Rebecca Adam, MBA
Andre Bliss, Ph.D., MBA
Shirley Doyle, MPH
Mike Eaton, PharmD
Jamie Galbreath, PhD, MPH, CHES
Kena Hahn, MHA
Nikki Hungate, MS, MHA
Dolores Karen Snyder, RN, MSN
Dr. Lesley Northrop
Ian Straayer, M.B.A.
Rebecca Adam, MBA
Rebecca Adam is the Stars Program Manager at CareFirst BlueCross BlueShield, serving Medicare Advantage members across the state of Maryland. CareFirst entered the Medicare Advantage space in 2021 so Becca has helped develop and drive the Stars strategy for new, growing plans. She is passionate about the CareFirst mission and focused on improving Member Experience for CareFirst members. Becca also received an MBA from the University of Maryland Smith School of Business.
Saeed founded Decision Point with the mission of improving health plan clinical, financial and operational performance through informed, data-driven predictions on strategic decisions. He has more than 25 years of health information technology experience, with a track record of developing innovative approaches to solve complex business problems. He has held key senior management positions at Eliza Corporation, Ingenix (currently Optum), IHCIS and ProVentive, where led high- performing teams focused creative uses of technology for practical problem-solving. Saeed is a graduate of The Johns Hopkins University with a BA in Economics.
Julie Billman is Vice President of Medicare at CareFirst BlueCross BlueShield
(CareFirst). Julie came to CareFirst to oversee the Medicare products including to
implement an organic member-focused Medicare Advantage plan. Her guidance
culminated in the launch of two Medicare Advantage with Prescription Drug (MAPD)
individual products that became effective in 2021 and a MAPD EGWP PPO product in
Julie has been working in the Medicare field for 29 years and began by helping Coventry Health Care file its first Medicare application and implement its Medicare Advantage program. CareFirst is not her first Blues experience; she served as a Director of Policy and Planning for Medicare at Capital BlueCross BlueShield. Most recently, Julie served as Senior Vice President of Operations and Performance at Gorman Health, overseeing a variety of projects for operational functions and implementations for Medicare Advantage plans.
Andre Bliss, Ph.D., MBA
Andre Bliss leads a group that develops and implements quality improvement initiatives aimed at measures involving Medicare STARs. A key role is coordinating with multiple teams on projects to improve and maintain UPMCs high STARs rating. Prior to this role, Andre was the Director of Business Intelligence and a member of the senior leadership team at Jordan Health in Rochester, NY. He has a Ph.D. from Niagara University in Leadership and Policy, an Advanced Certificate from the University of Rochester in Health Services Research and Policy, and an MBA from St. John Fisher University in Health Systems Management.
Simone A. Brooks is health care leader with a proven track record of developing and expanding
innovative solutions. She has over 15 years’ experience in wealth management, program development,
and corporate retail in regional and global organizations across multiple industries. In her current role as
Innovation Strategist at MVP Health Care, Simone facilitates consumer studies using qualitative research
as well as quantitative survey data. She advances the culture of innovation throughout the organization
to uphold customer-centricity.
Simone is passionate about driving health care equity and ensuring all populations receive fair health care, regardless of their ethnicity, income, gender, or otherwise. Prior to joining MVP, Simone was pivotal in driving partnerships between community-based organizations (CBOs), skilled nursing facilities, hospitals, and private practices to improve care for the Medicaid and uninsured populations. Additionally, she developed a certified training program for community health workers in collaboration with local community colleges and developed a value-based payment training program which taught executive leaders of almost two dozen local social care organizations.
Simone holds a Bachelor of Science in Economics, with a minor in Information Technology, from Rensselaer Polytechnic Institute. She also holds an Executive Master of Business Administration from University of Rochester’s Simon School of Business. She is a dual member of Toastmasters International, Inc. and is an active member of her church. Simone is married to her high school sweetheart and they have three children.
Luis has a Master’s degree in Economics and 10 years of experience in the Medicare Star Ratings Program. He previously worked as a Stars Director for the northeast region’s markets at Cigna and at MCS in Puerto Rico. During his tenure at these companies he helped all contracts improve at least half a Star in 1-2 years. In his free time Luis enjoys traveling, road trips, and cycling.
