The 14^th Medicare Stars, HEDIS^®, Quality & Risk Summit

Kim Barrus MSN, BSCIS, RN, PMP,

AVP, Quality & Accreditation,

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. She developed the SelectHealth Advanced Primary Care (a.k.a., patient centered medical home) program and supporting department. Kim facilitated the initial pilots of the program in 2010. Today the program has 1,240 participating providers at 222 participating clinics. Kim is currently the Director of Clinical Outcomes Management and has oversight for quality, medical home, NCQA accreditation, HEDIS and CMS Stars.

Anne Book,

Director Quality Improvement and Compliance,

HealthPartners

Anne Book is accountable for quality improvement strategy and execution across all product lines. This includes regulatory and accreditation compliance, HEDIS and Stars quality reporting, strategic analysis and prioritization to surface interventions, and the implementation of successful technology-driven improvement strategies. With more than 30 years’ experience in health care, Anne has held a variety of roles in marketing communications, sales and product management.

Jennifer Callahan,

President and CEO,

ATRIO Health Plans

Melissa (Missy) Skelton Duke, PharmD, MS, BCPS, FAPhA

Executive Director, Medicare Quality and Stars Strategy

Banner Health

Missy Skelton Duke is the Executive Director of Quality and Medicare Stars Strategy at Banner Health. In this role, she builds the strategic vision and strategies that optimize Banner Health Plans’ Medicare Advantage Star Rating. In this role, she drives alignment across complex provider networks, provider aggregators, population health services organizations, and health plan departments to provide the highest quality health care and service to their Medicare Advantage HMO, PPO, and Dual-Eligible members. Prior to this role, Missy served as the Executive Director of Population Health Pharmacy Solutions and Ambulatory Pharmacy Services and Senior Director of Specialty and Home Delivery Pharmacy Services at Banner Health. She has also served as the Clinical Pharmacy Services Manager for Intermountain Healthcare, where she was responsible for the growth and development of clinical services, collaborative pharmacy practice agreements, and professional development and competency assessment.

Missy has been active in pharmacy advocacy issues throughout her entire pharmacy career. She has served in numerous pharmacy leadership and advocacy roles at the state and national level, most recently serving as APhA Speaker of the House of Delegates.

She received her Doctor of Pharmacy degree from the University Of New Mexico College Of Pharmacy in 2008, and a Master of Science degree in Health Policy and Pharmacotherapy Outcomes Research from the University of Utah. She completed a 24-month residency program in Health-System Pharmacy Administration from Intermountain Healthcare in June of 2010.

Josh Edwards

Stars Program Senior Manager

Devoted Health

Brendan Generelli,

Director of Medicare Stars & Quality,

Johns Hopkins Health Plan

Brendan Generelli is Director of Medicare Stars & Quality at Johns Hopkins Health Plan. Prior to joining JHHP, Brendan was the Senior Program Manager for Stars and Quality at Blue Cross Blue Shield of Rhode Island, where he led them to achieving a 5 Star rating on multiple contracts in back to back years. Brendan has a deep passion for member experience, is a leading voice in the health equity space, and is always striving to improve the quality of care for Medicare Advantage beneficiaries.

Renee Golderman

Senior Vice President and Chief Quality Officer

Capital District Physicians’ Health Plan

With more than 30 years of progressive experience in the health care industry, Renée S. Golderman, MS, RN, NE-BC, is the Senior Vice President and Chief Quality Officer at CDPHP. In this role, Golderman provides the strategic leadership needed to design, implement, and manage quality improvement programs at CDPHP, and is responsible for the plan being named a 5 Star plan by the Centers for Medicare and Medicaid Services (CMS). Golderman was recently named as one of the Top 100 Women Leaders in New York by Women We Admire.

Golderman is responsible for directing HEDIS,QARR, NCQA, and Medicare Stars initiatives at CDPHP, which includes collaboration among Medicare risk, medical management, care management and network providers to drive innovative initiatives to improve quality outcomes and ensure member satisfaction. She has led health care transformation initiatives, including tools for population health and clinical integration strategies, and assists in design and operational aspects of primary care incentive programs.

