Rise

Heather Adams Senior Product Line Manager, Medicare

Blue Cross and Blue Shield of North Carolina

Heather Adams currently serves as the Senior Medicare Product Line Manager at Blue Cross & Blue Shield of North Carolina. She brings a multi-faceted, unique perspective to product design and management. For over a decade, her vast experience within multiple verticals of healthcare provides success in building high-performing, cross-functional teams to drive evidence-based initiatives in support of quality improvement and product optimization.  

In her current role, she leverages her experience and passion working with non-profits such as the American Cancer Society to implement Medicare product lines that provide the necessary support for all individuals to attain the highest level of care by breaking down barriers to health equity. Outside of her role at Blue Cross NC, Heather serves as the Vice Chair of the Alabama Department of Public Health’s Comprehensive Cancer Control Coalition, where she advances its reach across payor and health systems with a strategic focus on furthering initiatives that address healthcare equity in underrepresented/underserved populations. 

Rebecca Ballou Senior Business Development Executive

Amplifon Hearing Health Care

Rebecca Ballou is the Senior Business Development Executive at Amplifon Hearing Health Care. She plays a pivotal role in empowering health plans to increase their Star Ratings and member retention through the effective design, implementation, and administration of strategic benefits. Rebecca is especially passionate about strengthening the bond between health plans and their members and, at a macro level, fostering consumer access to health care and exceptional experiences across the health care ecosystem. In her career spanning more than 10 years, she has left an indelible mark on many facets of the health care landscape, including health plans, hospitals, integrated health systems, and provider organizations. Rebecca attended Eastern Illinois University and Syracuse University's Whitman Management School, and she currently resides in Chicago.

Amy Bassano Managing Director, Medicare

Health Management Associates & Former Deputy Director, CMS Innovation Center

A senior executive and nationally recognized health policy expert, Amy Bassano has more than 20 years of experience developing organizational vision and strategic plans, designing, and implementing payment systems, and driving change in the healthcare delivery system. 

She joins HMA as managing director of Medicare services after serving as the deputy director for the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare & Medicaid Services (CMS). 

As senior executive at the CMMI, she oversaw the development and implementation of value-based purchasing models for both Medicare and Medicaid including accountable care organizations, bundled payment programs, and specialty initiatives in oncology, kidney care, prescription drugs, state-based models and dual eligibles. Additionally, she collaborated with states, health plans, purchasers, and international organizations to lead the national and international movement to value in healthcare. 

In her more than 15 years at CMS, she served in various Medicare leadership roles including as director of the Hospital and Ambulatory Policy Group. In that role she developed and implemented hospital, physician, Part B prescription drugs, clinical laboratory, and other acute care payment policies, oversaw  regulatory and sub-regulatory requirements for these providers and suppliers. She also led implementation of multiple major pieces of legislation including the Affordable Care Act for the payment systems in the policy group. She previously served as director of the divisions of Practitioner Services and Ambulatory Services and in the Office of Management and Budget. 

Amy earned a Master of Policy Studies from John Hopkins University and a bachelor’s degree in history from Tufts University. 

Paul Cain Product Strategy Lead

Cigna

Paul is a career product management professional, having worked in many industries including consumer packaged goods, pharmaceuticals, healthcare information and Medicare Advantage. Currently he is Product Strategy Lead for Medicare Advantage products at Cigna Medicare where he oversees product management across the Southeast region.

Paul has experience in new product development, product strategy and planning, competitive analysis and data and analytics. He has an MBA from St. Joseph’s University and lives in the Philadelphia suburbs with his family.

James Cooper Consulting Actuary

Milliman

James is a Consulting Actuary with Milliman with over 10 years of experience. Since joining Milliman in 2014, James has had extensive experience assisting carriers and provider groups with their Medicare Advantage, ACA compliant Individual and Small Group, and Medicaid products. James’ Medicare expertise includes optimized pricing and product strategy leading to improved financial projections.