Sarah Chapman is the Senior Director, Digital Strategy at CareSource. She began her career in the early web chatrooms and has been deep in person-to-person interaction ever since. Sarah has managed consumer interaction and engagement on some of the world’s largest brands and is best known from her time behind the Charmin bear discussing iconic social media issues like the #MadPooper. In her current role, she blends the power of text, app, web, social and voice to help make a lasting difference in some of our most vulnerable populations and communities by encouraging people to engage with tools that improve their health and well-being.
Phil Collins is a seasoned professional with extensive experience in the managed care
industry. As the Senior Director of Quality at FarmboxRx, he plays a pivotal role in
overseeing performance analytics and collaborating with health plans to develop and
implement quality improvement strategies in programmatic design.
With a career spanning over 12 years, Phil has honed his expertise within MCO’s, including prominent names like Molina Healthcare and Atrio Health plan. During his tenure, he specialized in HEDIS measures, bringing in-depth knowledge and understanding of these essential quality metrics. He has actively participated in the chart review and data collection processes for Hybrid measures, ensuring accurate and comprehensive data analysis to support decision-making and performance evaluation.
A skilled analyst, Phil excels in producing reports that highlight current and projected HEDIS and CMS rates. These reports provide invaluable insights into the performance of health plans, enabling strategic decision-making to achieve higher HEDIS scores and Star Ratings.
Keslie joined Benelynk 4 years ago bringing over 25 years of comprehensive managed care and healthcare technology experience. Previously, Keslie spent 13 years as Vice President of Sales at Change Healthcare and its predecessor companies Altegra Health and Social Service Coordinators, helping plans improve risk-adjusted revenue and quality performance scores through social care programs including dual advocacy, Medicaid retention, and health education campaigns. Earlier in her career, Keslie led marketing for both commercial and Medicare plans, with a focus on provider risk-sharing payment models tied to quality and member surveys. Keslie's passion lies in working on strategies that put members at the center, are efficient and meaningful while ensuring her clients are provided with the services to drive accurate risk-adjusted and quality performance revenue.
In Keslie’s free time she volunteers at the local shelter and enjoys fishing.
Keslie holds a B.S. in Business Administration from Regis University in Denver, CO, and attended the MBA/Masters in Healthcare Administration program at Sacred Heart University in Fairfield, CT.
Shirley Doyle, MPH
As a Sr. Director in Sentara Government Programs, Shirley collaborates across Stars, Risk Adjustment,
Revenue/Financial Management, Clinical, Quality, and Population Health teams to identify and resolve
performance gaps to drive overall Medicare Advantage efficiency and outcomes.
Prior to joining Sentara, she held positions at Inovalon and Tricare with a concentration in health information technology development, Quality and Health Plan Performance Improvement, and Medical Economics. She holds advanced degrees in Biostatistics, Accounting, and Financial Management from the University of Oklahoma.
Mike Eaton, PharmD
Mike Eaton, PharmD started with SelectHealth in 2012. As the Director of Pharmacy Government
Programs, he is responsible Medicare, Medicaid, and FEHB lines of business. He ensures that all major
aspects of the Part D program are functioning and set up properly. This includes writing and updating
policies and procedures, taking the lead on any new guidance released from CMS to make certain it is
incorporated into daily processes, and working to make sure all programs and processes are in
compliance with CMS regulations. Dr. Eaton is also responsible for the clinical aspects of Part D
including formulary maintenance and Medication Therapy Management protocols. In addition, he
oversees the Medicaid and FEHB lines of business to ensure compliance and efficiency.
Dr. Eaton began his career in Medicare Part D in 2006 with RxAmerica (now CVS Caremark). He was involved initially with prior authorizations and member facing functions. However, in 2007 he moved to the Medicare Services department where he began working directly with clients and CMS on Medicare Part D. Dr. Eaton was the point of contact for RxAmerica’s Medication Therapy Management program and had the charge of primary contact for all formulary concerns and questions. He has worked in Medicare Part D since inception in 2006.
Dr. Eaton has worked in pharmacy for over 15 years earning his Doctor of Pharmacy at Idaho State University in 2006. He is an active member of the Academy of Managed Care Pharmacy.
Josh has an MBA in Marketing and a Masters in Health Communication. This is his tenth year working in Star Ratings; he spent the first eight at the perennially high-performing Martin's Point Health Care and in 2021 joined rapidly-growing Devoted Health where he focuses on operational stars measures and programmatic changes.
