2024 All-Star Speakers

Saeed Aminzadeh

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.

Jayme Ambrose, DNP RN CCM

Jayme Ambrose, DNP, RN, CCM, is the visionary Founder and Chief Executive Officer of Adobe Population Health, an Arizona-based company offering an innovative, first-of-its-kind solution to the issue of health equity. Founded in 2018, Adobe employs a technology-driven model for interventional care management and takes a holistic approach to population health by closing care gaps, reducing costs, and caring for the whole person.

Armed with a Master of Science-Nursing from Arizona State University, Jayme was accepted into the Doctoral program for Nursing Science & Leadership at Case Western University. It was there, she developed an integrated case management model, as part of her doctoral thesis, with the objective of addressing the social determinants of health that often contribute to poor health outcomes for at-risk populations. After completing her doctorate in 2012, Beech Medical Group agreed to pilot her model, if Jayme agreed to accept a position as VP of Clinical Services. In 2016, she signed her first insurance company contract and initiated a holistic approach to case management for Medicare members. Her model integrates data analysis and risk assessment with a human touch to deliver proactive and preventative care that improves health outcomes, decreases hospital and ER visits, and reduces overall healthcare costs. In 2018, Beech Medical Group sold the company but not before giving Jayme the opportunity to purchase her division. On that day, Adobe was born with one mission: To positively impact the lives we touch.

As part of an innovative technology platform, Adobe utilizes proprietary risk stratification tools to identify the issues of those at greatest risk including food insecurities, financial hardships, transportation issues and even loneliness. And then through a proprietary and ground-breaking application called MASLOW™, members are invited to answer questions related to social determinants of health and then are connected to for-profit, non-profit, and governmental resources based on geolocation. To ensure impact, a qualified team member through a hybrid care model reaches out to offer assistance, closing the care loop. It is this human touch that sets Adobe apart from other case management organizations. Today, Adobe employs 300 nurses, nurse practitioners, social workers, support coordinators, dieticians, care navigators, and transition specialists and serves more than 200,000 elderly and underserved patients across three states.

Jayme has served on several boards including The Arizona Homecare Association, The American Association of Occupational Health Nurses and the Case Management Society of America where she is currently a member. She also currently serves on the PAC board of the Arizona Nurses Association. In addition, Jayme is currently adjunct professor for Arizona State University where she teaches RN to BSN and MSN students and develops curriculum.

Eden Anne Encarnacion, MHA

Eden Encarnacion, MHA is currently the Sr. Manager, HEDIS for Medicare Stars Program at Blue Shield CA. She manages the member and provider-facing engagement programs to drive improvements in HEDIS performance. She has 8 plus years of experience leading Quality Improvement programs across multiple Lines of Business in both provider and payer settings. Her experience includes Risk Adjustment, Encounter Data Submission, and Member Experience (CAHPS, HOS). In her previous role as Director, Quality and Medicare Stars for Clever Care Health Plan, she led the development and implementation of the provider incentive program, transitions of care program, and multiple initiatives across HEDIS, Pharmacy, and CAHPS measures. Her previous roles also include Director of Quality Improvement and Physician Operations at Tenet Healthcare. In this capacity, she worked directly with multiple provider groups as well as with various health plans to manage end-to-end efforts and oversee performance on value-based care programs focused on Quality and Risk Adjustment improvement.

Jessica Assefa

Jessica Assefa provides expertise to health plans regarding Quality Improvement, CMS’s Quality Bonus Programs, 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) knowledge.​ Prior to joining the Convey family of companies, Jessica led the Medicare, Marketplace and Medicaid Star Ratings Programs and Quality Ratings Systems for an independent, nonprofit health plan in Minnesota, successfully achieving 4-, 4.5- and 5-Star Ratings for multiple Medicare and Marketplace contracts and product lines. Her managed care experience expands into Clinical Compliance, including training and oversight of care coordination entities for Medicare Advantage and D-SNP.

