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.  

 

 

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, 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

 

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