2021 All-Star Speakers

EnlivenHealth™

Irfan Ali, MRPharmS

Senior Director, Network Performance
Formerly, Director of Medicare Advantage Operations, CMS

Michael S. Adelberg

Principal, Lead, Healthcare Strategy Practice, Faegre Drinker Consulting
Decision Point Healthcare Solutions

Saeed Aminzadeh

Chief Executive Officer
GHG Advisors

Jessica Assefa

Senior Director of Star Ratings
HealthScape

Cary Badger

Principal
Excellus Health Plan

Danielle Banaszak, RPh

Quality Improvement Clinical Pharmacist
RxAnte

Chris Bane

VP of Business Development and Marketing
SelectHealth

Kim Barrus

Stars & Quality Performance Manager
Martin’s Point Health Care

Josh Edwards

Medicare Stars Programs Manager
Capital District Physicians’ Health Plan

Michael Farina

Director of Health Care Quality
Geisinger

David Griffith

Manager Pharmacy Operations
Health Alliance

Kena Hahn

Director Medicare Stars & Health Improvement
HealthMine

Kent Holdcroft

Executive Vice President of Growth
Johns Hopkins HealthCare LLC

Tejaswita Karve, Ph.D.

Director of Quality Improvement
Magellan Rx Management

Sagar S. Makanji, PharmD

Vice President, Clinical Strategy & Programs
Commonwealth Care Alliance

Derek McFerran

Senior Director of Pharmacy
Partners Health Plan

Diane Marrone

Chief of Care Coordination
Partners Health Plan

Premila Mary Kumar

Chief of Quality Initiatives
Wakely

Tim Murray, FSA, MAAA

Director & Senior Consulting Actuary
HealthMine

Cynthia Pawley-Martin

Consultant
Tandigm Health

Jason B. Ruda, MS, CPXP

Experience Director
GHG Advisors

John Selby

Senior Vice President
HealthMine

Melissa Smith

Executive Vice President, Consulting and Professional Services
Doctor On Demand

Dr. Prentiss Taylor

VP, Medical Affairs
Gateway Health Plan

Dan Weaver

Vice President, Stars Quality
Novillus LLC

Brent Zenobia, PhD.

Chief Strategist
Speakers Biographies


Irfan Ali, MRPharmS

Senior Director, Network Performance
EnlivenHealth™

Irfan leads the Network Performance and Clinical organizations at EnlivenHealth™, developing strategies that help to influence, communicate and impact outcomes for our health plan and retail pharmacy customers. Since joining Omnicell in 2007, Irfan has held several leadership positions focused on building medication adherence solutions within the UK, European and most recently global pharmacy markets. Prior to joining Omnicell, Irfan worked at a number of UK retail pharmacy companies, creating operational models to improve the delivery of medication adherence solutions. In addition, he spent five years launching and operating consulting services for the UK and European healthcare market. Irfan is a qualified pharmacist, holding a B.Sc. in Pharmacy from University of Portsmouth, UK.

Michael S. Adelberg

Principal, Lead, Healthcare Strategy Practice,
Faegre Drinker Consulting
Formerly, Director of Medicare Advantage Operations,
CMS

Mike Adelberg leads the Healthcare Strategy Practice at Faegre Baker Daniels Consulting. He has 25 years progressive healthcare industry and government experience in Medicare, Medicaid and commercial health insurance. Mike spent fifteen years at the Centers for Medicare and Medicaid Services (CMS), including concurrently serving as the director of the Insurance Programs Group and the acting director of the Exchange Policy and Operations Group in the Center for Consumer Information and Insurance Oversight (CCIIO) where he oversaw most of the functions of the federally-run health insurance exchanges; serving as the Director of Medicare Advantage Operations, where he supervised the annual cycle for review and award of Medicare Advantage bids and contracts, developed CMS’s operational policy, and led the monitoring of Medicare Advantage contractors; and serving as the associate regional administrator for Medicare operations (Chicago Region) and the director of education and assistance programs. Mike gained private sector experience as vice president of product development and government affairs for the Universal American Corporation, a multi-state health insurer which operated Medicare Advantage and Medicaid health plans (subsequently acquired by Wellcare).