Jenna Corbly Director of Medicare

CareOregon

Jenna Corbly, LNHA, MBA joined CareOregon in 2022 with over a decade of experience as a leader of Skilled Nursing Facilities. As the Director of Medicare for CareOregon Advantage, she oversees operations for the state of Oregon’s largest DSNP plan; spending much of her time around vendor management, supplemental benefits management, implementing new State and Federal requirements, and performance maximization. 

Omar Daoud Senior Director of Pharmacy

Community Health Plan of Washington

Omar joined Community Health Plan of Washington, CHPW, as the Director of Pharmacy in 2019 after sixteen years with Walgreens Co., where he led Specialty Pharmacy operations for the Pacific Northwest Region. 

Omar has extensive experience in Specialty Pharmacy, Managed Care including government programs, and Clinical Pharmacy quality initiatives. Omar’s current role is focused on PBM relationship oversight, clinical pharmacy integration, and utilization management of medical and prescription drug benefits. 

Omar received his Doctorate of Pharmacy Degree from the University of Washington in 2005 and continues to reside in the beautiful Pacific Northwest.

Shannon Decker Principal

VBC One

Dr. Shannon Decker is principal at VBC One, a consulting firm assisting physician groups, health plans and vendors maximize the performance of their value based contracts and offerings.  Dr. Decker has more than 20 years experience in health care and most recently led teams in risk, quality, data and analytics, telehealth, COVID response and delegation compliance.  Of her more than 20 years of experience in healthcare--15 include working with risk adjustment, quality and Medicare. Dr. Decker has a PhD. in Interdisciplinary Studies, dual MBA degrees--in Finance and in Marketing, as well as an M.Ed. in Secondary Education and a M.Ed. in Administration and Leadership. Dr. Decker is on the faculty at Arizona State University and is also an associate professor of Higher Education & Adult Learning (HEAL) and chief methodologist for Walden and Capella Universities where she chairs and oversees the dissertations of doctoral students. An author of two books and several peer-reviewed articles, and a prolific national public speaker, her interests include the study of human behavior and how theories on motivation and learning may be brought to bear on population health management.

Archie Dey Senior Director, Consumer Experience and Insights

SCAN Health Plan

Nick DiMauro Director of Business Development

Medline

As a notable leader and voice within the health plan space, Nick takes pride in working with Managed Care Organizations across both Medicare Advantage and Medicaid with the ultimate goal of promoting better quality of life for health plan members. Nick is currently a Director within the Health Plan division at Medline Industries and helps lead business and product development. Nick's goal is to provide innovative solutions to his health plan partners that promote member engagement and ultimately improve health outcomes.

Ryan Dodson Risk Adjustment Consultant

Choice Medical Group

Ryan Dodson’s background is in management and operational processes for 15 years, and he began working in the risk adjustment arena 15+ years ago. Ryan has proven himself by helping medical groups and health plans to accurately improve their documentation with a solid track record of provider engagement. Ryan uses a unique blend of comedy and deep risk adjustment knowledge to get buy-in from providers to improve their documentation. His track record of results of improving documentation and thus improving revenue streams and patient care brings value to any group he works with. Having worked on the provider, payer, and now the vendor side Ryan is able to bring a unique perspective to the conversation and develop out-of-the-box ideas to help any size group. In 2020 Ryan co-founded New Vision Healthcare Solutions to fill a niche in the market on providing provider education with data stemming from analytics and provider chart data. Ryan has a Certified Risk Adjustment Coder (CRC) credential through the AAPC. 

