medicare Strategic Business Operations & Compliance

Centene

Upon joining Health Net in 2005, I focused on supporting the Medicare Advantage and Medicare Supplement Enrollment, Eligibility and Premium Billing Teams. My concentration was on process improvement initiatives including increasing operational consistency, efficiency, reducing enrollment related errors, and decreased plan-controlled transaction rejections to 0%. In 2010, I led the business and IT teams to convert the day-to-day operation to a paperless environment. I joined our Enterprise Process Change Organization in late 2011 to managing four (4) states regulatory changes for Medicare, Medicaid and Commercial lines of business across. From 2018 to the end of 2022, I provided operational oversight and strategic leadership for our CA MMP product and managed the transition of its members along with 42K Wellcare MA Plan duals in CA to the Exclusive Aligned Enrollment (EAE) Dual Special Needs plan (D-SNP). Beginning in 2023, I have the privilege of caring for every Wellcare Medicare Advantage member in the state of CA where over 40% are dual eligible. I take to heart our vision- to transforming the health of the community, one person at a time.

Prior to my health insurance career, I worked for beverage distributors focusing on wine, beer and spirits in Los Angeles and Las Vegas. Currently, I call West Hills, CA my home along with my husband, two teenage boys, two ragdoll cats and a crazy hyper puppy. In my community, I serve as an executive on the Board of Directors of HAMAKOM, a local synagogue. My addiction to Costco and Amazon drives my husband insane and I strive to not kill the many fruit trees and vegetables we grow so I may share with my neighbors and those less fortunate.

Speaker 1

Lucy Marrero MA LMFT CPHQ

Director of Behavioral Health & Social Programs

Gold Coast Health Plan

Lucy Marrero is a Licensed Marriage and Family Therapist (LMFT), Certified Professional in Healthcare Quality (CPHQ), and community psychologist currently serving as the Director of Behavioral Health at Gold Coast Health Plan, the Medi-Cal Managed Care Plan for Ventura County, California. In this and previous roles, her track record of She is passionate about promoting seamless, high-quality, safe care through partnership and collaboration. Lucy is also a Patient Safety Champion with Patients for Patient Safety US and draws from lived expertise as a patient and caregiver to inform her work.

Speaker 1

Alan Rice

Population Health Specialist

VNS Health Plans

Alan Rice graduated Kean College of NJ in 1977 with a BSW degree and went to work for the NYC Department of Education as a Drug Counselor in a School Base Drug Prevention Program. In 1980 he went to work at Beth Israel Medical Center at the Bernstein Institute as a social work assistant on a male drug detox unit. During this time, Alan entered the first PEP program in the country at WSSW to be able to obtain his MSW which he did in June of1983. In July of 1983 he accepted a transfer to the Medical/Surgical Division of the Beth Israel Department of Social Work. In August of 1983, he was asked to become one of the first dedicated hospital AIDS social workers which he accepted. Alan has been involved with the HIV/AIDS since, providing social work services as well as having a progressive career as a supervisor, manager and Director of AIDS social workers in both a hospital and nursing home setting. Alan is presently the Population Health Specialist for VNSHealth, Select Health, a HIV Medicaid Manage Care Special Needs Plan, one of only three in NYS.

Alan is an adjunct professor at WSSW teaching an Addiction course, as well as teaching at Touro College School of Physician Assistant.

He has served on a variety of NYC and NYS committees around making services better to the HIV and AIDS population as well as the Substance Abuse population.

He was the first President on the board of Professional Association of Social Workers in HIV and AIDS and remains an active member.

Speaker 1

Jennifer D’ Angelo

COO & EVP

New Jersey Innovation Institute

Jennifer is a visionary leader, innovator, and strategist who currently holds the position of Chief Operating Officer & Executive Vice President of Healthcare at New Jersey Innovation Institute (NJII).

As NJII’s COO, plays a key leadership role in shaping the organization by streamlining processes and enhancing the organizational capabilities to not only achieve, but exceed, its goal of doubling the size of NJII and surpassing $70 million in revenue.

Jennifer also continues to lead the Healthcare division as Executive Vice President and leveraging her background in healthcare technology and management to significantly advance its mission and impact across the industry. The division manages federal and state grant funded programs focused on revolutionizing healthcare through data-driven transformation, including the management of the New Jersey Health Information Network (NJHIN) on behalf of the New Jersey Department of Health (NJDOH). The NJHIN is the only network that has been built specifically to facilitate the exchange of patient data for all New Jersey patients with their healthcare providers. With Jennifer at the helm, NJII and the NJHIN can increase interoperability, thus reducing the cost of healthcare and improving population health statewide.

Jennifer also oversees the NJII Healthcare Division’s for-profit subsidiary, Healthcare Innovation Solutions (HCIS), which assists thousands of physicians across the country in navigating the Centers for Medicare and Medicaid Services’ Merit-Based Incentive Payment Program (MIPS) and Quality Improvement Program-New Jersey (QIP-NJ).