Over the last nine years Josh has had a hand in ten 5 star contracts, most recently for Devoted's Ohio HMO contract, which earned 5 stars in its first year of eligibility.
Josh lives in Portland, Maine with his wife, kiddo, and two spoiled pandemic cats.
Allie El-Tawil has spent that past 7 years in the healthcare industry focused on quality improvement for the Medicare Advantage population. Allie’s true passion for making healthcare easy and accessible to the aging population brought her to her current role as the Stars Business Analyst for Blue Cross Blue Shield of Arizona, the state’s largest locally owned insurer. In this role Allie focuses on improving the member experience while project managing multiple quality improvement initiatives throughout the year.
Allie earned a Bachelor of Science degree in Nutrition from Arizona State University, and a Master of Public Health degree from the University of Arizona. Allie is also a member of the Arizona Public Health Association.
Jamie Galbreath, PhD, MPH, CHES
Jamie Galbreath is the Quality Improvement Associate Director for UCare where she provides oversight and manages the HEDIS® chart abstraction team, NCQA Accreditation (both Health Plan and Health Equity Accreditation), Star Ratings (Medicare, Marketplace and Medicaid), and regulatory quality improvement projects. Additionally, she leads clinical and public health performance improvement projects designed to improve member health outcomes.
Jamie has received her doctorate in Public Health with a specialization in Community Health Promotion and Education from Walden University. She also has her Master’s degree in Public Health from Walden University and Bachelors of Science degree in Community Health Education from the University of Minnesota Duluth. She has completed a certificate program from St. Thomas University in Health Care Management. Further, she is a Certified Health Education Specialist and a member of the Minnesota Society for Public Health Education and the Minnesota Public Health Association. Jamie has almost ten years of health care industry work experience and 18 years of experience working in the mental health and substance use field.
Brendan Generelli is the Senior Program Manager for Stars and Quality at Blue Cross Blue Shield of Rhode Island. In his 11 years at BCBSRI, Brendan has had a variety of roles ranging from Customer Service to Operations to Strategy, but has always maintained focus on member and provider experience. Under his management of the 5 Star program, BCBSRI became the first and only plan available to all Rhode Islanders to achieve a 5 Star rating and now has repeated that rating in back to back years.
Sumit Gupta is a Lead Data Scientist at Aetna CVS Health, using Data Science and analytics to empower stories that drive decisions, chart out member experience in each of the STARS domains, and utilize Machine Learning Algorithms and Deep Learning/ Language Processing to provide Patient focused equitable health. Prior to his current role, Sumit served as VP of data science at Havas Health leading engagements across Payers, Hospitals, and Member experience. He is known for painting the big picture for all stakeholders (business, operations, and technology) – utilizing his love for delivering data-driven analysis. He is passionate about equitable access and purging challenges to healthcare. Sumit was recognized by Morgan Stanley New York with Director’s Award for leadership and cross-collaboration. He has also been invited to judge Hackathons to inspire change at hubs such as Black Enterprise NY. He lives in New York and has a Master’s with Honors from New York University.
Kena Hahn, MHA
Kena Hahn is the Director of Medicare Stars and Outpatient Care Coordination for Health Alliance, a
vertically integrated health system with Carle that provides coverage to Illinois, Indiana, Iowa, and parts
of Washington state. She has 5 years of experience in star ratings including value based contracting,
supplemental benefits design, vendor management and collaborates with other population health
teams to drive improvement. Prior to working in the health plan industry, Kena served in a variety of
roles in ambulatory operations with a focus on process improvement and overall patient experience.
She brings over 19 years of experience in the healthcare field with a focus on Star ratings,
patient/member experience and process improvement.
In her current role, Kena has responsibility for creating and implementing an overall strategy to improve Star Ratings for Health Alliance’s Medicare Advantage products as well as oversight for all Outpatient Care Coordination teams and the population health digital strategy at the health plan.
In addition to her Bachelor of Science degrees in Biology and Marketing, Kena also has her Master’s in Health Administration degree. The ultimate vision she has for the Stars program is to utilize predictive analytics in conjunction with collaboration from the entire health plan organization and provider partners to reach and sustain a five star rating for our Medicare Advantage products.