David Etling Senior Vice President & General Manager

InComm Healthcare

Lisa Franklin Director of Individual Medicare Business and Product & Marketing Strategy (Government Programs)

CareFirst BlueCross BlueShield

Lisa Franklin is currently the Business Owner of Individual Medicare and Director of Product and Marketing Strategy focused on driving the Individual Medicare businesses to financial sustainability, leading the product lifecycle (strategy, design, management, and optimization), and development of robust marketing strategies around member retention and engagement. She drives the business to consistently assess and make improvements in the levers (cost of care, revenue, quality, and administrative costs) that ensure plans can continue to offer low premiums, supplemental benefits, and an overall great member experience. She leads the overall product vision and strategy, while continuously improving Individual Medicare Advantage plans (including Dual Special Needs), Medicare Supplemental, and Group Medicare Advantage plans in the Maryland, District of Columbia, and Northern Virginia areas. Her focus is managing a team that leads cross-functional discussions to meet milestones on the product roadmap driving towards short and long-term strategic goals. She also leads a team of marketing professionals focused on executing key messages through various channels (print, digital, phone, and more) for all government programs.  

Lisa previously worked at Johns Hopkins Healthcare in Maryland as Product Development Manager for Medicare Advantage plans. She has over 8 years of experience leading the Medicare Advantage Bid process at multiple organizations with a passion for ensuring that data is the driving force for every element of the product lifecycle. In her spare time, she enjoys spending time with her husband and corgi, Turbo, as well as spinning and shopping. 

Andy Friedell Chief Operating Officer

The Helper Bees

As COO, Andy helps drive growth and provides strategic direction across The Helper Bees’ products and services, ensuring that the work of the team is properly aligned with the goals of payers, patients and caregivers. He brings over 20 years of healthcare experience to the job. Andy founded healthAlign to help payers better manage a diverse range of services into the home and that business was acquired by The Helper Bees in 2021. Prior to founding healthAlign, he oversaw payer relations, nationwide business development, and large-scale strategic engagements at Maxim, one of the nation’s largest homecare companies. His work driving the product development function there brought about a community-based care management offering that has been shown to reduce readmissions by over 65% while also driving a 35% reduction in in-patient spending.

Andy came to Maxim from Medco Health Solutions where he worked on the development of the Medicare Part D drug benefit, the early launch of the internet pharmacy marketplace and the regulatory environment for mail service pharmacies. Andy began his career as an aide to former New Jersey Governor Christine Todd Whitman.

Ana Handshuh Principal

CAT5 Strategies

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

Andy Higgins Vice President, Product Development

Clever Care Health Plan

Andy Higgins is the Vice President of Product Development at Clever Care Health Plan, one of the fastest growing MA plans in the country. He has a passion for building products and services that help patients of all backgrounds improve their health and well-being. With over 20 years of healthcare experience, Andy has held a variety of leadership roles at Cigna, Aetna, CVS Health, and Highmark Blue Cross Blue Shield. Prior to joining Clever Care, he managed a portfolio of over 400k members and launched dozens of new plans and innovative supplemental benefits for seniors. Prior to that, he managed a $50M portfolio of clinical programs at CVS Health, where he was awarded two Breakthrough Awards for innovation and selected for CVS’s high potential leadership training program.

Danica (Dani) Holliston Manager of Medicare Product

Regence Blue Cross Blue Shield

Dani has been working within the health insurance industry since 2005. She has been working primarily with Medicare products since 2014, with a focus on Medicare Advantage plans. Regence covers the four states of Washington, Oregon, Idaho and Utah, and includes HMO, PPO, and PDP types of plans. Dani has an MBA from George Fox University, and a BA from Willamette University. Prior roles in the health insurance industry include sales, marketing communication, benefit management, and product management. She has worked with all lines of business including large group, small group, individual, and government programs, as well as ancillary products such as dental, vision, and hearing products.

Sion Hughes Senior Consultant

Wakely, an HMA Company

Sion Hughes has payer and provider experience with product and strategy. His experience includes building successful integrated delivery financial models, value-based payment program development, product development, and leading strategic efforts for growth of lives. Mr. Hughes has a proven track record of creating, improving, and expanding profitable Medicare Advantage products, Medicaid programs, and value-based payment models. His expertise centers around strategic thinking, increasing operating margins, and enhancing stakeholder experience. He is a subject matter expert in successful planning, contract negotiations, implementation, and growth of government products, as well as developing joint venture economic models. Mr. Hughes is the co-architect of Wakely Analytics Health Operations Optimization program, which helps to position payers and providers to be successful with managing risk. 

