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.

Laura Cranston

Laura Cranston, RPh

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.

Michelle Juhanson

Michelle 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

 

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
Marge Angello

Marge Angello, RN

Market President
AmeriHealth Caritas Pennsylvania

As the Market President of AmeriHealth Caritas Pennsylvania, Ms. Angello is responsible for the general oversight and day-to-day operations of the plan. She manages all aspects of the plan including Medical Affairs, Operations, Information Services, Quality, Marketing, Regulatory and Legislative Affairs.

Previously, Ms. Angello was the Interim Executive Director for AmeriHealth Caritas. Previous to this position, she was the Associate Vice President, Patient Care Management, where she was responsible for the direction and oversight of the Medical Management staff and case management activities. She also previously served as an Associate Vice President in the Medical Affairs department for Keystone First in Philadelphia. With more than 20 years’ experience in the managed care environment, Ms. Angello has held leadership positions with Keystone First, Keystone Health Plan Central, and HIP of New Jersey. She also practiced clinical nursing at Holy Spirit Hospital in Camp Hill, Pennsylvania.

A registered nurse, Ms. Angello attended St. Joseph's School of Nursing in Carbondale, Pennsylvania, and Marywood University in Scranton, Pennsylvania. Ms. Angello is a volunteer for the Pennsylvania Breast Cancer Coalition.

Charles Bacchi

Charles Bacchi

President & CEO
California Association of Health Plans

Charles Bacchi is the President & CEO for the California Association of Health Plans (CAHP) representing 49 health plans providing coverage to over 25 million Californians.  For the last ten years Mr. Bacchi served in leadership positions at CAHP, most recently as Executive Vice President, leading the Association’s advocacy before the California Legislature, the California Health Benefit Exchange, and the Department of Managed Health Care on behalf of CAHP’s health plan members.

A veteran of California’s political community, Mr. Bacchi has over 20 years of experience in California’s legislative, advocacy, and trade association arenas. Under the Affordable Care Act, health plans play a critical role in offering millions of Californians access to health care.  As state policymakers crafted California’s approach to ACA implementation, Bacchi played a prominent role as the health plan voice on a range of issues, including translation of the ACA into state law, the start-up of Covered California, and the expansion of the state’s Medicaid program, Medi-Cal.

Audrey S. Brown

Audrey S. Brown

President & CEO
Florida Association of Health Plans

Audrey S. Brown is the President and Chief Executive Officer (CEO) of the Florida Association of Health Plans.   Brown has held leadership positions in both the private and public sectors and has over a decade of insurance legislative and regulatory experience.

Most recently, Brown served as chief of staff to Florida Insurance Commissioner Kevin McCarty where she was chief policy advisor to the commissioner, chief lobbyist on agency fiscal matters and managed the operations of the Office of Insurance Regulation.  Additionally, Brown served as deputy chief of staff to the commissioner and as director of government relations. 

Prior to that, Brown was the manager of Contract Compliance & Administration for AvMed Health Plans.  She began her professional career serving in the Executive Office of Governor Jeb Bush.  Brown attended Florida State University and graduated with a Bachelor of Science in Political Science.

Bruce Carroll

Bruce Carroll

Vice President, Healthcare Policy and Market Access
Proteus Digital Health

As Vice President, Healthcare Policy and Market Access at Proteus, Bruce is responsible for developing and implementing policy, coverage, pricing, market access, and reimbursement strategies for the Digital Medicine sector. 

These efforts include forming coalitions with patient advocacy organizations and other digital health companies; educating lawmakers, regulators and other policymakers at the federal and state level; and engaging with state Medicaid directors and other public and private payers to secure favorable coverage and reimbursement. 

Bruce’s professional work experience includes over 25 years in healthcare policy, reimbursement, grassroots advocacy, and government relations.  Most of that time was spent at Centocor, Inc., and Johnson & Johnson in the Federal Affairs Office and in field-based advocacy management.

Sheena Cherian

Sheena A. Cherian, PharmD

Director, Clinical Outcomes and Therapeutic Optimization
PerformRx

As Director of Clinical Outcomes and Therapeutic Optimization, Sheena leverages her certifications in medication therapy management, patient-centered diabetes care and motivational interviewing to develop programs that deliver superior patient care resulting in improved health outcomes.  Sheena uses this role to mentor new pharmacists by serving as an advanced pharmacy practice resident preceptor.  Sheena is also a member of PerformRx’s Clinical Services Advisory Team, which ensures quality in various areas including DTM, Prior Authorization, Formulary Management, Drug Utilization Review and Specialty.

