Lili Brillstein
Matt Flora
Richard O'Donnell
Michael Ruiz
Anne Palmerine
Robin Wright King
Jennifer Winchester
Mark D. Wagner
Michael Rawdan, Ph.D., MBA
Linda Zang
Khaled Kadry
June St. John, CTP
Randy Vanderhoof
Robert Bowman
James Crawford
Michael Manna
Mary Eileen Bezman
Matt E. Moore
Tom Brekka
Lili Brillstein
Lili Brillstein is a nationally recognized thought leader in the advancement of Episodes of Care as a value-based approach for specialty care. She is the Director of Episodes of Care for the Market Innovations team of Horizon Blue Cross Blue Shield of New Jersey, and, under her leadership, has built the largest program for commercially insured patients in the country.
Lili is responsible for the overall direction, strategy, design and oversight of the Horizon Episodes of Care/Bundled Payment Program. When Lili joined Horizon in January of 2013, the Episodes program was still in pilot and included only total hip and total knee replacement episodes. The program has grown to include additional orthopaedic episodes (including low back/laminectomy, shoulder replacement, knee arthroscopy), obstetrics and gynecology, GI (including a Crohn's episode with a fully integrated behavioral health component), cardiology, and oncology.
Lili has been an Advisor to CMS on the OCM and other value-based models, as well as to several Specialty Practice organizations and Associations.
Lili is a passionate advocate of Episodes of Care/Bundled Payments as a strategy to successfully migrate from fee for service to quality- & value-based models that reward providers for excellent outcomes and patient experience, while reducing the overall cost of healthcare.
Her expertise at cultivating functionally collaborative relationships between payers and providers across the full continuum of health care has allowed not only the pillars of the triple aim to be achieved, but the spirit of the relationships have shifted from one of adversaries to one of collaborators.
Matt Flora
Matt Flora is the Director of Medical Informatics at Arkansas Blue Cross and Blue Shield (ABCBS). Matt has an M.S. in Statistics from the University of Arkansas and has worked in healthcare data analytics for over 12 years. In his current role at ABCBS, he has oversight of multiple analytics and informatics teams, including teams that focus on the research and implementation of payment innovations. Over the past five years, ABCBS has implemented statewide episodes of care, patient centered medical homes, collaborations with accountable care organizations, and has participated in CMS's Comprehensive Primary Care Initiative since its inception. Matt's analytic teams support Arkansas providers with the data needed to operate under these new payment models.
Richard O'Donnell
Rick O'Donnell received his undergraduate degree in Psychology and a graduate degree from the School of Public Health at the University of Michigan. (Go Blue!) After five years as an administrator of a network of community health centers in southwest Michigan, he became employed at one of the first Health Maintenance Organizations in Michigan, which later became Blue Care Network. After nine years of MCO experience, Rick became the first Director of Managed Care for Blodgett Memorial Medical Center in Grand Rapids, Michigan, which, upon merging with Butterworth Hospital, became Spectrum Health. He remained in that role for 15 years and then joined Trinity Health, first as Michigan Regional Director of Payer Strategies and Contracting and, subsequently, Corporate Vice-President. In October, 2012, Rick accepted an offer to head up the Provider Contracting and Network Development Division for Priority Health, the full-products health plan subsidiary of Spectrum Health. Rick has taught multiple college courses in Health Care Economics, and lectured extensively for HFMA and other health care education organizations at the national level. Rick, who is a native of Detroit, and his wife, Alice, a Registered Nurse, reside in Northville, Michigan. They have three adult children, none of whom have exhibited the slightest interest in health care careers.
Michael Ruiz
As UCare's Vice President of Provider Relations and Contracting, Michael Ruiz leads complex negotiations with providers and develops innovative Medicare, Medicaid and commercial value-based contracting arrangements. He also manages teams and processes to support improved operations and performance at UCare. Ruiz was most recently Vice President, Medicare Market Performance at UnitedHealthcare in Minnetonka, Minn. His responsibilities included overseeing value-based contracting analysis for incentive programs, addressing gaps in Medicare Star Ratings and improving medical cost performance for health plan members. He previously held positions as Senior Director, Accountable Care Strategy at UnitedHealthcare; Senior Provider Contract Manager with Blue Cross Blue Shield of Minnesota in Eagan, Minn.; Project Manager with Medical Management, Inc., of Portland, Ore.; and Hospital Director with Banfield Pet Hospitals in the Twin Cities area. Ruiz earned a Bachelor of Arts degree from the University of Minnesota. He is a member of the Health Care Financial Management Association. Ruiz and his family live in St. Paul, Minn., where he coaches the Mendota Heights Athletic Association Football, Highland Hoops Basketball League and Hi-Mac Baseball League, and is president of the Friends of the Oxford Pool.
