Speakers

Below you will find this year’s list of knowledgeable and dynamic speakers. Click on the boxes below to learn more about each individual.

Jerry Brehany

James Brehany, PharmD, JD, PA-C

Associate Vice President, Chief of Staff
AmeriHealth Mercy/PerformRx

James Brehany, PharmD, PA-C, JD, currently holds the position of Associate Vice President, Chief of Staff for AmeriHealth Mercy/PerformRx;   He has devoted the vast majority of his thirty year career in pharmacy to managed care.

During this time Jerry has held a number of operational, clinical, and management positions in both the PBM and managed health care markets, including Director of Drug Purchasing, Director Specialty Drug Operations, PBM Corporate Counsel, and Vice President/General Manager Mail Service Operations. In addition, Jerry, as an Associate Professor of Pharmacy Administration, taught Pharmacoeconomics and Principles of Managed Care at the University Of Rhode Island School Of Pharmacy.

Laura Cranston

Laura Cranston, R.Ph.

Executive Director
Pharmacy Quality Alliance, Inc.

Laura Cranston is currently the Executive Director of the Pharmacy Quality Alliance, Inc. (PQA), a non-profit, membership-based organization that was formed in April 2006.  PQA’s mission is to improve the quality of medication use across healthcare settings through a collaborative process to design and implement performance measures, demonstrate improvements in patient care, and recognize examples of exceptional pharmacy quality. Laura has built the PQA organization from the ground up with the leadership and engagement of a 17-member Board of Directors. Today, PQA is a 140-plus member organization that serves as a multi-stakeholder, consensus-based organization. PQA’s membership includes health plans, PBMs, government agencies including CMS and the FDA, retail pharmacy organizations, HIT and MTM vendors, standards setting organizations, pharmaceutical manufacturers and the majority of pharmacy practitioner and trade associations.

Laura Cranston has been over two decades in healthcare association management. She worked initially as a resident at the American Society of Consultant Pharmacists, than progressed to a position at the National Association of Chain Drug Stores, and then established the Institute for the Advancement of Community Pharmacy.

A pharmacy graduate of St. John’s University College of Pharmacy and Allied Health Professions (1984) in New York, Laura currently serves as Chair of the Dean’s Advisory Council of the St. John’s University College of Pharmacy and Allied Health Professions, and she also serves on the Board of Governors for the overall University. She is also on the Dean’s Advisory Council at the University of Notre Dame.

Laura is a frequent lecturer/presenter on the issues of appropriate and safe medication use, and quality measurement.

Karen Dale

Karen Dale R.N., M.S.N.

Market President
AmeriHealth Caritas District of Columbia

Karen M. Dale is the Market President for AmeriHealth Caritas District of Columbia, one of the largest Medicaid Managed Care Organizations in Washington, DC. She leads initiatives that strategically position the organization as a market leader with innovative solutions for the critical challenges faced by its members.

Ms. Dale is a highly skilled, visionary leader who has dedicated her entire career to helping others and ensuring equal health opportunities for populations at risk. Having held multiple positions of leadership during the past two decades, she has worked with a broad group of stakeholders to address policies, and other key factors that impact the production of health. She considers it a privilege to utilize her expertise in program development, significant knowledge of health care finance and delivery systems to make a difference in the lives of so many.

Ms. Dale has guided the execution of unique approaches to managing the complex needs of person with multiple health risks. These efforts include the use of telemedicine to aid in the management of chronic diseases, peer to peer outreach using community health workers, and the roll-out of a multifaceted member engagement approach. In addition, her philosophy that all persons deserve access to the right care, without barriers, starting where they are, has led to several collaborative relationships with providers, community partners, philanthropists and businesses to develop evidence-based, population health strategies.