He has also led or co-led health policy studies published in Health Affairs and The American Journal of Managed Care. Mike speaks and publishes frequently on healthcare topics and has served on numerous advisory committees. He’s been quoted in the Washington Post, New York Times, Modern Healthcare, NPR, and other leading media. In his spare time, Mike is an author. He’s written three novels, a history book, several scholarly journal articles, and over sixty book reviews.

Saeed Aminzadeh

Chief Executive Officer
Decision Point Healthcare Solutions

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.

Jessica Assefa

Senior Director of Star Ratings
GHG Advisors

Jessica Assefa is the Senior Director of Star Ratings at GHG Advisors. In this role, she provides expertise to health plans regarding Quality Improvement (QI), the Centers for Medicare & Medicaid (CMS) Services Quality Bonus Programs (QBP) and Star Ratings. Jessica is an accomplished nurse and brings clients over twenty years of diverse experience and achievement in managed care, quality improvement and clinical care in addition to strong Medicare, Medicaid, Marketplace and Dual-Special Needs Plans (D-SNP) programs knowledge.

Cary Badger

Principal
HealthScape

Cary Badger has over 25 years of healthcare industry experience with deep Medicare Advantage expertise, health plan operations, product development, marketing and sales, planning and business development. Cary has assisted HealthScape clients with market expansion and acquisition strategies, strategic partnerships, build/buy/outsourcing, new market and product entry and overall MA and commercial plan performance improvement.

Danielle Banaszak, RPh

Quality Improvement Clinical Pharmacist
Excellus Health Plan

Danielle is the Quality Improvement Clinical Pharmacist at Excellus Health Plan. She is a registered pharmacist who received her Bachelor of Science Pharmacy degree from University at Buffalo School of Pharmacy. Danielle also has completed the advanced training in medication therapy management and immunizations from the American Pharmacists Association (APhA). In her current role, Danielle is part of a team responsible for identification, development, and implementation of quality improvement initiatives to maintain and improve health plan quality measures, specifically Medicare Star Ratings. She has helped the company’s PPO and HMO contracts reach 4.5 stars and the PDP contract maintain a 5-star rating for the past 5 years. She has 30 years’ experience working in different areas of the pharmacy world and brings a unique perspective to overall healthcare for our members.

Chris Bane

VP of Business Development and Marketing
RxAnte

As VP of Business Development and Marketing at RxAnte, Chris focuses on addressing pharmacy aspects of the population health needs shared by managed care organizations and healthcare providers. Prior to RxAnte, Chris worked at UPMC Enterprises, the venture and innovation arm of the University of Pittsburgh Medical Center, where he evaluated and recommended investments in early stage healthcare companies. Chris previously led the design and delivery of transformative, enterprise healthcare solutions for government-sponsored health plans at Deloitte Consulting.

Kim Barrus

Stars & Quality Performance Manager
SelectHealth

Kim is a registered nurse who received her Bachelor of Science in Computer Information Systems from Columbia College of Missouri, and her Bachelor of Science in Nursing and Master of Science in Nursing from Western Governors University. She also maintains a Project Management Professional (PMP) certification from the Project Management Institute (PMI).

Kim Barrus began her career with SelectHealth 26 years ago and has worked in a variety of capacities in that time. Her current focus has been on the development and management of the SelectHealth Advanced Primary Care (a.k.a., patient centered medical home) program and CMS Stars.

Josh Edwards

Medicare Stars Programs Manager
Martin’s Point Health Care

Josh is the Medicare Stars Programs Manager at Martin’s Point Health Care in Portland, Maine. His company’s PPO contract reached 5-stars for the first time in 2020 and his HMO contract has achieved 5-stars five times since 2010, most recently in 2019.
In his role Josh is responsible for identification, development, and implementation of quality improvement initiatives to maintain and improve health plan quality measures, specifically Medicare Star Ratings.
Prior to his health care career Josh worked for several branches of the Walt Disney Company, including many years in production management at Walt Disney Animation Studios in Burbank, Calif. Josh has an MBA in Marketing from the American University in Dubai and a Master of Science in Health Communication from Boston University. He lives in Portland with his wife and eight-year-old daughter.