Prior to her appointment at NJII, Jennifer served as the Senior Vice President and Chief Information Officer at Bergen New Bridge Medical Center in Paramus, NJ; Chief Information Officer and Vice President of Information Services at Christian Health in Wyckoff, NJ; and Executive Director of Jersey Health Connect in Newark, NJ.

Jennifer has more than two decades of HealthIT experience and is one of the few women in leadership in the healthcare industry. Having worked as a Chief Information Office on the provider side of healthcare, Jennifer implemented and supported EHR and revenue initiatives; led cybersecurity, HIPPA and privacy, Information Services, Clinical Informatics and Telecommunications on a state- wide scale; and continues to provide a cutting-edge vision to the healthcare field and revolution. She has also been tapped by leading organizations for her expertise and thought leadership at various speaking engagements, including sitting on the NJBIZ Healthcare Technology Panel, and speaking at the American Health Information Management Association’s (AHIMA) Long-term and Post- acute Care and Health Information Technology Summit.

Jennifer is also committed to furthering HealthIT through volunteering and giving back her knowledge. She currently serves as a Board Member of NJHIMSS, along with serving on several regional and state leadership associations and committees including Health Care Association of New Jersey (HCANJ), national HIMSS, AHIMA, LeadingAge CAST, Jersey Health Connect, AEHiT, New Jersey Hospital Association (NJHA) and NJHIN. Most recently, she was selected to become a member in CHIEF – an organization designed for the most powerful women executives to strengthen their leadership and magnify their influence – and a nominee for the Civitas Networks for Health’s board. Through her experience volunteering, collaborating, networking, and advising these organizations, she has helped to make a significant impact on growing healthcare technology initiatives across New Jersey and beyond.

Speaker 1

Robert Millette

CEO

CharterCare Provider Group of RI

Robert Millette is CEO of CharterCare Provider Group of Rhode Island and Senior Vice President of Prospect Medical. He has 26 years of healthcare experience with a focus on finance. He has served as a finance and operations leader in acute care and OP management for BJC Healthcare and Ascension Medical Group and has been an operations and system level strategy executive for Ascension and Lee Health. Robert has spent the last decade in Value Based Care and Managed Care, standing up an owned MA and Medicaid plan, as well as two large IPA’s in risk arrangements.

Speaker 1

Mina Chang

Senior Policy Adviser

Ohio Office of Aging

Dr. Mina Chang brings over 25 years of distinguished leadership in health and human services across diverse governmental sectors and national markets. Currently, as the Senior Policy Advisor to the Director at the Ohio Department of Aging, she drives impactful policy changes to benefit 2.8 million older Ohioans. Previously, as the Deputy Director, she was at the forefront of transforming eldercare and healthy aging in Ohio, leading business intelligence and compliance strategies to ensure innovation and service excellence.

  In her role as VP of Quality at Bethesda, a national long-term care provider, she led COVID response efforts and managed a workforce of 3,000 across 400 programs in 13 states. As Assistant Health Commissioner for NYC, she spearheaded teams to expand health insurance services for 8 million residents, successfully onboarding 85,000 new members during ACA open enrollment.  

A respected industry speaker, Dr. Chang has advised influential organizations such as MACPAC, SAMHSA, and CHCS. She holds a Ph.D. in Public Policy and Management and an MPA from Ohio State University. As a Fellow of the American Healthcare Executives, Dr. Chang is dedicated to advancing excellence in public policy and healthcare leadership.

Speaker 1

Marcela Ruiz

Director, Value Based Purchasing

Banner Health

Marcela is experienced in both primary care and payer roles within the value-based payment (VBP) sector, where she has developed a comprehensive understanding of VBP contracting and relationship management. Her expertise is supported by her hands-on experience in clinical performance, allowing her to effectively bridge the gap between clinical outcomes and financial incentives. This unique combination of skills enables her to navigate the complexities of VBP models, facilitating collaboration between healthcare providers and payers to improve patient care and optimize resource utilization. Through her work, Marcela has demonstrated a commitment to advancing value-based strategies that enhance both healthcare quality and operational efficiency.

Speaker 1

Shannon Smith

Director, Care Transformation

Banner Health

Shannon brings over 18 years of healthcare experience in the Arizona market.  She has extensive experience in clinical program design and implementation, pharmacological disease support programs, chronic disease management, clinical performance improvement, and community program development.  She received her Master’s in Business Administration from the University of Arizona’s Eller College of Management and joined the Banner Connect Team as Director of Special Projects in 2021. In this role, Shannon has overseen the clinical quality performance and network development for three of Banner’s value-based networks: 1)  Banner Network of Southern Arizona, 2) Specialty Network Providers and 3) Banner Health Plans Value Based Performance (VBP) providers including directly contracted, risk based and aggregated providers.