Michael Bagel

Michael is a public policy expert with more than 15 years of working with federal policymakers and lawmakers to advance regulatory and legislative activities. He previously served as a senior policy advisor at the Department of Health and Human Services Office of the Secretary, attorney with the Office of Management and Budget, and as a law clerk at the US Department of Labor and Health Policy Associate with the Senate Finance Committee.

Chayla Beason

Chayla Beason is the Director of Medicare Advantage Clinical Data Strategy & Execution at Blue Cross Blue Shield of Michigan. She is responsible for consulting with business executives and enterprise partners to set the strategic direction and execute on the strategy to drive cost, process and operational efficiencies related to data acquisition, connectivity & EHR use, enablement & innovative solutions, interoperability and health information management for Medicare Advantage.

Andrew Bell

Andrew is the Medicare Stars Practice Leader at ProspHire, a national management consulting firm exclusively dedicated to healthcare. Specializing in delivery and execution, Andrew’s work has focused on the Payor Space supporting clients with go-to-market strategic planning, new product development, growth and transformation activities, post-acquisition integration efforts, and other strategic initiatives for MCOs. One of his key areas of expertise is Medicare Stars where he takes a lead role in guiding health plans through the program, enabling long-term sustainable success. He has a passion for staying at the forefront of policy changes, regulatory changes, and trends related to managed care, particularly in context to the Medicare Stars Program. Being an emerging thought leader in the field, he actively engages with new developments and industry changes, positioning himself and ProspHire as leaders in healthcare consulting.

Joel Brill, MD

Joel V. Brill, MD FACP is an executive clinician with over 35 years of experience providing strategic leadership and medical oversight to data-driven health organizations. He is skilled in strategy, development and implementation of innovative health programs, products and payment systems, with extensive experience in clinical practice, reimbursement, quality improvement, data analysis, and value-based care. Board Certified in Internal Medicine and Gastroenterology, Dr. Brill is an Assistant Clinical Professor of Medicine at the University of Arizona College of Medicine, and has been a CPT Advisor for over 25 years. Dr. Brill co-Chaired the Part D medication measures Technical Expert Panel for CMS, has published on episode and bundled payment methodologies, and developed and submitted advanced payment models to the HHS Physician Focused Payment Model Technical Advisory Committee. Dr. Brill received his undergraduate A.B. Biology at the University of California, Los Angeles, and graduated from the Rosalind Franklin University of Medicine and Science - Chicago Medical School. He completed his Internship and Residency in Internal Medicine at the UCLA – San Fernando Valley Program, a fellowship in Gastroenterology at Los Angeles County – USC Medical Center, and the Management Program for Health Care Organizations at the UCLA School of Public Health.

Jennifer Callahan

Jen Callahan is the Chief Operating Officer of ATRIO Health Plans. For the past 19 years, Jen has established herself as a trusted thought leader and helped shape the managed care industry with her innovative ideas and expertise. Jen has dedicated her career almost exclusively to managed care and is an industry leading expert in all areas of Medicare Advantage and Medicare Supplement programs.

Prior to joining ATRIO, she co-founded a field management organization, Keen Insurance Services, Inc. to create a provider-centric Medicare focused sales and distribution organization from the ground up. Prior to that, she held the position of Vice President, Medicare Product at Aetna, a CVS Health company where she oversaw the product development and implementation Aetna’s entire Medicare portfolio, contributing over $24 billion to Aetna’s revenue. Throughout her career, Jen has also held various leadership positions at Healthfirst, Inc. and Anthem, Inc. focused exclusively on Government sponsored business.

Jen received her Bachelor of Science degree from Fordham University and MBA from North Carolina State University. Jen currently resides in Waxhaw, a suburb of Charlotte, North Carolina with her husband, their three kids and fur baby, Vivi. Jen loves spending time with her family and friends and hosting them at their home.

Katie Capadona

Katie Capadona is the Risk Adjustment Revenue Manager for Security Health Plan. In this role she is responsible for implementing and maintaining end-to-end risk adjustment strategies for the organizations ACA, Medicaid, and Medicare programs. Prior to joining Security Health Plan, Katie led the Medicare risk adjustment strategy for a Wisconsin based FIDE-SNP/DSNP program for over 15 years. During her tenure there she worked closely with the IT, Quality, and Provider Education to develop a cohesive approach to Medicare Stars and Risk Adjustment that created operational efficiencies, improved provider engagement, and increased revenue.