Golderman is skilled at fostering relationships while executing on strategic plans to drive quality outcomes focused on the Quadruple Aim. Golderman demonstrates sound understanding of and has broad experience with hospital operations, health care finances, board responsibilities, physician relations, and knowledge of how all entities are interdependent, along with current knowledge of the trends and challenges in health care.

Prior to joining CDPHP, Golderman has held various positions in the health care industry and has a record of accomplishments in a range of health care settings, including both the clinical and administrative aspects of inpatient and outpatient care, quality and risk management, hospital and primary care business operations, as well as health plan leadership and administration. Golderman has served as the director of nursing for Seton Health System, part of the Ascension Health System where she was a recipient of the NYSNA Nursing Excellence Award in Administration/Management. In addition, she held clinical management positions at New England Baptist Hospital in Boston, Mass., and New Britain General Hospital in New Britain, Conn. She has also served as a clinical educator for The Eddy in Troy, N.Y.

Golderman earned a Bachelor of Science degree in nursing from SUNY Buffalo, and a Master of Science degree in health care management from Rensselaer Polytechnic Institute. Golderman is a nurse executive-board certified, by the American Nurses Credentialing Center (ANCC), and is a member of the National Association for Healthcare Quality.

Tara C. Griffin,

Director, Analytics Consulting,

Health Care Service Corporation (HCSC)

Director, Analytics Consulting at Blue Cross Blue Shield of Illinois, Montana, New Mexico, Oklahoma, and Texas. (Health Care Service Corporation: HCSC) Focus on HEDIS rate improvement. Conducts data-driven oversight and expansion of HEDIS analytics, data loading, data accuracy and data solutions for Commercial, Exchange, Federal Employee Program, Medicaid, and Medicare products. Works as part of a Data Analyst and Data Engineer team to grow machine learning. Significant contributions toward enhancing Provider Specialty Types within HEDIS mapping to differentiate specialists within Federally Qualified Health Centers, as well as expansion of Certified Nurse Specialists, Prenatal Care, Behavior Health, and Primary Care Providers across each product. Before this appointment, launched HEDIS performance improvement workgroups, as well as integrated member experience strategies for adult and child behavioral health, women’s health, transitions of care and assessed policy/procedures within clinical programs to meet NCQA accreditation requirements.

Tamara Migut,

Director of Quality Improvement,

Health Alliance Medical Plans

Pooja Naithani,

Vice President Risk Adjustment & Quality,

Clever Care Health Plan

Caroline Paes Leme Pires,

Care Consultant Sr.- Medicare Quality, East Region,

Elevance Health

Caroline Pires is an experienced Care Consultant in NY with a comprehensive background in Population Health and Change Management in healthcare. In my current role I have proven ability to implement value-based quality programs, strategize based on market trends, and collaborate with various stakeholders for effective resource allocation to support quality and cost improvement. She leverage her strong skills in data analysis to provide targeted solutions for HEDIS stars and CAHPS enhancement. In her free time she loves to play and dance with her daughter, read and try diferent cusines.

Corey Robinson,

Sr. Director, Medicare Pharmacy PDP Operations

Heath Care Service Corporation (HCSC)

Corey joined HCSC with its recent acquisition of Cigna’s Medicare and CareAllies businesses. Corey has been with Cigna for more than 11 years with accountability for multiple lines of business across the commercial and government books of business. In his current role, Corey leads Medicare PDP operations and vendor management.

Corey has prior experience in the financial services and telecom industry. He prides himself on being an authentic leader who delivers results. He has led teams that have won numerous awards for outstanding customer service.

Amber Smits,

Manager, Strategic Initiatives and Health Equity,

Network Health

Ally Thomas, Ph.D.,

Associate Vice President, Quality Improvement,

UPMC Health Plan

Ally Thomas, Ph.D. is the Associate Vice President of Quality Improvement at UPMC Health Plan. She oversees several teams including Medicare STARs, Quality Data and Analytics, Community-Based Quality Programs, Member Experience and Operational Excellence, and Program Development and Innovation.

