Kevin Mowll

Kevin Mowll

Executive Director of RISE

Chair of the Executive Committee of the Board

Chair of the RISE Association Advisory Board 

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.

Prior to joining RISE, Kevin was Vice President for Senior Products with the Tufts Health Plan in Boston, responsible for sales, marketing, product development, business performance and strategic planning for the senior products business unit. Kevin has a diverse background and an expertise in Medicare health plans. His expertise focuses on:

  • Consumer-driven product design and value segmentation
  • Growth-oriented product development and implementation
  • Market-based sales team development and execution
  • Strategic and business planning
  • Financial performance management and business plan execution
  • Optimization of sales channel distribution models

Kevin was previously Vice President for Senior Products with the Tufts Health Plan in Boston. He was responsible for sales, marketing, product development, business performance and strategic planning for the strategic business unit. Kevin has a diverse background and an expertise in Medicare health plans.

Earlier, Kevin was the Vice President, Medicare Products, for Capital District Physicians’ Health Plan in Albany, New York, when the Medicare Advantage membership grew from 12,000 to 30,000, including both individual and group retiree business.

Originally, from Southern California, Kevin worked for PacifiCare Health Systems and CIGNA Healthplans. At PacifiCare (which was acquired in 2005 by United Healthcare) Kevin led the development and launch of multiple products and conducted service area expansions for health plans, led a multi-functional franchise team for start-up Medicare health plans, and ran provider network management.

A speaker at national conferences on Medicare Advantage business themes, Kevin has also chaired several events. He founded a professional social networking group on LinkedIn called Medicare Advantage Healthplan Colleagues, focused on educating and sharing best practices by developing a virtual community with shared interests and concerns. The group attracted over 11,000 members from across the country.

Kevin is married and has three adult children, and now lives in Santa Barbara, California.

Tags: Kevin Mowll, RISE, Board

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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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Protecting Risk Adjusted Revenue in Small and Mid-Tier Health Plans

If you’ve ever heard the phrase “working without a net” then you’ve heard a phrase that accurately describes the status of risk-adjusted revenue for small and mid-tier health plans. And when you’re working without that net, you’ve got to secure every dollar possible. Easier said than done given the inherent complexity of the encounter management lifecycle and the constant changes and updates that continue to vex managed care plans of all types. What’s required is a simple, best practice approach to encounter data management that is built to serve the needs of health plans regardless of their size. Implementing a best practice approach for small and mid-tier managed care health plans to protect and grow risk-adjusted revenue begins by joining Edifecs for this impactful, actionable webinar.


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