RISE Executive Committee of the Advisory Board

 RISE Executive Board Org Chart

The overall audience for HEA conferences has tended to fall into particular areas of interest, and so we have stratified the RISE board into working groups focused around the needs of these audiences. Each advisory board has its own chairperson and its associated individual advisory board members. Additionally, there is an executive committee for coordination and overall leadership, which includes the chairpersons of the advisory boards plus several members at large and a few RISE leaders.

The work of the advisory board is guided by the vision and mission of RISE, along with its values set forth in the paradigm and business model.  The role of the RISE Advisory Board member is to provide strategic and tactical advice on building and implementing a robust community within the health care reform movement, particularly involving health plans, payers and provider organizations (including physician groups, IPAs and office practices, hospitals, ACOs, and more). The mission of RISE is to advance the capabilities, knowhow and expertise of the employees in this eco-system in order to not only benefit the performance of their employer companies but also to enhance their personal careers as knowledge workers, given the challenges of the environment and technical demands of the jobs in this system. 

In support of this role, RISE advisory board members are key contributors to the business planning and execution of the intellectual value of the community it serves.  The board members’ role is:

  • To serve as thought leaders in the industry
  • To advise RISE on strategies and business plans to pursue the vision and achieve the mission of RISE within this eco-system as a win-win proposition, based upon personal experience and perspectives on the subject matter at hand
  • To learn from and collaborate with other Board members in order to further enhance the value of RISE in service of this eco-system
  • To guide and advise, provide oversight and recommendations on the development of programs and initiatives that create value as discussed above, providing and setting the bar for:
    • Creation and nurturing of a community of professionals and their employers within selected segments of the larger eco-system
    • Identification of content programming, audience development, services and strategies that not only pace with the changes in the health care market, but anticipate important changes and trends
    • Career development opportunities for industry professionals whose specific needs around skills and competency development might be well served through RISE and HEA
    • A “go to” resource for knowledge and affiliations that promote success and advancement

The Advisory Board as a whole provides valuable contributions to the mission of RISE.  The eight advisory boards represent the more significant domains within the scope of the RISE Revenue and Quality area of health care reform payers and providers.  At this moment, we are calling out several topic-oriented advisory boards plus two additional aligned advisory boards supporting the mission of RISE:

  1. The Risk Adjustment Advisory Board – Chaired by Dave Meyer from SCAN Health Plan, this addresses all lines of business but primarily CMS and HHS risk adjustment.  It is concerned with the largest target audience developed so far by RISE and initiatives currently under way, such as user groups on RADV, RAPS/EDPS, HCC coding, a RAPS/ EDPS data collaboration study, stand-alone training and education workshops, an HCC coding faculty design committee, and a calendar of existing conferences.
  2. The Quality and Accountability Advisory Board – Chaired by Ryan McKeown from Optum, this addresses all lines of business, including ACOs and the emerging MACRA areas, but primarily has a cultivated audience for Medicare Stars, QRS, HEDIS, CAHPS, etc.  There is a robust annual calendar of conferences currently operating, and there are industry benchmarking studies planned for the near future.
  3. The ACA Market Advisory Board – Chaired by Scott Filiault, this addresses the dynamic market issues of the ACA commercial marketplace for individual and small group plans, including the strategies for plan design, member acquisition and retention, management of the MLR, risk adjustment, quality and accountability, and so on.  This group will work closely with the Risk Adjustment Advisory Board around this topic, and similarly with the Quality and Accountability Advisory Board. 
  4. The Provider Volume to Value Advisory Board – Chaired by Ana Handshuh from Ultimate Health Plans, this focuses on the transformation taking place and the enabling strategies for provider organizations to adapt and succeed as the payment paradigm shifts from volume-based techniques to advanced and accountable models such as ACOs, bundled payments, and so on.  As with other Advisory Boards, close coordination and collaboration will be required between groups.
  5. The Comprehensive Payment Integrity Advisory Board – Chaired by Tom Martin from Wellcare, this advisory board represents a new level of development and a spotlight on an area where RISE / HEA had a limited portfolio of events without a strategic focus, yet demonstrates a potential for significant growth and service to the professionals involved in such areas as third party liability, payment recovery, SIU, and more. 
  6. The Regulatory and Compliance Oversight Board -  Chaired by Osato Chitou with Gateway Health Plan, this is also a new focus for RISE / HEA, recognizing the significant importance of this area of discipline as it is integral to corporate risk management and business performance in nearly every functional area.  Like the other new board, it represents an opportunity for growth, development and service to an important community.
  7. The Martin Block Award Advisory Board – Chaired by Kevin Healy from Optum, this service group is responsible for promoting and recognizing clinical excellence and innovation in our industry, particularly where the financial dimensions of risk adjustment have overshadowed the importance quality of care work being done.  An annual recognition award is being made at the RISE Nashville event in memory of the extraordinary contributions made by Dr. Martin L. Block.
  8. The RISE Association Advisory Board – Chaired by Kevin Mowll, Executive Director of RISE, this group leverages the creative and talented resources of its members to advance the RISE association overall, and to serve as a conduit for input from the other advisory boards and requests for facilitation to get their plans achieved.  It drives the development of newsletters, website content, structure and functionality, association membership benefits, and support tactics and strategies. 
  9. The Medicare Market Advisory Board – Chaired by Kevin Mowll, this is a separate and parallel board created around the initial core membership in Medicare marketing, sales and product management.  It currently consists of eight executives from Medicare healthplans across the country and will soon be expanded to include key sponsors to help fund and collaborate around strategic direction.  