Anne Palmerine
Anne Palmerine is the Associate Vice President of Customer Engagement and Enrollment Services for UPMC Health Plan. Anne has led UPMC Health Plan in Customer Service for the past fourteen years, including Enrollment and Retail. Accomplishments have included implementation of a highly esteemed Health Care Concierge program, implementation of Genesys call center technology, driving first call resolution and service recovery, integration of an omnichannel experience, and achieving JD Power Call Center Certification in 2009, 2011, 2012, 2014 and 2016. Achievements have included from JD Power #1 PA Region Overall Member Satisfaction, from ICMI, Best Strategic Value to our Organization and from IQPC, Best in Class Contact Center (Over 200 Seats). Anne has managed in customer service call centers for the past 24 years with a focus on customer retention, growth, and sales.
She has a bachelor's degree from West Virginia University and an MBA from the University of Pittsburgh.
Robin Wright King
Robin Wright King is Director of Consumer-Directed Health (CDH) Strategy and Product Management at Blue Cross Blue Shield of Massachusetts. She is responsible for the Plan's CDH strategy and offerings. Her work encompasses development of strategies to bring relevant and enabling benefit designs to the market that are easy to use and help members to make informed healthcare decisions for themselves and their families. This includes all aspects of the consumer engagement and experience for those enrolled in CDH plans including healthcare financial accounts, communications, education, wellness incentives, and adoption strategies. She previously managed the consumer-directed health function at Blue Cross Blue Shield of Michigan.
Jennifer Winchester
Jennifer Winchester is the Senior Director of Provider Network Innovations and Partnerships at BlueCross BlueShield of South Carolina, where she is responsible for designing and implementing alternative payment methodologies for providers in South Carolina. She has over 15 years of provider and payer experience in managed care where she most recently served as the Director of Managed Care for Lexington Medical Center in West Columbia, SC. Jennifer is a skillful negotiator and excels in directing complex projects. Jennifer's healthcare vision is to create win-win solutions for providers and payers that are effective, value-added and sustainable.
Mark D. Wagner
Mark Wagner leads Provider Reimbursement Teams ensuring the analytics and systems can support current and future reimbursement negotiations, methodologies and strategies. His oversight of provider pricing analytics and implementation spans all the different lines of business including Medicare, Medicaid and Commercial products.
Mark has over a decade of experience in the health care industry ranging from Research and Development, Marketing, Operations as well as Sales. Mark earned a Bachelor of Science degree in Biology from the State University of New York at Geneseo and an Masters of Business Administration from the University of Rochester's Simon School of Business. Mark resides in Rochester, New York
Michael Rawdan, Ph.D., MBA
Michael is responsible for Account Management & charter for a structure that redefines the Patient Financial Experience for the largest Provider in Idaho. He has over 20 years' experience in customer management and patient experience working for firms such as Capital One and Hewlett-Packard.
Michael has held various roles across diverse organizations including customer management and insights for Capital One. At Hewlett-Packard, Michael was the Executive responsible for a $2B e-Commerce organization. Within HP, Michael managed Data & Analytics to drive user interface changes that drove significant improvements in performance.
These experiences have led Michael to St. Luke's Health System where he has been tasked with identifying and developing solutions that improve Patient Financial Experience from end to end. This is defined as pre-patient experience through each step of the clinical and non-clinical touch points.
Michael holds a BS in Marketing from the University of Tampa, MBA from Northwest Nazarene University and a dual PhD. in International Business & Decision Sciences from NOVA Southeastern University.
Linda Zang
Linda Zang, CCM, is the assistant treasurer at the University of Pittsburgh Medical Center, where her responsibilities include cash forecasting, payment posting, cash accounting, banking operations and financial technology development for UPMC�s 160 subsidiaries. She has 35 years of experience in the treasury field, involving retailing, banking and healthcare. She has been past president of the Pittsburgh Association for Financial Professionals.
She received her B.S. from Georgetown University and M.B.A. from Golden Gate University, San Francisco. Ms. Zang has won several national awards for treasury technology, including the Pinacle Award from the Association of Financial Professionals, and the Alexander Hamilton Award from Treasury & Risk magazine. She is the author of a number of articles and has spoken regularly at financial conferences.