Camille Clarke-Smith, EdD, MS, CHES, CPT

Dr. Camille Clarke-Smith is a Program Director in the Quality Improvement Department at UPMC Health Plan. Dr. Clarke-Smith created and currently leads the Medicare Faith and Wellness Program, originally launched as the Medicare Healthy Church Challenge in 2019 that engages Faith-Based Organizations’ Medicare beneficiaries. The program focuses on enhancing health outcomes in communities, enhance member satisfaction, and contribute to higher quality ratings for Medicare STARs.

Dr. Clarke-Smith is also the host of the UPMC Health Plan micro-cast: Health Break. Outside of UPMC Health Plan, Dr. Clarke-Smith is the founder of the non-profit organization T.H.A.W (Transforming the Health of African American Women) Inc. Dr. Clarke-Smith earned a BS in Psychology and Sociology, MS in Exercise Science, and an EdD in health and physical activity from the University of Pittsburgh and is currently pursuing her MSW at Carlow University.

Phil Collins

Keslie Crichton

Keslie brings a long history of strong execution and delivery for integrated solutions across risk adjustment, quality performance and eligibility and enrollment solutions in both Medicare and Medicaid.

At BeneLynk, Keslie is responsible for driving enterprise growth and innovative partnerships to improve outreach strategies and health outcomes for our client’s members. Keslie works closely with BeneLynk’s product team to offer differentiated services and capabilities to maintain its market leader position.

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.

Prior to joining BeneLynk, Keslie served as Vice President, Sales, and Account Management at Change Healthcare (formerly Altegra Health/Social Service Coordinators). 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.

Omar Daoud

Omar joined Community Health Plan of Washington, CHPW, as the Director of Pharmacy in 2019 after sixteen years with Walgreens Co., where he led Specialty Pharmacy operations for the Pacific Northwest Region.

Omar has extensive experience in Specialty Pharmacy, Managed Care including government programs, and Clinical Pharmacy quality initiatives. Omar’s current role is focused on PBM relationship oversight, clinical pharmacy integration, and utilization management of medical and prescription drug benefits. Omar received his Doctorate of Pharmacy Degree from the University of Washington in 2005 and continues to reside in the beautiful Pacific Northwest.

Jonathan Davis

Jonathan was inspired to start Trualta when he saw the inequity in support for the 54 million family members and friends who care for our most vulnerable populations. Six years later his team has pioneered educational, emotional and social support for caregivers and has paved the way to create communities of caregivers across the U.S. and Canada who help close gaps in care, improve quality and influence families’ decisions that impact retention and growth. Trualta now enables government partners in 32 states, nationwide Medicaid & Medicare plans, and large health systems to deliver self-paced training, live classes, and virtual support groups to thousands of family caregivers every year.

Jonathan previously worked as an investor in healthcare education at a private equity fund and prior to that he was a consultant at McKinsey & Co. When not working, you can find him traveling with his family, cruising on his snowboard, or frustrated on the golf course.

Kirstine Donato

Kirstine has a bachelor’s degree in Kinesiology and a master’s degree in business administration. Ever since she was a little girl, Kirstine’s passion has always been to improve the life of others through their health. Currently, Kirstine is the Program Manager, supporting the Medicare line of business, at Blue Shield of California. In her role, she manages and coordinates the development of member- facing programs related to Stars and HEDIS, strategizing on ways to make healthcare more accessible so members can stay on top of their health.

Michael Farina

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.

Michael P. Franks

Michael P. Franks is a seasoned healthcare and finance executive with extensive experience in profitable membership growth within highly competitive markets. He currently serves as the Senior Vice President of Plan Product at Arizona Complete Health – Centene, where he leads a management team with strategic expertise across the Western Region, including Arizona, Nevada and New Mexico. Under his leadership, the company has managed over $1 billion in Medicare Advantage revenue and $700 million in Marketplace revenue.