Sheena earned her Doctor of Pharmacy degree from University of Pittsburgh School of Pharmacy, graduating summa cum laude. Sheena has received the Mortar & Pestle Professionalism Award based on her ideals of professionalism and excellence in patient care and demonstration of exceptional service and commitment to the profession of pharmacy through the development of the “Innovations in Pharmacy” Award.  She is actively engaged in Pharmacy Quality Alliance, Academy of Managed Care Pharmacy and American Pharmacists Association.

Megan Coder

Megan Coder

Executive Director
Digital Therapeutics Alliance

Megan Coder, PharmD, MBA, is Executive Director of the Digital Therapeutics Alliance. DTA’s mission is to broaden the understanding, adoption, and integration of clinically-validated digital therapeutics into mainstream healthcare through education, advocacy, and research.

With more than a decade of experience in the healthcare industry, Megan's expertise extends from strategic growth and partnership development within the digital health sector, to the direct delivery of patient care. Prior to joining DTA, Megan worked with Voluntis, Iodine, the Pharmaceutical Care Management Association, and the Pharmacy Technician Certification Board.

A proud Badger, Megan graduated from the University of Wisconsin—Madison School of Pharmacy and completed an Executive Residency in Association Management & Leadership with the American Pharmacists Association.

Karen Dale

Karen M. 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, a mission-based Medicaid Managed Care Organizations (MMCO) in Washington, DC. She is ushering in the next generation of managed care with innovative solutions for the critical challenges faced by the members served by the MMCO. Opportunities for people to experience health and wellness are enhanced by addressing the social, economic, and environmental conditions that are drivers of poor health outcomes and harmful health disparities with comprehensive and tailored solutions.

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 three 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 persons 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 human-centered design 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 implement evidence-based, population health strategies.

Ms. 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 a Board Member for both Volunteers of America National Services and, the Volunteers of America National Board.  In 2016, she was the recipient of the Washington Business Journal Minority Business Leader Award and, in 2017 the Women Who Mean Business Award.

Andrea Gelzer

Andrea Gelzer, MD, MS, FACP

Senior Vice President of Medical Affairs
AmeriHealth Caritas

Andrea Gelzer is the senior vice president of medical affairs for AmeriHealth Caritas, a Medicaid managed care organization operating in 16 states and the District of Columbia, where she has also served as corporate chief medical officer for the past seven years.  She previously served as chief medical officer for Boston Medical Center HealthNet Plan, the largest Medicaid managed care company in Massachusetts.  She also served in multiple roles, including senior vice president of clinical public affairs at CIGNA Corporation, and for 14 years worked in private practice in Internal Medicine.

Dr. Gelzer serves as the Chairman of the Board of Directors of HealthShare Exchange, Philadelphia’s regional health information exchange and is a board member for the Association of Community Affiliated Plans (ACAP).  She is the past-chair of the Chief Medical Officer Leadership Council at America’s Health Insurance Plans (AHIP) and serves on numerous additional national professional committees in the United States including the National Committee for Quality Assurance (NCQA) Committee on Performance Measurement and the HHS Health Care Payment Learning & Action Network (LAN) Guiding 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 board certified by the American Board of Internal Medicine and by the American Board of Preventive Medicine in clinical informatics.

Phil Gerbino

Phil Gerbino, PharmD

President Emeritus, Linwood F. Tice Professor Emeritus
University of the Sciences

Dr. Gerbino currently a Strategic Consultant for Pharmaceutical Industry, Health Care and Higher Education, is the retired President of University of the Sciences serving in that capacity for over 16 years.  Dr. Gerbino helped guide and facilitated the growth of the 190-year-old institution from its 1821 roots as Philadelphia College of Pharmacy and Science (PCPS) into the five colleges that now comprise the University.

Dr. Gerbino is a strategic problem solver and an accomplished professional chairman and facilitator, leading hundreds of internal and external and national and global meetings for pharmaceutical industry, pharmacy and health care. He has published and lectured extensively and globally. He served as President of the American Pharmaceutical Association in 1990. He served simultaneously as a civilian pharmacy consultant to the Air Force Surgeon General and consultant designee to the Army, Medical Service Corps, and also to DOD, Health Affairs.