Scott Filiault

Scott Filiault is the Chief Revenue Officer of Pulse8, a cutting-edge healthcare technology and data analytics company focused on delivering the highest financial impact by providing an unprecedented view into risk adjustment for health plans with Commercial, Medicare Advantage and Long-Term Care populations.... Read More


Kevin Healy

Kevin is currently the Senior Vice President of Optum's Clinical Solutions focusing on the Payer and ACO markets. Kevin is responsible for solving for the needs of today's complex requirements as they pertain to data analytics, care and disease management, wellness, propsective and retrospective risk adjustment, STARS, Hedis, quality and complex population management.... Read More


Nathan Goldstein

Nathan Goldstein is a serial entrepreneur with a passion for reforming health care. As Chief Strategy Officer of CenseoHealth, he is responsible for spear heading efforts to identify and execute new opportunities for the Company to leverage its in-home diagnostic and care expertise to drive improved care for its clients and members.... Read More


Osato Chitou

Ms. Chitou currently serves as Medicare Compliance Officer for Gateway Health Plan. Prior to joining Gateway, Ms. Chitou served as the Director of Medicare Compliance for Amida Care, a not for profit health plan in New York founded by several community based organizations.... Read More


Jennifer Pereur

Jennifer Pereur is the Director of Government Programs for Hill Physicians Medical Group, an independent practice association (IPA) in Northern California. The group consists of over 3,000 contracted physicians who provide care to 300,000 managed care members. Jennifer oversees both the Medicare and Medicaid lines of business. ... Read More


David Meyer

Dave is a strong leader with 14+ years of experience in Revenue and Clinical Outcomes Program Development and Management in various healthcare environments (Plans, MG/IPA, Academic, and Consulting). Proven record of success in optimizing Operations, PE / Investor Meetings, Maintaining Compliance, Recovering / Maximizing Revenue, Enhancing Clinical Quality and Developing Software and Custom Analytics. Specialties: RA / HCC, Pay for Performance (P4P), CMS Stars Program, NCQA HEDIS, Off-shore Software Product Development, HOS, CAS, NCQA Accreditation, Physician Profiling, Encounter Programs, Contract and Claims Analytics.... Read More


Ellen Wofford

As Chief Operating Officer, Ellen Wofford is responsible for the operational leadership of Healthcare Education Associates. She is dedicated to constantly improving the systems which create and deliver HEA’s products and services. Based in the North Carolina office she manages the registration, sales, telesales, speaker coordination, meeting planning, human resources, IT and website teams. She has over 17 years tenure in the conference industry.... Read More


Kevin Mowll

Executive Director of RISE Kevin Mowll has joined RISE as its Executive Director. In his role, Kevin is responsible for building up the RISE association, creating a better value for our members, enhancing member education and content, as well as expanding and enhancing our conference offerings.... Read More


Ryan McKeown

Ryan McKeown is the Vice President, Market Strategy and Business Integration for Optum. He is responsible for ensuring the STARS, certified HEDIS and other quality solutions best enable health plans to maximize their star ratings and achieve the highest levels of distinction in quality measurement. ... Read More


Tom Martin

Director, WellCare Health Plans Tom serves at WellCare Health Plans, Inc. in Tampa, FL as Director of Recovery. Graduating with a BA in Corporate Communication from the College of Charleston in 2001, Tom joined the Japan Exchange & Teaching (JET) Program which landed him in Hyogo Prefecture to teach English communication to senior high school students for 2 years.... Read More


Ana Handshuh

Ana Handshuh Chair of the Provider Volume to Value Advisory Board for RISE VP of Managed Care Services, Ultimate Health Plans, Florida... Read More