Dr. Thomas joined UPMC Health Plan in 2018 to build a newly formed Medicare STARs analytic team. One year later, in addition to the analytics, she was asked to build the overall Medicare STARs program. This new program resulted in UPMC Health Plan earning their first 5-STAR Rating for the 2022 STAR Rating Year and maintaining that 5-STAR for the 2023 STAR Rating Year. In 2021, Dr. Thomas was asked to expand these best practices to enhance Quality across the business as Associate Vice President of Quality Improvement.

Dr. Thomas is also responsible for leading the development of several innovative programs including the Medicare Faith & Wellness Program and partnering with Astrata (www.astrata.co ) to advance the use of Natural Language Processing to enhance the development and impact of various interventions.

Prior to joining UPMC Health Plan, Dr. Thomas worked as a researcher in psychology and education. Specializing in program design and evaluation, statistics, measurement science, survey design, social cognition, learning and instruction, and accountability programs. During this time, she collaborated on several contracts and multi-million-dollar NSF grants with the City University of New York and the University of Pittsburgh.

Dr. Thomas received her Ph.D. in Educational Psychology with a specialization in Quantitative Methods in Education and Psychological Research from the Graduate Center, CUNY.  As well as her M.A. in Psychology from San Diego State University and her B.A. in Psychology from Biola University.

Dan Weaver,

Senior Vice President, Stars & Quality,

Zing Health

Daniel Weaver recently joined Zing Health, a tech-forward health plan based in Chicago, as the Senior Vice President of Stars and Quality. With over 25 years of experience in Operations and Star Ratings strategy, Daniel has previously served as VP, Government Quality Programs at Highmark Wholecare (formerly Gateway Health Plan) and Director of Stars Programs at Highmark Health, helping both organizations achieve and maintain their first 4.5 Star Ratings. In his career, Dan has overseen the development and implementation of many analytics-driven and beneficiary-focused programs, has adopted continuous improvement and operational excellence philosophies for sustained success, and embraces innovation focused on overcoming socioeconomic barriers to achieving health equity and optimal quality outcomes. In his new role with Zing Health, Daniel will focus on implementing a high-performing Stars infrastructure to support the organization’s rapid growth with a focus on servicing special needs members in several states.

John Willis,

Vice President, Quality and Clinical Integration,

Network Health

John Willis serves as the Vice President-Quality and Clinical Integration at Network Health. A social worker by education, John has taken his educational skills and applied these skills to managed care to ensure the highest quality outcomes and best member experience possible through a personalized approach and implementation of industry best practices. John feels that healthcare is local, and success comes from taking that approach into every interaction with our members.

John has been working in managed care and quality improvement for over 20 years and has worked with national, regional, and Blues plans throughout his career. He has successfully built high-performing teams and strategy to ensure 5-Star performance within the organizations he has worked. Having worked in the CMS Star Ratings area since its inception, he has built a library of tried-and-true interventions, tactics, and long-term strategy to drive both improvement and maintenance of plan performance.

John has presented at multiple industry conferences, written many clinical and quality focused white papers, and engaged in advocacy efforts to drive continued change and enhancements to the CMS Star Rating program. Forward-thinking in his approach, John is always looking to the future to ensure strategy is built to continue driving superior performance for the long-term. He approaches quality as a game, where the rules are constantly changing, and never taking your “eye off the ball” is the key to success.

Sabrina Zerzouri,

Lead Stars Program Manager,

Blue Cross Blue Shield of Rhode Island

Sabrina Zerzouri is the Lead Stars Program Manager at BCBSRI. She has experience working with national, regional, and state health plans to manage the Star Rating program. In her current role, Sabrina provides strategic guidance to cross functional teams throughout the organization to positively impact member experience, health outcomes, and Star Ratings. She is particularly passionate about advancing health equity, ensuring that diverse member populations receive accessible, effective, and culturally responsive healthcare. Her strategic mindset and commitment to continuous quality improvement make her an invaluable asset in the evolving Medicare Advantage landscape.

Saeed Aminzadeh,

Chief Product Officer,

mPulse

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.

Liz Carr,

VP Product Delivery and Customer Experience,

Ingenia Health

As VP of Product Delivery and Customer Experience at Ingenia Health, Liz directs the account management, operations and support teams for new client implementations and production clients. Liz is a trusted advisor to health plan leaders on all things related to Quality organization and analytics. She enjoys taking creative yet pragmatic approaches to problem solving in order to deliver the most value to clients.