Karen Dale holds a Master of Science Degree in Psychiatric Mental Health Nursing from The Catholic University, Washington, DC, a Bachelors of Science Degree in Nursing from George Mason University, Fairfax, Virginia, and was a member of the Leadership Greater Washington Class of 2003. She serves as Board Chair for CommonHealth ACTION, a Board Member for both Volunteers of America National Services and, the Volunteers of America National Board.  In addition, she serves on the District of Columbia State Innovation Model Advisory Committee.

Andrea Gelzer, MD, MS, FACP

Andrea Gelzer, MD, MS, FACP

Senior Vice President and Corporate Chief Medical Officer
AmeriHealth Caritas

Dr. Andrea Gelzer is the senior vice president and corporate chief medical officer for AmeriHealth Caritas. She is responsible for setting the company’s overall medical management, quality, informatics, and provider value-based engagement strategies, and clinical policy development.

Before joining AmeriHealth Caritas, Dr. Gelzer served as the Chief Medical Officer for Boston Medical Center HealthNet Plan, a managed care plan providing coverage for Medicaid and other low-income residents in Massachusetts. She also served as Senior Vice President Clinical Public Affairs at CIGNA Corporation, and spent 16 years practicing internal medicine.

Dr. Gelzer serves on several national committees focused on improving health care quality for Medicaid and Medicare beneficiaries, including the Agency for Healthcare Research and Quality (AHRQ) National Advisory Council, the CMS Technical Expert Panel on the National Impact Assessment of CMS Quality Measures, and the Health Resources and Services Administration (HSRA) Interconception Care in Medicaid (CoIN) Committee.

Dr. Gelzer earned her undergraduate degree from Tufts University and her doctor of medicine from St. George's University. She also received a master’s degree in preventive medicine/administrative medicine at the University of Wisconsin Madison. She is a board certified by the American Board of Internal Medicine and by the American Board of Preventive Medicine in clinical informatics.

MichaelGolinkoff

Michael Golinkoff, Ph.D., M.B.A.

President
PerformCare

Michael Golinkoff, Ph.D., M.B.A., is president of PerformCare, a behavioral health care subsidiary of AmeriHealth Caritas. In addition, Dr. Golinkoff is a senior vice president for AmeriHealth Caritas, focusing on behavioral innovation to address medical issues in the populations served by AmeriHealth Caritas. He has nearly 30 years of clinical and medical management experience.

Most recently, Dr. Golinkoff was executive vice president of Clinical Specialty Operations for Aetna Inc., where he was responsible for clinical and customer service operations centers for both Behavioral Health and Active Health, Aetna’s informatics-based medical management organization. Prior to working at Aetna, Dr. Golinkoff held a number of senior leadership roles for United Behavioral Health.

He is a member of the American Psychological Association and the Pennsylvania Psychological Association. Dr. Golinkoff is the treasurer for the Association for Behavioral Health and Wellness. He has served on the advisory board of a number of behavioral health and populations health companies. In addition, Dr. Golinkoff is a member of the board for Emily’s Entourage, a nonprofit organization raising money to cure cystic fibrosis.

Dr. Golinkoff holds a Ph.D. in clinical and developmental psychology from the University of Illinois-Chicago and a Master of Business Administration from the Wharton School at the University of Pennsylvania. He completed his pre-  and post-doctoral internship and fellowship at New York Hospital-Cornell Medical Center.

Andrew Haydon

Andrew Haydon

Pharmacy Director
Contra Costa Health Plan

Andrew Haydon is currently the Pharmacy Director for Contra Costa Health Plan (CCHP) in northern California.  In this role he functions as the administrator of the Contra Costa Regional Medical Center (CCRMC) 340B contract pharmacy network, and also serves as an active member of the CCRMC 340B oversight committee.  Prior to joining CCHP Andrew was a clinical pharmacist with the California Department of Corrections and the Department of Veterans Affairs.  Additionally, Andrew worked for a number of years as a compounding pharmacist in rural northern California where he helped create and implement 340B contracts for rural hospitals and Native American Health Centers.   Andrew is an alumnus of the University of the Pacific School of Pharmacy, and is also a 12 year veteran of the Air Force.  He continues to learn and involve himself in the 340B community, and is pleased to be able to share his experience.  

