Thomas "Tommy" Duncan is the founder, CEO and a member of the board of Trusted Health Plans, Inc., a fully-licensed Medicaid HMO, with plans in Washington, D.C. and Southeastern Michigan. As CEO, Duncan has transformed Trusted from a start-up into one of today's most successful national Medicaid health plans. In the last four years, Trusted has increased primary care visits by 24%, reduced both emergency room visits by 12% and inpatient visits by 20%. Duncan continues to improve the traditional model of Medicaid health delivery. His prior experience includes founding Care Compensation Specialists, which specialized in the enrollment of Medicaid, Temporary Assistance for Needy Families, Aid to Blind & Disabled, and Supplemental Security Income populations. Within two years, Care Compensation Specialists was purchased by Accretive Health, a publicly- traded firm offering revenue cycle management services for hospitals. Serving as vice president at Accretive, Duncan recouped close to $700 million of previously uncovered revenue for the hospitals he serviced. The seasoned health care executive received his MBA from Florida A & M University, School of Business, magna cum laude, and has completed the Harvard Business School Key Executives Program. Today, Duncan serves on the board of Medicaid Health Plans of America, is a member of Young Presidents' Organization in Washington, D.C., and speaks nationwide on transforming today's Medicaid delivery system. When not running a health plan or spending time with his family, Duncan can be found playing chess or working on his upcoming book about fixing the Medicaid system.
Jim Milanowski has over 22 years' experience in the management of mental health, substance abuse, behavioral health managed care and medical care coverage programs. Mr. Milanowski currently serves as the President and Chief Executive Officer of the Genesee Health Plan (GHP), administering a community based indigent health care plan. The health plan has covered over 70,000 Genesee County residents since 2001. Since the start of enrollment into Affordable Care Act in 2013, GHP has conducted outreach and enrollment sessions with over 15,000 Genesee County residents. The health plan received the 2015 Pinnacle Award from the Michigan Association of Health Plans for this effort.
As a strong advocate, his expertise includes working to reduce racial disparities, uncompensated care, and the impact of chronic disease. During his leadership, Genesee Health Plan has received the national quality award from URAC for Best Practices in Patient Empowerment and Protection, the Greater Flint Labor Council's Community Partnership Award and the Robert M. Pestronk Excellence in Public Health Award. He is a founding member of the Health Net Collaborative, and a member of the Greater Flint Health Coalition Access, Dental and Medical Group Visit Committees. He is the Treasurer of the Michigan Association of County Health Plans and is on the Board of Directors for the Genesee Community Health Center.
Mr. Milanowski received his Bachelor of Arts degree in Psychology from Spring Arbor University and his Master's of Science degree in Clinical Psychology from Eastern Michigan University. He is a limited-licensed psychologist in the state of Michigan, and has extensive counseling experience with adult, child, and adolescent populations.
Lisa Holden is the Vice President of Accountable Care for Independent Health Care Plan (iCare) located in Milwaukee, Wisconsin. In her role, Holden is responsible for developing and implementing strategies and programs to obtain measured care management performance levels and for the on-going management of the iCare's member experience within its model of care.
Holden has extensive and varied experience in nonprofit management, government affairs, public policy, coalition building and leadership.
Prior to joining iCare in 2014, Holden was the Senior Director of Organizational Development and Education at Visiting Nurse and Hospice Care of Santa Barbara.
Holden's public policy and government affairs experience includes eight years serving as the Executive Director of the Connecticut Coalition Against Domestic Violence (CCADV) and Board Member for the National Network to End Domestic Violence. Under her leadership CCADV became a state and national leader on addressing the needs of domestic violence victims within the criminal justice system.
Holden's nursing leadership career included serving as the Regional Manager for Ambulatory and Community Women's Health Services for Aurora Health Care in Milwaukee, WI. In that position, Holden led efforts to improve health care services for women and children and foster reform and improvements in government agencies and community organizations to reduce infant mortality. From 1983 to 2000, Holden was extensively involved in both the March of Dimes and the Wisconsin Association of Perinatal Care (WAPC), chairing the joint Public Policy committee.
As Director of Pharmacy Therapeutics at Fallon Health, Karen implemented transitions of care and MTM programs for Medicare Advantage, Senior Care Options, Dual Eligible and PACE programs. These programs are integrated with the care and utilization management teams and preliminary data indicates a decreased 30-day admission rate for members enrolled into these programs.