Khaled Kadry
As a lifelong public health advocate and professional with 10+ years of experience, Mr. Khaled Kadry has held various positions in healthcare experience, including work surrounding revenue cycle management, consulting, performance improvements and business analytics. Mr. Kadry has held positions at Navigant Consulting, Northwell, Montefiore - KPMG and is currently the revenue cycle director at Columbia University Medical Center.
Mr Kadry has a BSc in Business Management at Baruch College and earned an MBA from Dowling College and MHA from Columbia University. Mr. Kadry also has an Executive Certification in financial management from Cornell University and is certified in Green Belt Six Sigma and Six Sigma Lean.
His areas of expertise include revenue cycle, P&L, staffing, financial restructuring, data analytics and process improvements.
Mr. Kadry was born and raised in Cairo, Egypt, and moved to New York over twenty years ago to attend Baruch College.
June St. John, CTP
June has 32 years of Treasury Services product management and customer service experience. Since 2005, she has helped lead Wells Fargo's solutions development for the healthcare industry. Currently she is responsible for Wells Fargo's Revenue Cycle Management - Claims Payment Solution for Commercial/Government Insurance Payments product strategy and Supplier Payment Solution, a healthcare provider supply chain management payables strategy.
June is a frequent presenter and author on the convergence of healthcare and banking.
June holds both graduate and undergraduate degrees from the University of North Florida in Jacksonville, FL.
Randy Vanderhoof
Randy Vanderhoof is the executive director of the Secure Technology Alliance, a not-for-profit, multi-industry association, working to stimulate the understanding, adoption and widespread application of secure solutions, including smart cards, embedded chip technology, and related hardware and software.
The Alliance organization provides a forum for industry stakeholders to collaborate and educate others on the appropriate uses of secure technologies to enable privacy and data protection.
In addition to his leadership role with the Secure Technology Alliance, he is also the Director of the U.S. Payments Forum, an independent, cross-industry organization established to support the alignment of global payment networks, regional payment networks, issuers, processors, merchants, and industry suppliers to promote the efficient, timely, and effective introduction of EMV chip technology and other new and emerging payments technologies in the U.S. that protect the security of, and enhance opportunities for payment transactions within the U.S..
Prior to joining the Smart Card Alliance, he spent a majority of his professional career in management positions with a number of global organizations involving smart card identity and payments technology including IBM Global Smart Card Solutions, First Access, Inc., and Schlumberger (now Gemalto).
Randy is a graduate of Saint Joseph's University in Philadelphia, PA with a BS in Management Marketing. He received his MBA from Rider University in Lawrenceville, NJ.
Robert Bowman
Bob Bowman is the Associate Director of Transactions for the CAQH Committee of the Operating Rule for Information Exchange (CORE). Bob oversees the CORE Rule development process, supports the CORE Certification process, which was designed to demonstrate adoption of the CORE rules, serves as a CORE liaison to the standard development organizations (SDOs) and supports CORE's industry education and outreach. Prior to joining CAQH CORE, Bob served as the EDI manager for Humana, Inc. He also worked at Xerox as an implementation manager - implementing EDI, Web, and HIPAA projects for state, federal, and commercial clients.
Jim Crawford
Mr. Crawford is a relationship officer for the Healthcare Sales team for BNY Mellon's Treasury Services, responsible for marketing domestic and international cash management solutions to organizations in the healthcare industry. These include insurance companies, hospital systems, pharmaceuticals, biotech and both manufacturers and distributors of medical devices.
Prior to joining BNY Mellon, Jim led Finance and Accounting Business Processing Outsourcing (BPO) efforts in North America for Cognizant, a global leader in business and technology services, where he was responsible for business development for Finance and Accounting in North America. Jim's past roles include vice president of Business Development at SourceNet, the BNY Mellon Accounts Payable Services group where he managed relationships with the company's clients and prospects in the Midwest and Northeastern United States. Prior to joining SourceNet, Jim worked in a number of business development roles, developing human resources and benefits solutions for Automatic Data Processing (ADP) and led the document management outsourcing efforts for the Healthcare National Account organization of Standard Register. Jim is a graduate of Iowa State University.
Jim has been a guest speaker on the topic of financial process outsourcing and accounts payable processes at several National AFP conferences and over a dozen regional financial conferences and meetings.