Michael Farina

Director of Health Care Quality
Capital District Physicians’ Health Plan

Michael A. Farina, R Ph., MBA joined CDPHP in 2019 and is currently the Director of Health Care Quality In this role, he has primary responsibility for the HEDIS hybrid abstraction process, day to day operational aspects of the quality department. Michael earned a Bachelor of Science degree from Albany College of Pharmacy and a masters of Business Administration from Union College. Michael is a registered pharmacist in New York State.

David Griffith

Manager Pharmacy Operations
Geisinger

2007 Graduate of Coastal Carolina University with a B.S. in Applied Mathematics and a minor in Statistics. Joined Geisinger in February 2008 and has progressed from an entry level analyst in Clinical Informatics to Manager of Pharmacy Operations. Currently responsible for oversight of the Pharmacy STAR program, Pharmacy HEDIS initiatives, Drug Utilization Review program, and the configuration of the electronic prior authorization system for both pharmacy and medical benefit drug reviews.

Kena Hahn

Director Medicare Stars & Health Improvement
Health Alliance

Kena Hahn is the Director of the Medicare Star Ratings program for Health Alliance, a vertically integrated health system with Carle that provides coverage to Illinois, Indiana, Iowa, and parts of Washington state. Prior to this Kena served as a Patient Experience Advisor at Carle where she was responsible for the education and improvement efforts with all staff and physicians to improve CG CAHPS scores for Carle’s ambulatory clinics. She brings over 14 years of experience in the healthcare field with focus on patient/member experience and process improvement.

In her current roll, Kena has responsibility for the facilitation and coordination of the Star Ratings program for Health Alliance’s Medicare Advantage products. In 2016 the organization was at a 4.5 Star Rating and they are currently working towards becoming a 5 Star 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 5 star Medicare Advantage products.

Kent Holdcroft

Executive Vice President of Growth
HealthMine

Kent Holdcroft is the Executive Vice President of Growth at HealthMine, bringing over 15 years of operational, consulting, and business development experience with healthcare technology vendors to our team. Prior to HealthMine, Kent was Executive Vice President at AdhereHealth where he installed the teams and processes that led to record growth and innovation in product strategy. Before that, Kent had multiple successes with AIM Healthcare (now a part of Optum, a United Health Group, Inc. company), rising to National Director as it expanded into new markets. Kent received his Bachelor’s degree in Psychology from Miami University and Master’s in Counseling from the University of Toledo. In his free time, Kent serves on the Board of Directors at BrightStone, Inc., as well as with the Tennessee Crohn’s & Colitis Foundation.

Tejaswita Karve, Ph.D.

Director of Quality Improvement
Johns Hopkins HealthCare LLC

Sagar S. Makanji, PharmD

Vice President, Clinical Strategy & Programs
Magellan Rx Management

Sagar Makanji is Vice President of Clinical Strategy & Programs at MRx, where he leads the design, implementation, and management of clinical programs for health plan clients. His primary focus is quality improvement programs that enhance the level of care for several disease states including diabetes, hypertension, hyperlipidemia, rheumatoid arthritis, osteoporosis, and asthma with a key emphasis on CMS Star Ratings and HEDIS quality measures. Sagar is also responsible for developing innovative strategies to maximize patient engagement and outcomes for various population segments including commercial, Medicaid, and dual-eligibles. Part of this role also includes developing strategic partnerships to improve clinical program offerings in the marketplace for all lines of business. Sagar is currently a registered pharmacist in both Rhode Island and Connecticut and has additional advanced training in medication therapy management and immunizations from the American Pharmacists Association (APhA).

Derek McFerran

Senior Director of Pharmacy
Commonwealth Care Alliance

Dr. Derek McFerran is the Senior Director of Pharmacy at Commonwealth Care Alliance (CCA). At CCA, he is responsible for the oversight, design, and strategic vision of a robust, clinically informed, efficiently executed pharmacy program. This includes pharmacy operations, clinical pharmacy, pharmacy-based quality measures, and state/federal regulatory pharmacy compliance.