Franks has a proven track record of forming strategic value-based partnerships to manage revenue, cost, and quality outcomes while enhancing care affordability. His expertise includes health plan operations, financial analysis, product development, network contracting, and Medicare quality programs. Throughout his career, Franks has held significant roles such as Senior Director at Banner Health, where he led risk adjustment and quality programs, and Medicare President Western Region at Humana, where he oversaw P&L for the Western Region Medicare, including Arizona, California and Hawaii. His efforts have consistently led to substantial financial performance improvements and membership growth.

He holds a Bachelor of Science in Accounting from Indiana University's Kelley School of Business and is a Chartered Financial Analyst (CFA) charter holder. Franks is also actively involved in the community, serving on the Board of Directors for the Boys & Girls Club of Scottsdale, Volunteer Mentor with the ASSK Foster Care Agency, Member of Neighbors Helping Neighbors and as an advisory board member for Sunshine Acres Children’s Home.

Brendan Generelli

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.

Maddie Hirsch

Maddie Hirsch is a healthcare leader with over a decade of experience across the industry, currently serving as Director of Client Operations at Papa. In this role, she manages critical functions supporting Papa's health plan clients, including the Social Care Navigation function, which aims to improve member health outcomes by addressing social and healthcare needs surfaced by Papa's network of Papa Pals. Previously, during her seven-year tenure at Oscar Health, Maddie spearheaded various roles, notably leading the design and implementation of Population Health programs aimed at improving health outcomes while reducing healthcare costs.

Keith Michael

After years of working at large consumer product companies like Kodak, Philips and Georgia Pacific managing product, marketing and branding, Keith decided to take what he has learned on the way and dive into the Payments, Prepaid, and Financial Services industry. In the 10 years that followed, Keith has worked at gift card aggregator InComm Payments and payment acquirer Fiserv managing the open loop business for both Consumer and B2B reward and loyalty programs. Following his entrepreneurial spirit Keith joined GiftCard Partners.

Using what he’d learned from past experiences, Keith’s idea is simple, do what’s right for the customer, the end-user and the company you work for. This focus drives creativity, and a smarter way to deliver on new capabilities that will drive the business and the category forward.

Bonnie Thompson, MSN, MBA, PMP

Bonnie Thompson joined the Press Ganey team in 2019 with more than 16 years of experience in nursing, healthcare and payer leadership roles, after transitioning from direct care delivering as a Nurse and Nurse Practitioner. She has worked with a range of organizations from small, rural critical access hospitals to major healthcare systems and both small and large health plans to develop systems, processes, and the culture to support the delivery of safe, high-quality care that is the foundation of an exceptional experience. In her role at Press Ganey, Bonnie drives improvement using data-driven strategies implemented within a framework of high reliability.

Prior to joining Press Ganey, Bonnie served as Director of Health System Improvements at Greater Oregon Behavioral Health, a Medicaid Coordinated Care Organization provider. Bonnie provided organizational oversight for services aimed to assure exceptional Member Experience (quality, accreditation, credentialing, provider relations, utilization management, network management and member services). As a Senior Operations Partner at Providence St. Joseph Health, she led groups of executives, providers, and operational leaders to develop transformational solutions to improve patient care, performance, culture and financial outcomes. Bonnie also spent three years as Chief Operations Officer/Chief Nursing Officer at Providence Seaside Hospital where she oversaw the 25-bed critical access hospital and hospital-based clinics.

Giuliano Torelli

Giuliano is the Medicare Program Manager for at Elevance Health, covering the Connecticut Market . In his role he facilitates programs to align with external stakeholders performance goals as it pertains to Stars, HEDIS, Risk Adjustment and CAHPS, while ensuring that patients are getting the care they need. Giuliano has been involved in healthcare quality improvement for over 8 years, priding himself in fostering great relationships to ensure a successful collaboration. In his free time he enjoys golfing and teaching cycling classes as - spinning instructor.

Mick Twomey

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 Wallace

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.