Nikki Hungate, MS, MHA
Nikki Hungate, a long-time resident of the Western New York region, currently serves as the Senior Leader of Medicare & Government Programs Product Strategy at MVP Health Care. Utilizing the 17 years of experience in the health plan industry she is accountable for leading a team of product innovators that create and deliver a suite of high-quality government products that address the needs of the community in a customer-centric fashion, placing emphasis on those populations that are most vulnerable and underserved.
Nikki holds a Bachelor and Master of Science in Health Administration from Roberts Wesleyan College. She is currently a doctoral candidate at the University of Charleston in the Executive Leadership program. Nikki has a passion for sharing knowledge, and also serves as an adjunct professor in the health sciences degree programs at Monroe Community College and Roberts Wesleyan College. In her free time, she volunteers as fundraising coordinator for the local Vietnam Veterans of America chapter in Rochester, NY.
Katie is the Vice President of Clinical, Quality and Engagement at Convey Health Solutions. In her role, Katie is responsible for the strategic design, execution and support of the Rewards and Incentives program, and in partnership with the business development team, build additional clinical and quality programs for future client needs. She will serve as the organization’s subject matter expert in the area of clinical quality and CMS Medicare Stars program components, including increased focus on member experience and engagement.
Katie has over 15 years of experience in the healthcare industry, with the past 12 years focused on Medicare Advantage working in both the health plan, for plans such as Humana, Aetna, and Johns Hopkins Healthcare, and the value based provider space. Her expertise has been centered around strategic design and execution of clinical quality initiatives, coding and documentation education, risk adjustment and HEDIS® operations, member experience and retention, data integrity, and process improvement.
Prior to being in healthcare, she was in the hospitality industry with an extensive background in operations management, human resources leadership and customer satisfaction. Her passion has always been centered around a people first mentality and that has continued throughout both her professional and personal life.
Katie has a master’s degree in business administration with a focus on strategic leadership from Amberton University and she is a certified professional coder (CPC).
Devon Lor, MSN, RN is a Registered Nurse specialized in quality improvement and accreditation. She has over 10 years of healthcare quality experience in both health systems and health plans, and over 20 years in healthcare. These efforts include Medicare Star ratings, practitioner performance, member experience, as well as improving HEDIS clinical outcomes through evidence based interventions. Additional oversight includes accreditation, clinical appeals and grievances, condition management, and peer review. She has also had the opportunity to impact quality in education and nursing as an undergraduate assistant professor of nursing.
Devon is the Clinical Manager of the Quality Health Integration department at Network Health Plan in Wisconsin. Her goal is to provide high quality care while lowering costs and providing a great member experience.
Nate has Master’s degrees in Experimental Psychology and Cognitive Neuroscience/Aging from the College of William & Mary and Washington University in St. Louis. He is a Senior Consultant for Rex Wallace Consulting, where he specializes in helping health plans achieve their Quality Improvement performance goals through data-driven and equity-focused strategies. He began his career spending over a decade in academic research, specializing in the neural bases of schizophrenia, brain aging, Alzheimer’s Disease and human cognition. Nate has been published in the Journal of Clinical and Experimental Neuropsychology and Frontiers in Integrative Neuroscience, and regularly presented research findings at industry conferences. Nate shifted into a managed care career at Centene Corporation, where he began in Stars providing direct strategy and measurement assistance to health plans. During his time, he helped a contract at risk for a second strike move from 2.5 to 3.5, and helped a D-SNP contract hit 4 Stars for the first time through intense performance management, initiative development, data analysis and barrier resolution. He then built and led an Enterprise Quality Analytics and Data Science team specializing in data strategy, QI initiative outcomes studies, member-level predictive modeling of experience and clinical outcomes, and performance forecasting. Additionally, he was the key analytics lead in the development of an award-winning QI Health Equity Analysis Model, incorporating stratified reporting and advanced statistical modeling to help health plans identify health disparities and drivers in HEDIS® and CAHPS. He went on to lead Ratings Improvement Strategy, National Vendor Management, and Quality RFP/Business Development for Medicare, Medicaid, and Marketplace lines of business.