Michael Manna
Mr. Manna serves as a Healthcare Industry Solutions Specialist within the Commercial Banking business at J.P. Morgan. Providing consultative services for the treasury and payments teams, he is focused on aligning multiple and technically complex treasury solutions to meet the highly customized and unique needs of clients engaged in Healthcare financial operations. Through direct collaboration, Mr. Manna assists the firm's clients to improve the working capital cycle through the optimization of accounts receivable and accounts payable functions, managing liquidity, and providing forward looking analysis of industry trends. Mr. Manna's entire twenty-five plus year career has been centered on technologies that enable financial transaction processing; for twelve of those years, his concentration has been on the intersection of treasury functions with Healthcare financial management. Prior to joining J. P. Morgan in July of 2017, he served as First Vice President - Healthcare Consultant at SunTrust Bank where he represented treasury services as a member of the bank's Healthcare Steering Committee. He has held senior positions in sales, sales management, product management, general management, and M&A assignments at a variety of private and public companies. An authority on Healthcare revenue cycle, Mr. Manna speaks regularly at industry conferences, covering topics as diverse as the impact of legislative changes on the Healthcare industry to best practices in lockbox processing. He is a current and long time member of both the Healthcare Information and Management System Society and the Healthcare Financial Management Association. An honors graduate of Boston College, he holds a Bachelor of Arts degree with concentrations in both Political Science and Philosophy. He currently resides in North Texas and is a member of the Board of Directors of the Perot Family Campus of the North Texas Food Bank.
Mary Eileen Bezman
Mary Eileen Bezman, MBA, is a Pharmacy Revenue Manager at NY Presbyterian Hospital. Ms. Bezman brings over 15 years of experience in healthcare IT, Revenue Cycle management, and training to her role as she leads the Pharmacy Revenue initiative at NY Presbyterian Hospital and network facilities.
Prior to joining New York Presbyterian Hospital, Ms. Bezman spent several years in varying progressive roles at Siemens American Healthware Systems and in private healthcare consulting. Ms. Bezman provided IT consulting and training services to Nassau University Medical Center, NYU, Beth Israel Consortium, Kingsbrook Jewish Medical Center and Maimonides hospitals. In addition, Ms. Bezman has taught at Kingsborough Community College and Hofstra University.
Most recently Ms. Bezman has joined the Pharmacy Department at NY Presbyterian Hospital. She has focused her expertise in the complex areas of medication purchasing, IT Setup, charging, contract negotiation, and revenue realization as well as support for the Internal Control and Corporate Compliance departments.
Ms. Bezman holds a Master of Business Administration degree from Rensselaer Polytechnic Institute and a Bachelor of Science degree in Mathematics from Stony Brook University.
Matt E. Moore
Matt Moore is the Senior Director of Consumer Payments at the new Change Healthcare. Prior to the
McKesson Technologies and Change Healthcare merger (which occurred in March 2017), Matt joined
McKesson 7 years ago and is responsible for the consumer payments business and product & service
solutions.
Prior to Change Healthcare, Matt spent the previous 20 years of his career working for and
with large U.S. financial institutions developing and launching online transactional solutions, invoice
printing and remittance processing solutions for retail and commercial companies, and built EBPP and
EIPP revenue management services.
Tom Brekka
VestaCare helps hospitals and other medical care providers secure the majority of their patient-responsible revenues, while enhancing patient satisfaction by helping them avoid the devastating impact of medical bad debt.
Brekka has nearly three decades of healthcare industry experience as both an entrepreneur and executive manager of high technology companies.
He was the founder and CEO of WiSE Medical Systems, which developed the first mobile point-of-care information system for physicians. Brekka raised over $30 million from business partners Pfizer and AMP in the launch of WiSE. He was also founder and CEO of two semiconductor industry companies Sequoia Semiconductor and Syncerption, which was sold to MCT, Minneapolis, MN. While at MedPlus, now owned by Quest Diagnostics, Brekka assisted in developing early cloud-based solutions for their hospital medical record products.
Brekka has published numerous articles and papers on health related matters, has been a keynote speaker at the Self Insurance Industry Association national conference and the AAPPO American Association of PPOs conference. Also, Mr. Brekka will be a keynote speaker at the upcoming Silicon Valley CFO Hospital Conference in San Jose, CA, as well as panel presenter and workshop leader at Becker's RCM/HIT Healthcare Conference in Chicago, both in September 2017.
He has been married for 32 years, has three children and is a competitive triathlete, runner and ocean swimmer.