Tamara Khachikyan

Tamara Khachikyan is the Operational Program Manager at Blue Shield of California. Tamara’s current role focuses on providing strategic direction, oversight, and management of the Medicare Member Engagement programs, aiming to improve Medicare Stars performance. The effectiveness of the programs she leads and oversees is not only reflected in the health outcomes of the members but also the improvement in quality metrics. Prior to joining Blue Shield of California, she was a Senior Consultant at Kaiser Permanente who successfully managed the health plan’s NCQA Accreditation. With her substantial expertise in quality improvement, project management, and consulting, Tamara understands the quality and value of healthcare services.

Tamara Migut

Tamara is the Director of Quality Management for Health Alliance, a subsidiary of Carle Health. Carle, a Vertically Integrated Health System, encompasses hospitals, physicians, outpatient and wellness divisions, as well as the health plan. She has been in her role since 2019. In Tamara’s role, she has oversight of the Health Alliance quality improvement program, HEDIS data collection and reporting, and Member/Provider Resolutions. <

She brings over 23 years of experience in the healthcare field at Carle Health with focus on patient/member experience, data collection and analytics, and process improvement. <

In addition to her Bachelor of Science degree in Pharmacy from Midwestern University Chicago College of Pharmacy, Tamara is also a Certified Professional in Healthcare Quality from the Healthcare Quality Certification Commission.

Jessica Muratore

Jessica Muratore 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 where she became skilled in the interpretation of federal and state laws before entering managed care. Currently, she is the Chief Operating Officer with Rex Wallace Consulting, LLC (RWC) focusing on quality improvement across all lines of business with both health plan and vendor clients.  Before joining RWC, Jessica spent 10 years on the payer side.  Jessica worked for MVP Health Care and Centene Corporation in executive leadership positions. 

She was responsible for national market performance and execution, governance, quality improvement organizational structure, NCQA health plan accreditation, delegation oversight, quality compliance and program operations, federal and state audits, quality improvement strategy, and quality Medicaid RFPs and new health plan implementations.  She has extensive experience working with the Medicare, Medicaid, Marketplace, Commercial and the Basic Health Program populations.

Jenna Pinnelle

Jenna Pinnelle is the Medicare Program Manager for the state of Maine at Elevance Health. In her current role she manages and coordinates the development of provider programs related to Stars, HEDIS , Risk Adjustment and CAHPS. She has been involved in healthcare quality improvement for over 10 years and has a passion for elevating patient outcomes and experience throughout the healthcare continuum. In her free time she enjoys exploring the outdoors through surfing, hiking, and snowshoeing.

Moraima Rios Gonzalez

10+ years of experience in the healthcare industry specifically focused on Medicare Advantage Stars Rating, public policy, and compliance. Currently serving as the subject matter expert on Stars Rating Methodology and its related data sources. Responsible for leading analyses used to establish effective Stars strategies and initiatives impacting HEDIS, Operational, Member Experience among other measures. During my tenure MCS became the first Medicare Advantage Plan in Puerto Rico to attain 5 stars.

Completed my Dr. PH in Health System Analysis and Management from the University of Puerto Rico on 2016 and a Credential in Public Leadership from Harvard University on 2021.

Lisette Roman

Lisette is responsible for overseeing the design, development, and delivery of data-driven solutions based on the unique needs of Decision Point customers.

Lisette brings her training in health informatics and her experience in healthcare quality, self-reported outcomes, care management, and clinical operations from the provider and payer settings to understand healthcare organizations' needs and deliver actionable recommendations.

Sabrina Zerzouri

Sabrina Zerzouri is a Senior Program Manager of Medicare Quality at Point32Health where she is responsible for Medicare Star performance oversight and quality improvement. Her background in Public Health has contributed greatly to her success in developing creative strategies to address clinical and member experience quality gaps in healthcare today. She has developed successful provider engagement programs, actionable and informed reporting, and creative tactical solutions to overcome performance barriers. She believes in the power of data to address disparities in health equity and to improve health outcomes. Sabrina is active in professional organizations and is currently a Board Member for the New England Association of Healthcare Quality and a participant in the Boston Chamber of Commerce Women’s Leadership Program, Class of 2024.