Dolores Karen Snyder, RN, MSN
Dolores (Karen) Snyder is the Director for Medicare Stars at Sentara Health Plans. Her expertise is in
Quality and Medicare Stars Improvement. Combining her clinical background with a working knowledge
of the CMS Medicare regulations and Star Rating measurement and methodology, she has led
collaborative improvement in ratings resulting in improved clinical outcomes and addition of millions of
dollars to the organization’s bottom line.
In her earlier career, Karen gained quality and leadership experience in Medicare Advantage, Commercial Insurance, and Accountable Care Organizations as part of a fully integrated system in Northeast Tennessee. Prior to that, she was Director of Organizational Development for an 11-hospital system with management, administrative, and education duties. Karen has over 35 years of experience in multiple clinical and administrative settings, always maintaining a strong focus on quality, performance, and team building. Karen holds a master’s degree in nursing, a bachelor’s in nursing, and a bachelor’s in health education all from East Tennessee State University.
Based in Brentwood, Tennessee, Dave is a nationally recognized thought leader and change agent, with over 20 years of experience in healthcare commercial and government programs operations, data science, clinical outcomes, revenue and quality. On the health tech side, Dave has worked at multiple SaaS organizations where he has led sales/business development/client management, informatics, operations for quality (HEDIS, STARS) and data completeness (Risk Adjustment, EDI submission, etc.) and professional services.
Elena has 9 years of experience working with MCOs and implementing quality improvement initiatives. In her current role, she monitors and studies multiple years’ worth of Stars measure trends, manages numerous quality improvement workgroups, and elaborates on changes to the plan’s Stars performance projections to senior leadership. While helping maintain the plan’s high performance, she communicates and collaborates with all teams in Senior Care including Member Experience, Provider Outreach, Supplemental Data Collection, and many more. She recently completed the certification to be a Project Management Professional (PMP) and is constantly working on improving her project management skills.
She received her Bachelor of Science and Master of Science Degrees in Health and Human Sciences at the University of Memphis. She recently moved to Chattanooga, TN where she resides with her husband (Lane), two-year old daughter (Cecilia), and two dachshunds. In her spare time, she enjoys cooking, being outdoors, and traveling.
She has a Master’s degree in Public Administration and Bachelor’s degrees in Political Science and Psychology. She spent the first half of her career in the legal field focused on civil litigation at the largest law firm in Rochester – Harter Secrest & Emery LLP - where she became skilled in the interpretation of federal and state laws before entering managed care.
Before joining RWC, over the past 10 years Jessica worked in managed care for MVP Health Care and Centene Corporation in executive leadership positions within Quality Improvement. She has extensive experience working with the Medicare, Medicaid, Marketplace, Commercial and the Basic Health Program populations. At MVP Health Care she led quality improvement strategy and program operations for all lines of business, compliance, and NCQA health plan accreditation, achieving 4.5 Stars on all Medicare contracts for multiple years in a row.
At Centene Jessica was responsible for enterprise-wide market performance, governance, and execution for all lines of business. She worked with each health plan on contract and measure-level goal setting, performance improvement strategy and execution, member and provider engagement, and performance management when goals and KPIs were at risk of not achieving contract and enterprise 4+ Star performance.
In 2014, she also started as an adjunct professor at SUNY Brockport’s Public Administration Master’s Program teaching classes on healthcare focusing on government programs (Medicare, Medicaid), global health care systems and the Patient Protection and the Affordable Care Act.
Dr. Lesley Northrop
Dr. Lesley Northrop currently serves as Chief Diagnostics Officer for Everly Health, the digital health company at the forefront of the virtual diagnostics-driven care industry. Prior to Everly Health, Lesley was the Chief Scientific Officer at Aspira Women’s Health for over three years. She was responsible for the company’s innovation pipeline, from ideation in R&D to clinical diagnostic validation and product launches, developing tests specific to detecting the risk of women’s oncological diseases.
Lesley has worked in molecular genetics for 20 years in academic research labs, private and large hospital clinical practices, as well as genetic commercial companies predominantly focused on female reproductive health. She obtained her American Board of Medical Genetics and Genomics fellowship in clinical molecular genetics certification at Columbia University Medical Center and a Ph.D. in Neuroendocrinology and Reproduction from Boston University. She has since published several peer-reviewed articles and book chapters, and presented at prestigious scientific meetings.