Hovannes Daniels

Hovannes Daniels is Vice President of Decision Support and Risk Adjustment. He is responsible for managing Kaiser Permanente’s analytic information and data as well as driving the risk adjustment initiative forward in partnership with the Permanente Medical Groups which accounts for approximately 40% of Kaiser Permanente's revenue. The Decision Support group comprises approximately 250 individuals that perform analytics nationally, as well as regional analytic and program management teams who serve as local liaisons with care delivery leaders, physicians, coders, finance, legal and compliance leads. ... Read More


Kenneth Persaud

Dr. Ken Persaud is a physician executive with experience in clinical practice, leading physician groups, managed care, Medicare MSSP, clinical re-design to achieve high quality, development & implementation of equitable healthcare models, physician compensation, global capitation contracting and start-ups. ... Read More


Log on to Your Rise Account

Forgot your password?
Create an Account


Latest Posts

And the Money Kept Rolling In...

By Julie Mason, Principal, Medicare Compliance Solutions Several days ago, CMS announced the 17 Medicare Advantage (MA) plans subject to civil monetary penalties (CMPs) based on their 2016 audit findings. Until this year, the months of February and March in the MA space meant the application season. Now, based on CMS’ March 1 memo on CMPs, it is the application-and-enforcement actions season. Unlike past years, when CMS posted audit-based enforcement actions on a rolling basis throughout the year, they are now holding public notification of audit-based CMPs until the first quarter of the following year. (Although the CMS memo didn’t explicitly address timing of intermediate sanctions—e.g., freezing of enrollment and marketing—one should presume those actions will be imposed and announced on a more immediate basis.) This change in process allows CMS to evaluate all audits simultaneously (grading on a curve?), and that can’t happen until the end of audit season, typically November or early December. Add a couple of months for decision-making by CMS and the twenty layers of review required to issue just about anything, and that brings us to deep into the first quarter of the next year. So what does this mean for MA plans scheduled for a 2017 audit, or the many MA plans who suspect they’re on the 2017 audit hit-list? For one, it means that audited MA plans may not know until well after the audit closes whether they will be sanctioned. Following a CMS audit, there is often a fair amount of conjecture amongst senior management regarding whether the audit findings are significant enough to result in sanctions or enforcement actions. It’s not a fun exercise, and will be more protracted now that sanctions are announced in one fell swoop in the first quarter of the following year. For all MA plans, it means there won’t be a clear window on CMS’ approach to enforcement during the current year. And with a new and unpredictable administration in place (sort of), we will all be looking for clues. The March 1 memo stated that sanctions and enforcement actions for regulatory violations identified through sources other than audits would continue to be posted to the CMS website “within the normal timeframe after notification to the sponsor,” which typically has been within a few days or so. But non-audit related sanctions and enforcement actions are few and far between, or at least they have been up until now. ...
Read More

Winning in Risk Adjustment Five Steps for Health Plan Executives to Boost Coding Accuracy and Efficiency

Executive Summary An educational whitepaper, courtesy of Talix As the healthcare industry continues to shift from volume-based to value-based reimbursement, health plans are moving to change the way they do business. Recognizing that the cost of and incentives associated with traditional fee-for-service care are unsustainable, they are expanding their risk-based contracting efforts and seeking out more innovative ways to help providers deliver better care at a lower cost. For these payer organizations, accurate and timely risk adjustment is crucial to their success, as it has a direct impact on both plan revenue and care quality. The stakes are high and will only continue to grow. In today’s highly regulated, competitive and increasingly quality-focused market, payers must look to technology for cost-effective ways to expand their risk adjustment strategies. This white paper outlines the risk adjustment challenges health plans face and how technology-enabled data analytics can help plans tackle the problem and master risk adjustment through five proven steps for improved coding efficiency, productivity and accuracy. A Changing Marketplace...
Read More

Upcoming Conference


The RISE Quality Leadership Summit 

This unique event incorporates three conferences presented side-by-side: the Star Ratings Strategic Planning Forum, the HEDIS Forum, and the CAHPS, HOS & Member Survey Forum. Register for one conference for an in-depth examination of a single area, or design your own event by opting for the all-access pass and choosing the sessions from each conference which correspond exactly to your interests.


Upcoming Webinar

360° Risk Adjustment: A Strategy for Success in the Value-Based Care Era


In this webinar, attendees will discover that when risk adjustment is treated as a priority – not just as an actuarial exercise – and brought into the organization’s long-term strategy, it can be properly leveraged as an asset to drive growth and advance the organization’s mission of keeping patients healthy. Risk-bearing entities who embrace a 360° approach to risk adjustment will outpace their competitors in the transition to value-based care models.


Connect With Us

Copyright © 2014 Resource Initiative & Society for Education. All rights reserved.