Derek graduated from the University of Connecticut Pharmacy School with a Pharm D. He is board-certified in geriatrics, a fellow of the Academy Society of Consultant Pharmacists, AHIP certified health insurance executive and fellow, and participates on the editorial review board of the Consultant Pharmacist publication.

Diane Marrone

Chief of Care Coordination
Partners Health Plan

Diane joined PHP in 2014 as a director of Care Coordination and has served as Chief of Care Coordination since March 2019. Prior to joining the PHP team, she held varied positions within the non-profit sector serving individuals with I/DD from birth through adulthood. Diane has vast experience in promoting the use of a multi-disciplinary, person-centered approach to ensure the provision of high-quality services to individuals with I/DD and their families. She obtained her Master of Social Work degree from Fordham University and is a Licensed Clinical Social Worker and Certified School Social Worker. She also holds an Executive Education Certificate in Non-Profit Leadership from Fordham University.

Premila Mary Kumar

Chief of Quality Initiatives
Partners Health Plan

Premila Mary Kumar is the Chief of Quality Initiatives at Partners Health Plan and Care Design New York. Premila has over 20+ years of experience working within the Managed Care environment for such companies as CIGNA Healthcare, Horizon Blue Cross Blue Shield of NJ, and CenterLight Healthcare. Prior to coming to PHP, Premila’s most recent employment experience was as Vice President of Population Health Management and Quality Assurance Performance Improvement at GuildNet. Prior to her position at GuildNet, Premila was the Assistant Vice President for Medical Management at CenterLight Healthcare, New York. Premila is known for implementing innovative initiatives to improve quality measures, HEDIS rates, reduce ER visits, hospital admissions and overall cost for consumer and employer. She is also known for developing disease management programs at Horizon Blue Cross Blue Shield of NJ and CIGNA Healthcare Tristate region.

Premila has been a speaker at several national professional conferences and has contributed her expertise to develop award-winning health education products for Managed Care plans. She has been a guest faculty speaker at Rutgers School of Pharmacy, served on the editorial board for Population Health Insider magazine and was appointed as a resource member for the legislated New Jersey Obesity Prevention Task Force. She most recently participated and was a member of the Value-Based Payment NYS MLTC Clinical Advisory Group. She earned her medical degree from Stanley Medical College, Madras University, India as well as a professional designation from Academy of Healthcare Management.

Tim Murray, FSA, MAAA

Director & Senior Consulting Actuary
Wakely

Tim Murray, FSA, MAAA is a Director & Senior Consulting Actuary. He leads Wakely's New York office. He joined the firm in 2017 and has worked as a health actuary for seventeen years. Over the course of his career, Tim has consulted to and served health plans on matters of pricing strategy, product design, forecasting, financial reporting, and Merger & Acquisition due diligence. Prior to joining Wakely, Tim spent 4.5 years leading the actuarial forecasting and pricing functions of a health plan, encompassing a wide array of traditional (e.g. Medicare pricing, M&A due diligence) and less traditional (e.g. payment policy lobbying) project work. Tim also spent 2 years in an equity research role covering publicly traded managed care and health care facility stocks, providing investment/industry guidance to institutional investors.

Tim earned a B.S. in Mathematics from the University of Notre Dame. He a Fellow of the Society of Actuaries and a member of the American Academy of Actuaries.

Cynthia Pawley-Martin

Consultant
HealthMine

Cynthia Pawley-Martin brings a wealth of expertise from her long tenured career as a healthcare quality improvement professional, where she has provided expertise to health plans and provider practices in a wide range of areas including Quality Improvement, the Centers for Medicare & Medicaid Services Quality Bonus Programs, Star Ratings, Quality Rating System (QRS), and Patient Centered Medical Home (PCMH). Cynthia is a Registered Nurse (RN) certified in Healthcare Quality with more than twenty years of experience in the healthcare industry. Her areas of expertise include CMS regulatory requirements (Quality/Star Ratings/Physician Quality Reporting System (PQRS), HEDIS®, CAHPS, HOS, Models of Care (MOCs), and providing support for Patient-Centered Medical Home (PCMH) and PQRS.