Susan Hayes

Susan Hayes, MCJ, AHFI, CPhT.

Principal
POS

Susan has over 35 years’ experience in the health care consulting and management industry. As a founder of POS, Susan is responsible for the strategic direction of the firm and specific sales, proposal, product pricing and development.  Susan is a lead project manager for the firm's clients, including USI Insurance and health plan and unions including Health Plus of Michigan, Connecticut Coalition of Taft Hartley Health Plans and SMART Union and many other government, union, employer and managed care organizations.  In her many years in the pharmacy benefits industry, Susan has developed a broad understanding of the market place, services offered by the pharmacy benefit managers and pricing terms that are currently available in the industry.

Prior to POS, Susan was Vice President of Marketing for Systemed Pharmacy, Inc. and Vice President, Marketing of Walgreens Healthcare Plus.  In both positions, she was responsible for the strategic development of the target market and product mix for PBMs, growing retail and mail service revenues and enhancing overall client retention.  For five years prior to Walgreen Co., Susan was the National Practice Leader for William M. Mercer, Inc., specializing in prescription drug auditing and bid procurement amounting to over $1 million annually in revenue.  Clients included Fortune 500 employers.


She has published several articles in Business Insurance and Employee Benefit News and was recently quoted in Fortune Magazine and the Wall Street Journal regarding pharmacy benefit practices.  Susan is a co-producer of the Pharmacy Benefits Academy and is part of their distinguished faculty.   Susan has testified to the Committee on Oversight and Government Reform, Subcommittee on Federal Workforce, Postal Service and the District of Columbia on Transparency in the PBM Industry.

Susan has a B.S. in Criminal Justice from Northeastern Illinois University and a Master’s Degree in Criminal Justice Boston University, Metropolitan College.  Susan will begin her Doctoral Program in Criminology in the Fall of 2016 at the University of Portsmouth, Centre for Counter Fraud Activities, UK. She is a Certified Registered Pharmacy Technician in the State of Illinois.  Susan is a member of the Professional Council for Roosevelt University, School of Pharmacy. In 2012, Susan earned her Accredited Healthcare Fraud Investigator (AFHI) designation from the National Healthcare Anti-Fraud Association.

Lilly Higgins

Dr. Lily Higgins

Network Medical Director
Keystone First

Dr. Lily Higgins is the Network Medical Director for Keystone First.  In this position, she is responsible for Keystone First’s quality assurance efforts and the management of its relationships with the local medical community, including primary care providers, specialists and hospitals.

Dr. Higgins is a board certified pediatrician with over twenty-five years of clinical experience. Her education includes a Bachelor of Arts in Biology from Cornell University, a Master’s Degree in Nutrition from Columbia University of Physician and Surgeons, a Medical Degree from Drexel University School of Medicine, and a Master of Business Administration in Medical Services Management from John Hopkins University.

Most of her clinical career, she has served the multicultural pediatric populations in Philadelphia. She emigrated with her family from China as a young child which has given Dr. Higgins a unique understanding of the diverse health care challenges and needs of the Medicaid members, as well as an understanding of the challenges for providers who serve this population.

Dr. Higgins is a Fellow of the American Academy of Pediatrics. She is also on the Board of the PA chapter of March of Dimes and PA Preemie Society.

She has been married for more than twenty-five years to a neonatologist with four children.

Michelle Juhanson

Michelle Marie Juhanson

Director of Compliance and Quality
PerformRx

Michelle Juhanson has been working for the AmeriHealth Caritas Family of Companies since 2007, and for PerformRx since 2009. As Director of Compliance and Quality, she  is accountable for the audit, compliance, and quality functions in PerformRx and has proven expertise in Medicare Part D, FWA, auditing, and URAC and NCQA accreditations. She is a member of various industry coalitions and work groups. She is also a public speaker with a passion for regulatory compliance, beneficiary protections, and giving business owners a framework to develop compliant solutions in an ever-changing healthcare landscape.