Nazanin Salehitezangi

Nazanin is a Manager of Health Data Exchange Adoption and Analytics Consulting at Health Care Service Corporation which operates Blue Cross and Blue Shield® Plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. Nazanin’s current role at HCSC focuses on building core capabilities for a real-time bi-directional health data exchange. Nazanin’s work involves strategic and operational activities in acquiring health data to facilitate treatment, payment, and operations. She is also responsible for the adoption, value realization, and analytics needed to drive the Health Data Exchange program at HCSC. Prior to HCSC, Nazanin worked in an administrative role at Northwestern Medicine’s Feinberg School of Medicine in their outcomes transplant research group. Nazanin earned her bachelor’s degree in psychology from the University of Illinois at Chicago and holds a certificate in Leadership Principles from Harvard Business School Online. She is currently pursuing her Master of Science in Health Informatics with a focus on Healthcare Administration at Northwestern University. Nazanin has over a decade of combined healthcare and health insurance experience. Nazanin has a passion for solving healthcare’s biggest challenges and improving patient outcomes by using technology and data.

Reva Sheehan

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.

Kim Shell

An expert in multiple aspects of CMS star ratings and quality, Kim is a strategic minded healthcare executive, committed to creativity and innovation in every aspect of health care.

Kim has almost 30 years of extensive experience focused on quality management stars, accreditation and process improvement, inclusive of Six Sigma projects in the national health plan industry. Working for several of the largest US health plans for extended periods, she has designed and implemented roadmaps and tactical strategies designed to improve performance, increase member engagement and yield greater returns. Her experience includes working in local, regional, and national leadership roles and experience with Medicaid, Medicare and Commercial lines of business.

She has led efforts not only with health plans but also with other partners such as providers assisting in strategic design to maximize the efficiencies between payor and providers. Additionally, she has direct experience in 14 states/markets overseeing all aspects of quality, HEDIS/CAHPS/HOS as well as Risk Adjustment.

Kim has excelled in developing strategies to achieve outcomes on multiple aspects of quality, operations and network areas. Her outcomes have included being the recipient of the 5 Star Award for being the first plan in a national MCO to achieve the coveted 5-star rating, receiving the Executive Development Program nomination and incremental increases in the number of plans achieving their star goal from 42% to 67% within 2 years in another national Medicare plan.

Becky Simmons, RN, BSN

Becky is responsible for managing star ratings and other value-based performance strategies at Security Health Plan. Becky has over 15 years of experience managing primary care practices. She has a strong background and understanding of evidenced-based care, planning and directing departmental goals, developing quality improvement initiatives, and expertise in Medicare Stars, CAHPS, and federally qualified health centers. Becky has helped practices become accredited patient-centered homes, implemented care management programs, and introduced behavioral health into primary care.

Melissa Smith

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.

Stephen P. Winn, CPHQ

Stephen Winn is the Senior Director for Quality at the Mid-Atlantic Permanente Medical Group, a large multi-specialty medical group based in the Mid-Atlantic, and oversees Quality Program reporting, including HEDIS. With more than a decade of experience, he focuses on building programs, systems, and workflows that promote the delivery of high-quality care and accurate reporting.

Prior to working in Healthcare, he was an International Economist at the U.S. Department of Treasury.

Elizabeth Zahar

Elizabeth Zahar is a Program Manager with the Medicare Faith and Wellness Program at UPMC Health Plan. The program focuses on enhancing health outcomes in communities, enhancing member satisfaction, and contributing to higher quality ratings for Medicare STARs. Elizabeth joined the team in 2022 after spending 9 years in the Member Services Department, bringing expertise in VoC, root cause analysis, health promotion, and member engagement. She collaborates with internal teams to ensure all program materials and communications align with brand, legal, privacy and compliance standards, and is responsible for the majority of the communications between the program and its participants. Elizabeth strives to promote healthy equity for members and provide access to care for those who may be at risk.