He has served nationally on editorial and advisory boards of pharmacy, medical, and healthcare organizations and publications, and for over 35 years has been as a consultant on strategic planning, marketing, and new business development to the pharmaceutical and healthcare industries. He has also executive coached and participated or led the integration or consolidation of departments, companies and divisions in the pharmaceutical and health care industries.

Dr. Gerbino has or continues to serve on boards of directors of private and public healthcare companies, and regional professional and civic organizations, including BioAdvance, Pennsylvania Bio, The College of Physicians of Philadelphia, and the University City Science Center. He has chaired the University City Keystone Innovation Zone and has served as an advisor or consultant to Quaker BioVentures, Highland Capital, InVentivHealth, Star Life Sciences, HealthCarePays, SpectaMD, TherimuneX and others. He has been a board member at Genesis Health Care, NeighborCare, Family Meds, Health A-Z, Care Partners Plus, Cybear, Target Rx and others. Dr. Gerbino is a Fellow of the College of Physicians of Philadelphia; the American Pharmacists Association (APhA), Academy of Pharmacy Practice and Management; and the American Society of Consultant Pharmacists (ASCP). He received the 2010 Frank Baldino Jr., CEO of the Year Award from Pennsylvania Bio was recognized in PharmaVoice, 2005, Top 100 as a “Change Agent”. He is the recipient of numerous national leadership awards.

Prior to being named President at University of the Sciences, Dr. Gerbino served as Dean of the School of Pharmacy and Vice President of Academic Affairs at USciences/PCP&S.  In retirement he retains the title of President Emeritus, USciences and Linwood F. Tice Professor Emeritus at the Philadelphia College of Pharmacy.  Dr. Gerbino earned his B.S. in Pharmacy and his Pharm.D., from PCPS where he worked for more than 38 years as an educator, administrator and leader. He also is certified in Organizational Development.

Susan Hayes

Susan Hayes

Principal
Pharmacy Outcome Specialists

Susan Hayes Principal Susan has over 38 years’ experience in the health care consulting and management industry. As a founder of Pharmacy Outcomes Specialists, Susan has been responsible for the last 21 years 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, which include Meridian Health Plan, Connecticut Coalition of Taft Hartley Health Plans and SMART International 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. Susan provides expert witness testimony on key prescription drug industry litigation. Susan is the lead pharmacy consultant for USI Insurance services. 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 for 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 Criminology from Boston University and is currently enrolled in a Doctoral Program in Criminology at the University of Portsmouth, UK with an anticipated graduation date of 2020. Her thesis focuses on the integrity of pharmacists. She is a Certified Registered Pharmacy Technician and a Licensed Private Detective (Lic # 115.002527) 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.

Linda T. Hines

Linda T. Hines, RN, MS, MBA

Chief Executive Officer
Virginia Premier Health Plan, Inc.

Mrs. Hines is currently the Chief Executive Officer for Virginia Premier Health Plan, Inc. which serves approximately 220,000 enrollees for the Commonwealth of Virginia, which includes Medicaid/FAMIS, Medicare Advantage and a Dual Special Needs Plan.   Previously, she served as the Chief Operating Officer and Vice President of Health Services and was responsible for the overall operations of Virginia Premier Health Plan.  Mrs. Hines has worked in managed care for over 20 years and brings a strong clinical, administrative and management background in the medical, operational and strategic planning arena of managed care.  She has been instrumental in developing several best practice programs that have national recognition. 

She is active in a variety of professional activities including being appointed to the Virginia State Board of Health by Governor Terry McAuliffe and reappointed by Governor Ralph Northam, Virginia Association of Health Plans, Leadership in Metro Richmond, and former task force member to Governor Elect Tim Kaine’s healthcare policy committee.  In addition, Mrs. Hines has served as adjunct faculty for the School of Nursing for Virginia Commonwealth University. Mrs. Hines earned her Bachelor of Science (Nursing) and her Master of Science (Nursing Administration) as well as Executive MBA from Virginia Commonwealth University.