Michelle has 10 years of Part D compliance experience in multiple settings: Part D IRE (MAXIMUS Federal services), plan sponsor (Select Health of South Carolina), and PBM (PerformRx). She has overseen PerformRx and PerformSpecialty’s accreditation and reaccreditation with URAC in Pharmacy Benefit Managemetn (PBM), Drug Therapy Management (DTM), and Specialty Pharmacy. In 2015, she led PerformRx taskforce as one of only four organizations selected to participate in the CMS Point of Sale Pilot.

Michelle is certified in Health Care Compliance (CHC) and Health Care Privacy Compliance (CHPC) by the Health Care Compliance Association

Jeffrey Kreitman

Jeffrey Kreitman, Pharm.D.

Regional Pharmacy Director
AmeriHealth Caritas Family of Companies

Jeffrey Kreitman, Pharm.D. is the Regional Pharmacy Director for the AmeriHealth Caritas Family of Companies.  In his current role, he provides pharmacy support and expertise for four lines of business.  He has built strategic alliances with key areas throughout the organization to achieve the Triple Aim of improving the patient experience and population health while reducing the per capita cost of care.  Jeff has overseen the creation and implementation of pharmacy care gaps, pre-populated prescription templates, automated telephonic outreaches, and other innovative campaigns to encourage providers to adhere to evidence-based care principles and empower members to engage and take charge of their health.

Prior to joining AmeriHealth, Jeff worked in many facets of the pharmacy profession including community pharmacy, specialty pharmacy, academic detailing, and academia.

Dr. Kreitman earned his Bachelor of Science and Doctor of Pharmacy degrees from the Ernest Mario School of Pharmacy at Rutgers University.  He joined AmeriHealth in 2006.

Crystal Lennartz

Crystal Lennartz, PharmD, MBA

Director of Clinical Development
Health Mart McKesson Corporation

Crystal Lennartz is Director of Clinical Development for Health Mart McKesson Corporation’s independent pharmacy franchise of over 4,500 stores. She is a pharmacist with over 15 years experience working in or on behalf of community pharmacies. Prior to coming to McKesson, Crystal worked for the National Association of Chain Drug Stores (NACDS), SUPERVALU, and Walgreens. Crystal has both performed and managed provision of clinical services in community pharmacies including Medication Therapy Management, Immunizations, and Health Screenings.

Crystal also serves as co-chair of the Pharmacy Quality Alliance (PQA) Measure Development Team exploring MTM-Part D – Use of Patient Experience Survey following CMR Completion. She is passionate about helping pharmacies take a patient-centric approach to improving their pharmacy quality performance and maximizing value-based revenue opportunities.

She has both a Doctor of Pharmacy and Master of Business Administration from Drake University after which she completed an APhA-ASHP Accredited Residency in Pharmacy Practice with emphasis in Community Care.

Andrew Maiorini

Andrew Maiorini, RPh

Vice President, Clinical Programs
PerformRx

Andrew Maiorini has been with PerformRx since 2005, serving in various clinical roles supporting formulary management, Drug Utilization Review, and Drug Therapy Management. Andrew joined PerformRx as a clinical pharmacist. His scope of clinical expertise spans the growth and expansion of PerformRx’s award-winning Drug Therapy Management program, the implementation of Medicare Part D programs, as well as the specialty drug management, bleeding disorder and Hepatitis-C management programs. Additionally, he developed several advanced utilization management programs, including the opioid overutilization management program. In his current role, he oversees formulary development, drug therapy management, pharmacy informatics/analysis and PerformRx’s state-of-the-art prior authorization process.   