Liz began her career at MedVentive, a startup acquired by McKesson, and was on the product team for a Quality & Med Econ tool. She was a Certified Scaled Agile scrum master for the product development team and supported new client implementations. Liz made the transition to consulting, joining a boutique firm that focused on Quality and Risk Adjustment optimization for health plans. She led client accounts ranging from small Duals payers to national multi-state managed care organizations and worked with vendor partners to design new specialized software. Her projects ranged from new Quality tool implementations and multi-year HEDIS and STARS projects to organizational strategy consulting. Liz has a BA in Neuroscience from Johns Hopkins University

Shara Cohen,

President & CEO,

Carallel

Shara has spent more than 20 years helping healthcare organizations think differently about how to involve and empower people more effectively in their care and health. She continues in that work as CEO of Carallel.

Before joining Carallel, Shara was senior vice president of client experience with Emmi Solutions for six years, helping it become a leader in patient engagement. When Emmi was acquired by Wolters Kluwer Health in 2016, she joined the global leader in medical information as vice president of customer experience.

Shara has emerged as a leading voice at the intersection of caregiving and health equity, speaking at national healthcare conferences such as HLTH and earning recognition from Crain’s Chicago Business as a Notable Leader in Healthcare 2023 and as one of Fierce Healthcare’s Women of Influence 2024.

Shara earned a JD from Fordham University School of Law in New York, and a bachelor’s degree from the University of California, Berkeley. She shares her passion for supporting and empowering underserved communities as a board member for Chicago Training Center. CTC is a competitive rowing organization that offers Chicago’s youth athletic opportunities, mentorship and college scholarships. But most days, she and her wife are just chasing their toddler around.

Keslie Crichton,

Chief Sales Officer,

BeneLynk

Keslie is the Chief Sales Officer for BeneLynk. In her role, she is not only responsible for new business development but also works on innovative partnerships to improve outreach strategies and health outcomes for our client’s members. At the core of BeneLynk’s services, Keslie and her team work to identify, document, and solve members' social determinants of health (SDoH) challenges by “leading with help.” This increases BeneLynk’s engagement rates across our integrated services while also providing our clients with crucial information they need to deliver care and improve their quality metrics. Keslie has worked in managed care for over 25 years with a focus on SDoH solutions that improve members' lives but also provide a return on investment for our clients. Keslie's passion lies in working on strategies that put members at the center while ensuring we deliver accurate risk-adjusted revenue, quality performance, and member retention. Keslie holds a B.S. in Business Administration from Regis University and worked toward her MBA and Masters in Healthcare Administration at Sacred Heart University in Fairfield, CT.

Emily Endres,

Vice President, Client Services,

Pharmacy Quality Solutions

Emily Endres, as Vice President of Pharmacy, oversees and directs the organization’s focus on enhancing quality improvement strategies and initiatives for health plans, PBMs, and community pharmacies. With over two decades of dedicated service to the pharmacy industry, Emily brings a wealth of expertise, ranging from pharmacy practice, management and operations to advanced proficiency in Managed Care.

Brian Heacox – VP,

Product & Engagement,

mPulse

As Vice President of Product overseeing mPulse's Engagement & Analytics solutions, he is continuously assessing opportunities for improved member targeting and personalized messaging. Brian has a particular focus on developing and enhancing solutions that lower medical and administrative spend within the healthcare space.

Girish Chavan,

Co-Founder & CTO,

Astrata

Girish Chavan is the Co-founder and CTO of Astrata. He has over 22 years of experience building products using NLP and Machine Learning. Prior to founding Astrata, Girish was the Senior Director of Product Management at UPMC Enterprises, the investment and innovation arm of UPMC. He was also the co-founder of Veralytics Inc., a healthcare NLP/ML startup. Girish is a Pittsburgh 40 Under 40 honoree and holds a Master’s degree in Information Science from the University of Pittsburgh.