Mr. Hughes earned his bachelor’s degree in business management from Cleary University. 

Abby Katabaro Managing Director, Medicare Product

Blue Cross Blue Shield of Michigan

Abby Katabaro is a seasoned product leader who oversees Medicare product development and management as the Managing Director of Medicare Product at Blue Cross Blue Shield of Michigan. In her role, she provides strategic product planning, design, communications, and filing direction for the health plan, as well as leading vendor engagement and management of supplemental benefits. Prior to joining BCBSM in early 2024, Abby served as the National Director of Medicare Products at Kaiser Permanente where she was accountable for the development and implementation of competitive, growth-driving Medicare supplemental benefits as well as Medicare product strategy across the company’s market landscape. She also led Medicare product development for Centene and served in various roles at Wellcare Health Plans, where she developed Medicare products and materials, designed plan product portfolios, and filed CMS bids.  

Abby previously held legal and corporate communications roles in the sports, education, and legal industries, of which she holds degrees in. Based out of Alpharetta, Georgia, you can find her volunteering for service dog and rescue organizations, working out, traveling, and going on local foodie adventures around Atlanta with her husband, two daughters and two retrievers.  

Jenn Kerfoot Chief Strategy & Growth Officer

DUOS

Jenn brings her deep understanding of the complexities and nuances within the Medicare Advantage & Value-Based Care landscape to their work at DUOS, where they lead business development, go-to-market strategy, and marketing. By leveraging data-driven insights and market intelligence, they spearhead the development of tailored products and services that cater to the unique needs of Medicare Advantage plans and deliver unparalleled value to clients and beneficiaries alike; previous leadership roles include FarmboxRx, Excelera Health, and NationsBenefits. Beyond her role at DUOS, Jenn actively contributes to the industry's progress as a thought leader leveraging expertise and advocacy for innovative healthcare practices to enhance healthcare accessibility and quality. 

Matt Kranovich Principal and Consulting Actuary

Milliman

Matt has over 20 years of experience as a healthcare actuary, with a primary focus on Medicare Advantage (MA) and Part D plans and financial reporting. He supports clients with pricing, reporting, pro forma projections, and related analyses in both the individual and group (EGWP) markets.

Since joining Milliman in 2012, Matt has assisted startup MA organizations, established regional plan sponsors, and large national carriers in product strategy and bid preparation across a wide variety of plan types including DSNPs, ISNPs, and CSNPs. He supports clients in every phase from initial product strategy through bid finalization, desk review, and audit support.

Matt began his actuarial career at HCSC, where he spent four years working in financial reporting and managed care pricing roles. He then moved to Deloitte Consulting, where he spent seven years leading CMS bid desk reviews of hundreds of Medicare bids on behalf of CMS, and contributed actuarial expertise to GAAP and statutory audits of health plans and supplemental health insurance carriers.

Kelsey McNamara Head of Research and Impact

Papa

Kelsey McNamara, MPH, is a public health professional with experience in digital health, behavioral interventions, and social drivers of health. As Head of Research and Impact at Papa, she evaluates the clinical and economic value that Papa provides to members and clients. Prior to joining Papa, McNamara held research and strategy positions at Omada Health, Google, and the Harvard Center for Work, Health and Wellbeing. McNamara received her BS from Cornell University and MPH with a focus in Social & Behavioral Sciences from Harvard University.

Gary Melis Clincical Pharmacist

Network Health

Gary is a clinical pharmacist at Network Health, a local health insurance provider in Northeast and Southeast Wisconsin. He is currently one of three pharmacists involved making MTM calls in-house. His responsibilities also involve NCQA, pharmacy appeals, P&T Committee, as well as member and provider relations.

Gary also has experience as pharmacy manager for a national long term care company, as pharmacy manager for a retail pharmacy chain, and as pharmacy director for a national health care provider. In addition, he has been a pharmacy instructor at a local medical college family practice clinic.