Andrew graduated from La Salle University with a Bachelor’s in Biology. He then received his Doctor of Pharmacy from Temple University’s School of Pharmacy. Andrew and then completed a General Practice Residency at Thomas Jefferson University Hospital. Prior to working at PerformRx, Andrew was the ICU Clinical Pharmacist for Delaware County Memorial Hospital in the Crozer-Keystone Health System. Andrew joined PerformRx in October of 2005.

Dino Martino

Dino Martino, RPh

Executive Director
PerformSpecialty

With more than 18 years in the specialty pharmacy arena, Dino Martino, RPh, has held senior leadership roles in various aspects of the industry ranging from pharmacy supervision and design during the growth of one of the first large scale specialty pharmacies in the 90s to ensuring regulatory pharmacy practice and operations responsibility acting as Pharmacist-In-Charge for one of the nation’s largest specialty pharmacies as recently as 2010.  In 2014, Dino accepted the role of Executive Director for PerformSpecialty where he is responsible for overseeing all operations. 

Other aspects of his experience include pharmacy design and implementation of technology solutions including inventory management, order fulfillment, and quality assurance in state-of-the-art high volume, multi-million dollar pharmacy dispensing systems. He has also led overall lean six sigma initiatives and continuous improvement efforts to support clinical and pharmacy operations efficiency and advancements in quality standards for patient services. He has obtained multiple accreditations for specialty pharmacies including URAC, ACHC, HQAA, and JCAHO and has served as a key information and operations systems consultant in major departments, including new corporate business development, clinical endeavors, third party/government payers and process improvement in all areas.

Dino holds a bachelor’s degree in Pharmacy from Duquesne University in Pittsburgh, Pennsylvania, and has completed additional post graduate work in the areas of biopharmaceutics and pharmacokinetics. He holds pharmacist licensure in multiple states.

Areas of Expertise

  • Pharmacy Regulations and Licensure
  • Facility Design
  • Pharmacy Operations
  • Support Programs
Jesse McCullough

Jesse McCullough

Director of Pharmacy
Rite Aid

Jesse McCullough currently serves as Rite Aid’s Director of Pharmacy Initiatives and Business Development.  In this role, his goal is to develop interventions for the benefit of pay for performance partners, empower pharmacists to practice to their fullest extent and to establish and cultivate provider relationship.  He previously served as in the Clinical Services departments at Rite Aid and Brooks Eckerd.  Within the Clinical departments of both companies, he has been involved in the development and execution of a number of initiatives including pharmacist based immunizations, Medication Therapy Management programs, and various disease state management programs.  Jesse graduated from the University of Pittsburgh, School of Pharmacy.

Shawn McHale, Pharm.D.

Shawn McHale, Pharm.D.

Manager of Prior Authorization Department
PerformRx

 

Shawn McHale, Pharm.D. is the Manager of PerformRx Prior Authorization Department. As Pharmacist Manager he is responsible for overseeing the Coverage Determination, Redetermination and Prior Authorization review process. Shawn has extensive Medicare Part D experience and was a member of the team that implemented the first Medicare Part D plans at PerformRx in 2006. He has served as Prior Authorization Department spokesperson during the CDAG portion of CMS Program Audits. In 2015, Shawn represented the Prior Authorization Department in the CMS Point of Sale Pilot.

Prior to joining PerformRx, he worked in home infusion, compounding and retail pharmacy practice settings.

Shawn earned his Bachelor of Science and Doctor of Pharmacy degrees from the Philadelphia College of Pharmacy and Science. He joined PerformRx in 2005.

Rodney Wise, M.D

Rodney Wise, M.D.

Market Medical Executive
AmeriHealth Caritas Louisiana

Rodney Wise, MD is a Louisiana native.   He earned his undergraduate degree from Northwestern State University in Natchitoches, LA and completed his M.D. at Louisiana State University School of Medicine – Shreveport, LA.  After medical school, Dr. Wise completed residency training in Obstetrics and Gynecology and a fellowship in Clinical Genetics, both at LSU Health Sciences Center- Shreveport. 