Prior to her current role at Fallon Health, Karen developed and implemented medication management programs for medically complex Massachusetts Medicaid members to ensure access to medically necessary drugs and provide comprehensive medication reviews. At Health New England (HNE), in Springfield, MA, Karen implemented clinic and university based MTM programs for commercial, Medicare and Medicaid populations and a care transition program in collaboration with a PBM. Karen also managed the HNE Integrated Care Management Team.
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.
Cindy Colligan, RN, BSN, MBA, CCM
Cindy Colligan, RN, BSN, MBA, CCM, is a Certified Nurse Case Manager (CCM). Currently she is the Director of Clinical Care Services, Government Programs, for Optima Health in Virginia Beach, VA. Her responsibilities include managing teams that include: Preauthorization, Appeals & Complaints, and Integrated Case Management for Government Programs. Cindy holds a Bachelors' of Science in Nursing from Old Dominion University, as well as Masters' of Business Administration from Averitt University. Her leadership experience includes Home Health, Home Infusion and a variety of Health Plan roles. She started her career in the United States Army as a Pediatric Nurse for 4 years active duty.
Molly joined PacificSource in February 2012 on the Medicare Utilization and Management team joined the Medicaid Member Support Services team in Case Management a year later. Her role evolved into a Complex Care Outreach Specialist and she created the Community Resource Huddle in Central Oregon. After three years in a member facing role, Molly accepted a new position as the CCO Project Coordinator for Central Oregon. Molly started working in healthcare 17 years ago starting at Good Samaritan Legacy Health Systems in Radiology. After five years with Legacy, Molly moved to Central Oregon and worked at St. Charles Health System in Pre-Surgery and OR scheduling. Molly was awarded PacificSource's Service Award in 2013 and Community Outreach award in 2014. Molly currently chairs the Aging and Disability Resources Center Operations Council, is the Non-Emergency Medical Transportation representative for the Public Transportation Advisory Committee, is the Chair of PacificSource's Healthy Communities Committee, and is the Co-Chair of the Homeless Leadership Coalition of Central Oregon. Molly lives with her husband and their children in Bend. Molly enjoys spending time with friends and family, fishing, home improvement projects, and yard work. Molly is now also leading her daughter's Girl Scout Troup and coaching her 4th grade volleyball team.
Trudy Townsend is a Community Health Development Coordinator for PacificSource in the Columbia Gorge Coordinated Care Organization. Trudy is no stranger to leading community based initiatives designed to improve outcomes for individuals and groups of people. She began her career as a Director of the Wasco County Commission on Children and Families where she emerged as a leader in community mobilization. Later she took on the role of Director of a Safe Schools Healthy Students initiative for the North Wasco County School District. It was there that she led an initiative to transform the entire region into a trauma informed, resilience building community. At PacificSource, Trudy has been a part of several initiatives to transform healthcare and improve health outcomes in the Columbia Gorge region. When Trudy is not leading community initiatives she works as a consultant for the Sanctuary Model for Trauma informed care or she spends time hiking and paddle boarding with her sons.
Amy Riegel is the Director, JobConnect OH at CareSource. She plays an integral role in building a new division of CareSource that will transition current Medicaid members off of government subsidies into a high quality life. JobConnect will accomplish this goal through assisting members to build a solid structure of economic and social supports that when coupled with the health supports currently in place will give members a new path for their future. Prior to joining CareSource, Amy was with the City of Dayton for ten years serving as the Manager of Community Development and Grant Administration. Amy provided policy leadership to the City in the areas of housing development, asset based community development, education, and homelessness reduction. During her tenure she oversaw the administration of over $200 million dollars in HUD funding and used forward thinking strategies to provide a 3:1 leverage with private, local and state dollars. She works tirelessly for the underserved within the community. She has served on numerous Boards within Ohio that are focused on poverty elimination, affordable housing, and neighborhood revitalization. Amy is a graduate of Wright State University. She has her Housing Development Finance Professional certification from The National Development Council. She is proud to live in Dayton, Ohio with her husband and three young daughters.