Courtney Meyer Senior Director, Development & Distribution

Sanford Health Plan

Courtney Meyer is the Senior Director of Development & Distribution at Sanford Health Plan where she oversees the plan’s strategic growth including the product development teams for individual, commercial, and Medicare lines of business as well as the various teams that support the distribution channels.  Courtney is an innovative leader with >14 years’ experience in the health insurance industry with a background in broker sales. 

With a proven track record in driving strategic growth and improving operational efficiency, Courtney excels in leveraging data-driven insights to inform product development and market expansion strategies. Her leadership has resulted in significant revenue growth, cost savings, and enhanced member engagement across various projects.  Most recently her team led the successful launch of a Medicare Advantage plan exceeding market entry goals.  In the plan’s second year in existence it received a 4.5 star rating. 

Courtney has an MBA from Kaplan University and lives in South Dakota with her family where they enjoy spending as much time as possible outdoors, usually camping, archery hunting, gardening, hiking, or attending baseball games.

Tim Murray Principal

Wakely, an HMA Company

Tim Murray, FSA, MAAA, is a Principal in Wakely’s New York office. He joined the firm in 2017 and has worked as a health actuary for more than twenty years. Over the course of his career, Tim has consulted to and served health plans, provider groups, and solutions providers on matters of strategy, pricing, product design, forecasting, financial reporting, and Merger & Acquisition due diligence. Prior to joining Wakely, Tim spent 4.5 years leading the actuarial forecasting and budgeting functions of a Medicare Advantage-focused health plan, encompassing a wide array of traditional (e.g. Medicare bidding, M&A due diligence) and less traditional (e.g. payment policy lobbying) project work. Tim also spent 2 years in an equity research role covering publicly traded managed care and healthcare facility stocks, providing investment/industry guidance to institutional investors.

Monica Pagels Manager of Product Development

Emergient

Monica Pagels is the Manager of Product Development at Emergient. Emergient brings leading end-to-end Medicare Advantage capabilities to new markets through joint venture partnerships with health plans.  As Manager of Product Development, Monica is responsible for the annual Medicare bids, product implementation and oversees product strategy and vendor management. Monica works closely with sales, marketing, enrollment, billing, claims, and customer service to deliver best in class benefits and member experience, leading to a retention rate of over 95% across all Emergient markets.

Harbinder Raina Principal

ZS

Harbinder is a leader in ZS’s health plan and provider industry practice. Harbinder advises U.S. health plans and providers across a range of issue areas including customer experience, population health management, go-to-market strategies and advanced analytics. Prior to his current role at ZS, Harbinder worked as a tech consultant in the health insurance and property and casualty insurance industries. Harbinder has a B.E. in mechanical engineering from NIT Surathkal (India) and an MBA from the Ross School of Business at the University of Michigan. 

Laura Sheriff Industry Expert in Risk Adjustment Operations

Laura Sheriff is a highly experienced and skilled professional in the healthcare industry, with a wealth of knowledge and expertise in risk adjustment, quality improvement, and population health analytics. With her background in Medicare, Medicaid, and Marketplace Managed Care, as well as her leadership abilities and certifications as a professional coder and risk coder, Laura brings a unique set of skills to her consulting work with physician groups and health plans.

Melissa Smith Founder

Newton Smith Group

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

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

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

Rex Wallace CEO

Rex Wallace Consulting, LLC

Rex Wallace is the founder and principal of Rex Wallace Consulting, LLC, a firm that specializes in improving Star Ratings for Medicare Advantage health plans. Rex assesses plans and guides them in the development and implementation of leading strategies to drive material Quality Improvement. Since its inception in 2017, RWC has helped multiple Medicare Advantage contracts achieve significant improvements in Star Ratings, including single-year full-Star improvements. Prior to launching RWC, Rex spent twenty-three years in strategic healthcare roles, with a strong focus on Medicare Advantage. Most recently, he led Stars for a large, multi-state plan that consistently achieved 4 and 4.5 Stars across its multiple contracts.