Eric Linzer

Eric Linzer

President & CEO
New York Health Plan Association

Eric Linzer is president and CEO of the New York Health Plan Association (HPA) organization, an Albany-based organization that represents 28 health plans in New York State.  These plans provide comprehensive health care services to more than eight million New Yorkers.

As the chief executive of HPA, Eric is responsible for development of policy positions for the organization, advocacy with the executive and legislative branches of government, and serves as lead spokesperson to the media and the public on issues relating to the managed care industry.

Eric came to HPA from the Massachusetts Association of Health Plans (MAHP) where he spent 15 years, most recently serving as executive vice president, where his responsibilities encompassed overseeing a wide range of operational activities as well as legislative and regulatory issues, outreach to business groups and brokers, and media relations and communications.

Prior to joining MAHP in 2002, Eric was an account supervisor in the public relations division of Arnold Worldwide and worked in the public affairs department of Harvard Pilgrim Health Care. He holds a JD from Suffolk University Law School, a Master’s degree in Political Science from Suffolk University and earned his Bachelor’s degree from Boston College. He is also a past recipient of the Massachusetts Medical Law Report’s Leader in Quality – Rx for Excellence Award.

Eric and his wife, Pamela, have three teenage children, Hayes, Abigail and Megan, and a German Shepherd mix named Sarah.

 

Doug Long

Doug Long

Vice President of Industry Relations
IQVIA

Doug Long is Vice President of Industry Relations at IQVIA (formerlyQuintilesIMS) the world’s largest pharmaceutical information company. IQVIA offers services to the pharmaceutical industry in over 101 countries around the globe.

Doug has been with IQVIA since 1989.  His fundamental task is to help secure data for all existing and new databases supported by IQVIA, manage supplier, manufacturer & association relationships, and develop information for data partners.  As direct consequence of his involvement in these areas, Doug has considerable experience with, and a unique perspective on, the changing U.S. and global healthcare marketplace and pharmaceutical distribution.

Doug is a frequent Industry speaker for the following groups: Health Distribution Management Association, National Association of Chain Drug Stores, Food Marketing Institute, National Council of Prescription Drug Programs, Pharmaceutical Care Management Association, National Community Pharmacist Association, International Federation of Pharmaceutical Wholesalers, Generic Pharmaceutical Association, BIO, AMCP, PhRMA, HSCA and many others.  Doug was recently the opening speaker at the HHS Pharmaceutical Forum on Innovation, Access, Affordability & Better Health. His topic was the balance between Innovation and Smarter Spending.

Doug is the recipient of the 2016 IFPW Leadership Award. This award is given to an industry leader who has demonstrated a commitment to international collaboration and information sharing to assist IFPW on its mission to help members and stakeholders advance the safe, efficient and continuous access to pharmaceuticals worldwide through the promotion of good distribution practices and services.

Doug also received the distinguished “Harold W. Pratt Award” in 2011 which recognizes individuals whose activities have contributed to the promotion, recognition and improvement of the practice of pharmacy within the chain drug industry.  NACDS President and CEO Steven C. Anderson, IOM, CAE, stated,

“Doug Long has earned a reputation as one of the foremost ‘go-to’ sources when it comes to the numbers and trends behind this industry.  He has built a reputation of synthesizing the latest industry information and forecasting ‘what’s next’ in ways that helps stakeholders to understand what it means for their day-to-day businesses.”

Prior to receiving the Pratt Award, Doug was honored with the HDMA NEXUS Award for lifetime achievement in 2004, the IMS prestigious Summit Award in 2003 and the IMS CEO Team award in 2013.  Before joining IMS Health Doug held positions at Nielsen Market Research for sixteen years in various sales and marketing capacities.  A native of Illinois, Doug received a BA from DePauw University and holds an MBA in Management from Fairleigh Dickinson University in New Jersey. 

Joanne McFall

Joanne McFall

Market President
Keystone First

Joanne McFall is the Market President for Keystone First, Pennsylvania’s largest Medicaid managed care organization, and is responsible for providing day-to-day leadership, stakeholder engagement, and strategic focus to ensure improved population health for the health plan’s more than 430,000 members.

As Market President, Ms. McFall oversees the strategic direction, growth and leadership of Keystone First, including the daily operations of Provider Network Management, Member Outreach and Engagement, Communications and Marketing, Compliance, and Regulatory/Legislative Affairs.