Melanie Cavaliere serves as the Chief of Innovative Care Delivery at the Maryland Health Care Commission (MHCC). Melanie has over twenty years of professional experience in health care policy and employee benefits consulting. Current projects include designing and implementing statewide practice transformation efforts in Maryland for primary care and specialty practices. Melanie previously worked as a Vice President at Discern Consulting in Baltimore, Maryland where she developed and implemented PCMH and ACO incentive plan and reward programs and Value Based Insurance Design (VBID) strategies. Melanie has also held consulting positions at Mercer and Aon. Melanie received a Bachelor of Arts in Psychology and a Master of Science in Industrial and Labor Relations from West Virginia University.
Della Gregg has been with the Oklahoma Health Care Authority (OHCA) since 2007, serving as the Health Management Program (HMP) Manager since 2012. Previous OHCA roles include HMP Specialist and Senior Research Analyst in the Health Policy Division. Gregg is also a certified Chronic Care Professional Health Coach. Prior to joining OHCA, Gregg worked in both primary care and hospital settings. She earned a Bachelor of Arts in Liberal Studies from the University of Oklahoma. Gregg lives in the Oklahoma City area with her husband and three teenagers. She enjoys attending and cheering at her children's numerous athletic events.
Gary Melis R.Ph.
Gary Melis is a Clinical Pharmacist for the past six years at Network Health, a local health insurance provider in Northeast and Southeast Wisconsin. He is currently one of two pharmacists involved making MTM calls in-house. His responsibilities also involve NCQA, pharmacy appeals, P&T Committee, Member and Provider relations. Gary's also has experience as pharmacy manager for a national long term care company, pharmacy manager for retail pharmacy chain, and Pharmacy Director for a National Health Care provider. He has also been a pharmacy instructor at local medical college family practice clinic.
Darren Clonts is a Clinical Pharmacist with Cigna Medical Group (CMG). In his role, he is actively involved in the management of diabetic patients via a collaborative practice arrangement and has been responsible for the development and implementation of CMG's pharmacist medication reconciliation post-hospital discharge program. Darren began his work with Cigna in 2009 and has held various roles including Pharmacy Manager and other project management and leadership oriented roles. Darren received his Doctor of Pharmacy degree from the University of Arizona College of Pharmacy in 2009. In 2015, he received his Master in Business Administration degree from the University of Phoenix School of Business. He also holds certificates in Medication Therapy Management, Cardiovascular Disease Risk Management, and Diabetes Care from the American Pharmacist Association. Darren's professional interests include team-based care, six sigma process improvement, Medicare Advantage and other value based payment models and how pharmacy fits into the equation. Personally, he enjoys hiking, fishing, sports, and spending time with his wife and six children.
Alen Pajazetovic, PharmD, BCACP
Alen Pajazetovic is a Clinical Pharmacist with Cigna Medical Group (CMG). In his current role, he is primarily involved in the development and implementation of quality initiatives to improve Part D STARs measures, and formulary management. Alen joined Cigna Medical Group in 2012 and has held various roles including staff pharmacist, pharmacy supervisor, and clinical pharmacist. Alen received his Doctor of Pharmacy degree from Midwestern University - College of Pharmacy Glendale in 2012. In 2016, he received his designation as a Board Certified Ambulatory Care Pharmacist. Alen's professional interests include quality improvement, informatics, collaborative practice and Medicare Advantage. Alen enjoys travelling, hiking, and snowboarding in his free-time.
Donna Mowry is the Manager of Operations for Neighborhood Health Plan of Rhode Island’s [email protected] program. [email protected] is a home-based primary care program for high-risk members, carried out by Nurse Practitioner-led teams. Mowry has been with the program since its inception in 2014. As Manager of Operations, Mowry manages the delivery of health based primary care services designed to meet members where they live. Her background prior to Neighborhood was focused in medical office management. Mowry received a Masters of Business Administration from Johnson & Wales University and a Graduate Certificate of Business Analytics from Bryant University.
Shelley L. Grimm, BSN, MBA
Shelley L. Grimm, BSN, MBA, is a graduate of the University of Pittsburgh School of Nursing and the University of Pittsburgh Katz Graduate School of Business. She is the Manager of Program Development at Gateway Health where she manages a team of Clinical Specialists who design programs and interventions to meet the needs of members with complex medical, behavioral and psychosocial needs. Shelley has over 20 years experience in disease management, population health, program development and project management.