Cynthia has consulted with dozens of Medicare Advantage plans with their Star Ratings programs and comes with a solid record of success leading and supporting Quality Improvement programs across healthcare delivery systems, including health plans and large physician practices. Her leadership skills allow her to effectively communicate across all organizational levels and enables those teams to reach consensus among diverse stakeholders to deliver better services for the healthcare clients.

Cynthia has not only guided plans in CMS quality program assessment, implementation, organizational design, and MOC development. She has also supported provider groups in obtaining and maintaining PCMH recognition.

Prior to her consultant roles, Cynthia served as Director of Star Ratings for a leading organization and has held numerous positions in Quality and managing HEDIS® for multiple products in the managed care arena.

Jason B. Ruda, MS, CPXP

Experience Director
Tandigm Health

An accomplished healthcare leader, Jason has vast experience in medical group management, operational and financial performance improvement, leadership development, and workforce engagement. In his current role as leader of the CAHPS Coaching Program at Horizon BCBS, Jason is accountable for designing and delivering on the overall CAHPS improvement strategy through workforce development and provider engagement.

Prior to joining Tandigm Health, Jason worked in world-class organizations such as Horizon Blue Cross Blue Shield, Studer Group, Baird Group, Mount Sinai Medical Center, Weill Cornell Medical College, and Guthrie Clinic. Apart from his daily activities, Jason is also the Founder and Executive Director of The Kindness For Karen Foundation; a not-for-profit organization that offers programs and services to support women and their families affected by lung cancer in underserved communities.

Throughout his career, Jason has consistently institutionalized a culture of service excellence, quality and ownership in his practices. His accomplishments come by hardwiring systems of accountability for leaders, physicians, and employees. This has proven successful in engaging these groups to own their part in achieving excellent patient experience and clinical outcomes.

John Selby

Senior Vice President
GHG Advisors

John A. Selby is a Vice President at GHG, responsible for developing and executing growth strategies for GHG and its clients. In this role, John collaborates with other members of the GHG leadership team and across the Convey Family of Companies to help clients improve financial, clinical, and operational performance while generating enrollment growth in Government and State Sponsored Programs (Medicare, Medicaid, and ACA).

Melissa Smith

Executive Vice President, Consulting and Professional Services
HealthMine

Melissa Smith is the Executive Vice President of Consulting and Professional Services 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 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.

Dr. Prentiss Taylor

VP, Medical Affairs
Doctor On Demand

Prentiss Taylor is the VP of Medical Affairs at Doctor On Demand, the nation's leading virtual care provider. He is also a practicing physician at Doctor On Demand, with board certification in Internal Medicine and Preventive Medicine. He has been awarded an Unsung Hero award for his volunteer work at a clinic for people without health insurance.

Dan Weaver

Vice President, Stars Quality
Gateway Health

Daniel Weaver is an established leader with extensive experience developing and implementing intervention strategies to improve Medicare Stars performance. With demonstrated success with innovative intervention programs, Daniel's team has consistently delivered market-leading performance and forward-thinking engagement with providers and members.

Brent Zenobia, PhD.

Chief Strategist
Novillus LLC

Brent Zenobia is Chief Strategist for Novillus LLC, in Portland Oregon, a startup focusing on innovative Risk Adjustment and Stars solutions for healthcare organizations. He has over 37 years experience in Medicare and ACA risk adjustment, Medicare Stars, quality metrics, value-based payment arrangements, and software engineering. He is an expert in Care Gap Management for HCCs and Stars and has architected several systems in this space. Prior to Novillus he served as business architect and process improvement specialist for Cambia Health Solutions, Sharp Laboratories of America, Intel, Hewlett Packard, and Bell-Northern Research.

Brent holds a Ph.D. in Systems Science/Engineering Management and MS in Software Engineering with a strong focus in technology forecasting, simulation modeling and software modeling. As Adjunct Professor at Oregon Health and Sciences University and Portland State University he taught courses in Technology Forecasting, Technology Assessment and Acquisition, Strategic Management of Technology, Technology Transfer, Software Process Improvement, and Software Engineering. He has been participating in the Da Vinci project since 2018. ,