Dr. Wise has been the Market Medical Executive for AmeriHealth Caritas Louisiana (ACLA) since December 2015.  Prior joining AmeriHealth he served as a Medical Director with Blue Cross and Blue Shield of Louisiana from 2012-2015.  He served as the Medicaid Medical Director for the State of Louisiana from 2009-2012.  

Prior to his managed care experience, Dr. Wise was a faculty member at LSUHSC-S from 1985-2009, and Director of OB/GYN at LSU-Monroe from 1989-2009.  He held the position of E. Earle Dilworth Endowed Professor of Obstetrics and Gynecology at LSUHSC-S from 2005 - 2012.  He also served as the Maternity Medical Director for the Louisiana Maternal Child Health Program of Public Health from 2003-2009. 

Dr. Wise has been active in many aspects of local, regional, state, and national health initiatives, especially in improving pregnancy outcomes, improving coordinated systems of care and the integration of behavioral health and physical health services.  With Medicaid he oversaw the development and implement of the Bayou Health Medicaid managed care program and the Louisiana Behavioral Health Partnership program of behavioral health managed care.   With both Blue Cross and AmeriHealth he has had active roles in the further integration of physical and behavioral health services.   He is currently working with ACLA to define and implement medical neighborhoods of care for Louisiana members.

Scott Woods

Senior Director, Policy
Pharmaceutical Care Management Association

Scott Woods is Senior Director, Policy at the Pharmaceutical Care Management Association. In this capacity, he advances PCMA's advocacy efforts through policy development, research, and analysis on a wide range of federal and state issues.

Prior to joining PCMA in 2015, Mr. Woods was a Senior Policy Manager at the Blue Cross Blue Shield Association (BCBSA), where he lead policy analysis on Medicaid, the Federal Employees Health Benefits Program, health care fraud, and other issues. Prior to his position at BCBSA, he worked on Medicaid, Medicare post-acute care, and health reform issues as an Associate at Avalere Health, a health care consulting firm in Washington, D.C. Mr. Woods holds a B.A. in political science from Yale University and a J.D. from the University of Tennessee College of Law, where he was Executive Editor of the Tennessee Law Review.

Mark Conklin, PharmD, MS

Mark Conklin, PharmD, MS

Interim President & VP, Operations
Pharmacy Quality Solutions, Inc.

Mark currently serves as the Interim President and Vice President of Operations for Pharmacy Quality Solutions (PQS). In his role with PQS, he is responsible for product development and technology operations for EQuIPP, a performance information management platform for health plans and community pharmacy organizations engaged in improving the quality of medication use.

Prior to joining PQS, Mark was the Director of Quality Innovations for the Pharmacy Quality Alliance where he was responsible for concept development in reporting medication use quality. After starting his career as a pharmacist with CVS Pharmacy, Mark spent much of his early career with Highmark Blue Cross Blue Shield as both a Clinical Pharmacist and a Business Innovation Strategy Consultant.

Mark received both his PharmD and his Masters in Pharmacy Administration from Duquesne University.

Alexandra Cruz

Alexandra Cruz, PharmD

Senior Pharmacy Manager
Healthfirst

Alexandra Cruz, PharmD is a Senior Pharmacy Manager at Healthfirst. In this position, she is responsible for implementing and overseeing Healthfirst’s pharmacy quality strategies and initiatives, with a large focus on the improvement of the Medicare Part D adherence measures. Prior to this role, Alexandra was a Clinical Pharmacist at Horizon Blue Cross Blue Shield of New Jersey for nearly 4 years. At Horizon, Alexandra was responsible for the Medicare Part D formulary management and submission and participated in Medication Therapy Management activities while supporting Medicare Star measure improvement. She graduated from Rutgers University and completed a Managed Care Residency at Horizon Blue Cross Blue Shield of NJ.

Our Sponsors

 

Major Sponsor

  • Lilly
  • Healthcare IT