Gabriel Uribe, MPA
Gabriel Uribe is the Independent Living and Diversity Services Manager at the Inland Empire Health Plan (IEHP). IEHP is a not-for-profit public entity, rapidly growing Medi-Cal and Medicare health plan in California. With a provider network of over 5,000 physicians and more than 2,000 employees, IEHP serves over 1.2 million residents of California's Riverside and San Bernardino counties who are enrolled in Medi-Cal, andCal MediConnect (Medicare). Mr. Uribe currently serves as the President and Chairman of the Inland Empire Disabilities Collaborative (IEDC). Launched as a vehicle for social change the IEDC provides networking and educational resources to more than 400 regional organizations that serve over 450,000 seniors and persons with disabilities in Southern California's Inland Empire. Gabriel is a doctoral student at the University of Southern California's School of Social Work and holds a Masters degree in Public Administration from Cal Poly Pomona. He has over a decade of professional experience in the delivery of public services for populations that experience social, educational and health disparities. He is committed to the equitable and responsive delivery of health care services to IEHP Members who identify as seniors and persons with disabilities.
Matthew Botti, MSN, RN, CCM
Matthew Botti is from Westbury, NY and graduated from Duquesne University with his BSN in 2004. He has over 10 years Emergency Room experience in the clinical setting and obtained his MSN from California University of Pennsylvania in 2017. He has over 5 years of Case Management experience both in the clinical and managed care setting. He is a recipient of the Duquesne Alumni Award, Cameo of Caring, and Daisy Award. He currently serves as Manager of Clinical Program Implementation for Gateway Health Plan.
Jenny Buckley, RN, BSN, CHPN
Jenny Buckley is a Certified Hospice and Palliative Care Nurse with 18 years' experience caring for terminally ill patients and their families. She has expertise in teaching and writing about end of life care conversations and best practices in palliative care. She is currently the Director of Palliative Care and Community Outreach at Weinstein Hospice in Atlanta, GA.
Aaron leads corporate partnerships with Medicaid, Medicare, and other risk-bearing organizations. Aaron specializes in developing strategic scopes of work aligned with an organization's financial and clinical goals. Aaron has spent the last decade in corporate leadership positions specifically pertaining to non-emergent medical transportation. Prior to One Call, he designed and led the largest and fastest growing transportation management programs for Medicaid and Medicare health plans. Prior to that, Aaron spent over a decade as a partner and owner in project management and technology consulting firms with specific practices around healthcare, logistics and government programs
Scott Afzal is the President of Audacious Inquiry and a Strategic Advisor for CRISP, a health information exchange serving Maryland, DC, and West Virginia. Across both roles, Scott establishes organizational growth strategies, delivery system reform initiatives, and technology solutions to support value-based payment models and connected communities. Through Ai, Mr. Afzal advises other states, health systems, and health information organizations on health information exchange (HIE) implementation approaches and sustainability strategy. Previously at CRISP, Mr. Afzal served as the Program Director for the organization's first 10 years; he managed the roll-out of CRISP's HIE network while leading the development of new service offerings. Scott is a noted speaker on HIE, having presented at regional and national health IT conferences. Prior to joining Audacious Inquiry, he served as a consultant with Accenture, Inc. out of their New York City office. Mr. Afzal holds a Bachelor of Science in Business Administration (BSBA) from Bucknell University.
Keith Degner is the Vice President of National Accounts at Shield HealthCare, an industry leader
serving the medical supply needs of the growing population of caregivers and families who
manage medical care at home. With more than two decades of service across the healthcare
industry, Degner currently spearheads Value-Based Contracting for the disposable supply side of
DME. His focus on environmental factors for care coordination at home - as well as effective
supply chain utilization and cost management – leads Shield HealthCare's efforts to build
productive business relationships across the customer spectrum.
As a national leader in incontinence, urological, ostomy, enteral nutrition and wound care supplies, Shield HealthCare is deeply committed to providing tools and resources to educate and support those with complex medical needs. Since 1957, Shield has been serving our local communities, ensuring smooth transitions from hospital to home. With outstanding customer service and a vast library of lifestyle, education and community connections, Shield focuses on empowering individuals to manage their healthcare conditions at home and lead enriched lives.