Sheehan is an experienced government programs subject matter expert with more than 15 years of industry experience ranging from long-term care and compound pharmacy management to health plan quality and operations, most recently leading Medicare 5-Star Quality initiatives at Priority Health. She is tasked with enhancing mPulse’s support of government plans through technology, relationships, and subject matter expertise.
Melissa Smith is the Chief Consulting Officer at Healthmine, bringing over 25 years of experience in Star Ratings, strategy, sales, and marketing for health plans, providers, pharmacy benefit managers, and industry vendors. Melissa has extensive experience developing strategic and tactical solutions to meet client needs and a strong background of building productive partnerships across internal teams and with external vendors to improve performance on clinical, medication, patient survey, and administrative quality measures.
Most recently, Melissa was Executive Vice President, Consulting and Professional Services, at Healthmine and before that, Senior Vice President of Sales, Marketing, Strategy and Stars at Gorman Health Group. She is a well-known thought leader and healthcare strategist with proven success developing enterprise-wide solutions to improve Star Ratings, quality performance, health outcomes, and the member experience. Melissa’s team helps clients improve performance within quality ratings systems, evaluate market dynamics and opportunities, optimize distribution channels, and support our clients’ strategic planning needs.
Prior to Gorman Health Group, Melissa served in a leadership capacity at Cigna-HealthSpring. Before working in Medicare Advantage and quality ratings systems, Melissa was an Associate Director at Vanderbilt University Medical Center. Melissa received her degree from Purdue University and began her career at KPMG, LLP. Melissa’s unique background of business process, regulatory compliance, and healthcare quality offers our clients unique access to healthcare strategy, quality performance, revenue optimization, and more.
Ian Straayer, M.B.A.
Ian Straayer is an experienced healthcare leader with a background of Quality Improvement in Outpatient, Inpatient and Health Plan settings. Ian is currently the manager of Quality Improvement at Priority Health in Grand Rapids Michigan. He has over 10 years’ experience in healthcare and has a proven track record of impacting Medicare Stars, leading efforts to earn Priority Health their first ever 5-star rating. Ian is passionate about driving quality efforts to improve the members care and experience, while also creating a strong relationship with the network of physicians he works with.
In his personal life, Mick Twomey is a husband and father of five who loves to travel and explore new things. In his role as CEO of Hyperlift, he thrives on combining thought leadership and data visualization to drive Star rating improvement for Hyperlift clients. He enjoys collaborating with clients and partners to drive continuous innovation in the solutions that Hyperlift offers.
Hyperlift was founded in 2017 with the expressed goal of changing how plans looked at Stars optimization and creating a repeatable model that could be ubiquitous across the industry. Through an action-oriented Stars Performance Scorecard, leading Stars experts, and a year-round technology-enabled approach, Hyperlift helps plans of all sizes and performance levels supercharge their Stars performance management.
Rex is a Quality Improvement expert who helps health plans achieve higher quality, operational excellence, and more meaningful engagement with all stakeholders. Prior to founding RWC, Rex was a health plan leader accountable for Star Ratings, Medicare operations, and the member experience for a multi-state, 100,000+ member plan. He led the turnaround of all nine contracts from 3.5 Stars to either 4 or 4.5 Stars through enhanced data-enabled engagement with the organization, its members, and its providers. Rex has 30 years of industry experience leading functions such as member retention, market analysis, customer service, and operational improvement.
Daniel Weaver is the Executive Vice President of Product Operations and Stars Strategy at NationsBenefits, with nearly 25 years of experience in Operations and Star Ratings strategy. Daniel most recently served as VP, Government Quality Programs at Gateway Health, where he led the company to its first 4.5 Star Rating and an improved Medicaid NCQA Accreditation rating. In his career, Dan has overseen the development and implementation of many analytics-driven and customer-focused programs, and he advocates for continuous improvement and operational excellence philosophies for sustained success. In his new role with NationsBenefits, Daniel will drive strategic planning, facilitate execution, oversee product financial performance, manage operational performance across all products, and ensure strong internal controls are in place to enable efficiency in the growth of the business. Daniel will also help drive prospective and retrospective investigation into quality outcomes and customer engagement across the company’s distinct benefit management programs while continuing to innovate new solutions for health plan partners focused on growth and strong quality performance.