RISE Executive Committee of the Advisory Board

Patrick Coulson

Patrick Coulson is a successful healthcare executive with more than 20 years’ experience leading healthcare sales with expertise in Medicare Advantage, risk adjustment and member engagement. He brings a proven success record in hyper-growth organizations, doubling revenue year after year for multiple years. Patrick’s sales and management experience includes health insurance, disease management, and provider industries. He is particularly adept at early stage companies, C-level new business sales, new product launches, sale force recruitment and training.... Read More

 

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, Strategy and Managed Care at Central Maine Healthcare... Read More

 

Tom Martin

Tom Martin is the Director, Payment Integrity Consulting at UnitedHealth Group... 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 Senior Vice President, Practice Operations, Ampliphy Physician Services. He 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

 

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RISE Risk Adjustment Academy: CMS & HHS Risk Adjustment 101 and HCC Coding Accuracy

Designed as an introduction or refresher that covers all the bases when working with Medicare Advantage or on commercial health insurance exchanges lines of business. The workshop program is a holistic orientation to the risk adjustment panorama and deep dive into HCC coding for accuracy. With a mix of health plan and provider audiences, a powerful environment for interaction and collaboration is built over two-days. You will gain insight, tips, and best practices to build upon your knowledge of risk adjustment, coding, and documentation.

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Upcoming Webinar

A Hitchhiker's Guide to HCCs, RAFs and More from a Payer Perspective

This webinar will provide a compelling and insightful overview of HCCs, Risk Adjustment Factors and Clinical Data. It seeks to present a clear understanding of what Payers must do to use these CMS mandated levers for improving patient care and getting appropriately reimbursed for the most severely ill patients. Join Prognos to get broad guidance on a pragmatic approach to implementing HCCs using all of the available clinical data resources including lab test results in a repeatable and streamlined process throughout the 12 month HCC reference period.

 

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