Reid Kiser,

Founder and CEO,

Kiser Healthcare Solutions, LLC

Reid is the founder and CEO of Kiser Healthcare Solutions, LLC, where he leverages 25 years of experience in healthcare leadership to address critical challenges in quality and performance measurement. His expertise spans a broad range of areas, including the development, implementation, and reporting of healthcare quality measures, as well as data collection, analysis, and electronic healthcare data exchange. He is also skilled in strategic planning and product development within the healthcare sector. Reid's extensive career includes significant national leadership roles. He served as the Director of the Division of Quality Measurement at the Centers for Medicare & Medicaid Services (CMS), where he provided technical guidance and oversaw the development and maintenance of quality measures for various CMS programs. Prior to CMS, he held leadership positions such as Senior Vice President for Performance Measurement and Research at the Pharmacy Quality Alliance (PQA), General Manager of Quality Spectrum at Inovalon, Director of Research and Measurement at the Council for Affordable Quality Healthcare (CAQH), National Director for Clinical Excellence Special Projects and Reporting at UnitedHealthcare, and Director of HEDIS Policy and Manager of HEDIS, CAHPS, and HOS Data Collection at the National Committee for Quality Assurance (NCQA).

Throughout his career, Reid has been actively involved in industry expert panels and committees focused on quality measurement and data analytics. He has also presented at numerous public meetings and industry conferences, sharing his insights and expertise on behalf of his employers and clients. His recent work at CMS emphasized advancing healthcare quality through technology, including digital quality measurement, while ensuring alignment with legislative mandates, CMS program priorities, and regulatory requirements.

Misty Milby,

VP of Clinical Business Development,

Everly Health Solutions

Misty Milby is a seasoned Registered Nurse with more than 25 years of experience spanning nurse management, clinical operations, telehealth strategy, and clinical business development. She currently serves as Vice President of Clinical Business Development at Everly Health, where she leads the expansion of clinical services for health plans and employers—focused on delivering innovative virtual care solutions and closing care gaps at scale, particularly those tied to quality initiatives such as HEDIS® measures developed and maintained by NCQA.

In this role, Misty plays a key part in translating clinical strategy into action, partnering closely with clients to design and implement programs that drive measurable outcomes and expand access to care. She leads the development of scalable frameworks that support clinical and operational alignment.

Misty also leads key workstreams related to clinical product innovation, market analysis, and strategic partnerships—ensuring Everly’s offerings support high-quality care delivery across diverse populations. She believes that accessible at-home testing and virtual care solutions have the power to transform healthcare by meeting patients where they are. Misty also serves as a member of the NCQA Industry Council on Health Care Quality, contributing to the advancement of standards that drive quality improvement across the healthcare ecosystem.
With a unique blend of clinical insight and business acumen, Misty is passionate about empowering individuals to take control of their health and driving meaningful, lasting change in the healthcare industry.

Mark Pencek,

Customer Experience Strategist

Mark Pencek is the former Vice President of Customer Experience for a nationally recognized top-performing health plan. With deep expertise in complex regulatory environments, he has consistently driven consumer-focused initiatives that enhance engagement, optimize operations, and improve financial performance. Throughout his healthcare career, Mark has led transformative strategies across all lines of business, leveraging digital innovation, personalized engagement, and team alignment and optimization to elevate performance. His Medicare Stars and CAHPS leadership has directly contributed to organizations achieving top industry honors, including dual 5-Star ratings across both HMO and PPO contracts.

Mark holds a BBA in Computer Science from Kent State University and an MBA from the Terry College of Business at the University of Georgia — Go Dawgs!

Subbu Ramalingam,

Managing Director,

Attac Consulting Group (ACG)

Strategy & execution consulting leader driving performance in healthcare quality, 5-star rating, risk adjustment, and cost results for healthcare organizations. Former VP of health plans handling Medicare, Medicaid, ACA and Commercial plans.

Dan Ready,

Vice President, Business Development,

mPulse

Dan leads business development and strategic partnerships at mPulse, leveraging over a decade of experience in advancing data-driven, consumer-focused solutions. In his current role, Dan partners with healthcare organizations to identify opportunities for innovation, aligning cutting-edge technologies with business objectives. His work focuses on fostering collaboration and designing strategies that personalize consumer engagement, streamline operational efficiencies, and drive measurable improvements in business performance.

Reva Sheehan,

– Sr. Director, Customer Insights,

mPulse

Reva has more than 15 years’ industry experience ranging from long term care and compound pharmacy management to health plan operations and quality. As an avid collaborator, Reva engages internal and external stakeholders to improve processes for optimal outcomes while keeping the member’s experience at the heart of every conversation.

Justin Skerbetz,

Chief Marketing and Strategy Officer, Healthcare Transformation Leader,

Insightin

Justin Skerbetz is a visionary healthcare transformation executive who has spent two decades breaking through conventional barriers to enhance healthcare experiences for millions of members. As Chief Marketing and Strategy Officer at Insightin Health, he has orchestrated revenue growth while pioneering AI-driven engagement strategies that fundamentally reimagine how health plans connect with their members.

Prior to Insightin Health, Justin's leadership catalyzed remarkable results at local, regional and national health plans, where his innovative approach to member engagement consistently shattered growth targets while strengthening operational foundations. His groundbreaking work earned him the Healthcare Innovation Awards for advancing health equity through personalized member experiences.

Justin's unique expertise lies at the intersection of predictive analytics, behavioral science, and healthcare operations—a combination that has enabled him to develop engagement frameworks that activate members at twice the industry standard rates. He has repeatedly demonstrated that by understanding the human factors behind healthcare decisions, organizations can create profoundly more effective member journeys.

A thought leader in healthcare transformation, Justin brings an unparalleled perspective on how strategic innovation can reshape healthcare delivery while delivering measurable business results.

Melissa Smith,

Founder and Senior Advisor,

Newton Smith Group

For more than a decade, Melissa Smith has been at the forefront of leading Medicare Advantage and Star Ratings teams. As the founder of Newton Smith Group and a Senior Advisor to Oliver Wyman, Melissa is a widely recognized thought leader and healthcare strategist. Her proven track record of success lies in developing comprehensive enterprise-wide solutions that enhance Star Ratings, quality performance, health outcomes, and the overall member experience. Melissa excels in crafting strategic and tactical solutions to meet client needs, forging productive partnerships across internal teams and external vendors, and improving performance on various quality measures. Her unique background in business, finance, regulatory compliance, and healthcare quality provides clients unparalleled access to healthcare strategy, quality performance, and revenue optimization. As the former Chief Consulting Officer at Healthmine and Senior Vice President at Gorman Health Group, Melissa's leadership spans across prestigious organizations like Cigna-HealthSpring and Vanderbilt University Medical Center. Graduating from Purdue University, Melissa began her career at KPMG, LLP and is a Certified Public Accountant.

Kimberly Switlick-Prose,

Vice President, Quality,

Pareto Intelligence

Kimberly Switlick-Prose is a strategic healthcare executive with over 20 years of experience in quality performance and health equity. As vice president of quality at Pareto Intelligence, she focuses on developing innovative strategies that enhance outcomes and create value through the application of behavioral design and organizational development principles.

Previously, Kimberly held leadership roles in major healthcare organizations, like Elevance Health and Blue Cross and Blue Shield of Minnesota, where she led initiatives in quality, Star performance, and risk adjustment. She successfully secured high Star ratings and optimized risk adjustment processes, driving significant improvements in member engagement and operational efficiency.

Known for her ability to foster collaboration and leverage data-driven insights, Kimberly is dedicated to advancing population health through sustainable growth strategies. A dynamic and respected industry speaker, she frequently captivates audiences at global conferences, delivering powerful workshops on consumer engagement, clinical data exchange, operating-model design, and more. Kimberly is committed to driving positive change in healthcare, making a lasting impact on the communities she serves.

Rebecca Yarish,

Senior Manager,

ProspHire

Rebecca is a Senior Manager at ProspHire, a national management consulting firm dedicated exclusively to healthcare. She specializes in delivery and execution within the Payor Space, with a strong focus on Medicare Advantage and Stars Performance Improvement. Leveraging a data-driven approach, Rebecca helps clients assess their current performance, identify key opportunities, and develop sustainable improvement programs to enhance Star Ratings and drive long-term success.