Ms. McFall brings to the role more than 25 years of experience in health care operations, strategic planning, medical cost containment, information technology and financial oversight.

Prior to her role as Market President, Ms. McFall was Vice President and Chief of Staff at AmeriHealth Caritas, a national leader in health solutions for people in need, where she served as a liaison between the corporate Chief Operating Officer and all direct reporting departments and corporate functions. In this role, she was also responsible for all corporate project management and new business implementations in support of the organization's growth strategy.

Previously, Ms. McFall was Associate Vice President at AmeriHealth Caritas with responsibility for high-level oversight of operational functions and process improvement/cost containment opportunities.

Ms. McFall is a member of the Boards of Directors for the Urban Affairs Coalition and the Girl Scouts of Eastern Pennsylvania. She received her MBA in Health and Medical Services Administration from Widener University and her Bachelor of Arts in Communication from the University of Delaware.

Jennifer Babcock

Jennifer McGuigan Babcock

Vice President for Medicaid Policy and Director of Strategic Operations
ACAP

Jennifer McGuigan Babcock is ACAP’s Vice President for Medicaid Policy and Director of Strategic Operations. She was appointed to direct ACAP’s Medicaid policy work in 2015 after spending over four years as ACAP’s Vice President for Exchanges. In 2010, she served the Eligibility and Enrollment team within the Office of Health Insurance Exchanges in the Department of Health and Human Service’s Office of Consumer Information and Insurance Oversight (OCIIO, now known as CCIIO), focusing primarily on the interplay between Medicaid and Exchange coverage. Before joining OCIIO, Jennifer served as ACAP’s Director of Policy, working primarily on Medicaid and CHIP health plan issues.  Previously, she worked on policy related to Medicaid, CHIP, the uninsured, and private health insurance in the Office of Health Policy for the Assistant Secretary for Planning and Evaluation (ASPE) at the Department of Health and Human Services.  She has also held positions with CHIP at the Centers for Medicare & Medicaid Services as special assistant to the Deputy Secretary of Health Care Financing at the Maryland Department of Health and Mental Hygiene, and as an associate consultant with The Lewin Group in Falls Church.  Jennifer also served as an MPH Fellow at the Consumer Health Foundation in Washington, D.C., and as Executive Director of the Lovelight Foundation, an anti-poverty organization in Detroit. She has a Masters of Public Health from the University of Michigan, Department of Health Management and Policy, and a Bachelor of Arts in English from Kalamazoo College in Michigan.

 

Heather McShain

Deputy Chief, Financial Crimes
U.S. Attorney's Office

Heather K. McShain is a Deputy Chief in the Financial Crimes Section and supervises the Health Care Fraud Unit within the U.S. Attorney’s Office for the Northern District of Illinois. Heather also serves as the Office’s Criminal Health Care Fraud Coordinator. Her responsibilities include supervising all criminal health care fraud matters and coordinating a multi-agency health care fraud working group.  Previously, Heather served as a Deputy Chief in General Crimes and a line AUSA in the General Crimes, Financial Crimes, and Public Corruption and Organized Crime Sections. Prior to moving to Chicago, Heather also served as an AUSA in the Civil Division within the U.S. Attorney’s Office for the Southern District of New York, an associate at Jones Day in Washington, D.C., and a law clerk to Judge Robert Cowen, U.S. Court of Appeals for the Third Circuit, and Judge William Lee, U.S. District Court for the Northern District of Indiana. Heather obtained a B.S. in Mathematics from the University of Notre Dame and a J.D. from Notre Dame Law School, where she served as Lead Article Editor on the Notre Dame Law Review. 

Karen Michael

Karen Michael, RN, MSN, MBA

Vice President of Corporate Medical Management
AmeriHealth Caritas Family of Companies

Karen Michael, RN, MSN, MBA has over 35 years of experience in the health care field, including 25 years in managed care and 15 years focusing on needs of vulnerable populations. Karen is the vice president of corporate medical management at AmeriHealth Caritas Family of Companies (ACFC), a mission-based managed care organization that serves over 5.5 million members across 16 states and the District of Columbia to develop health solutions for the underserved.  She is responsible for oversight and continued development of ACFC’s integrated care management, clinical quality improvement, and health care disparities programs across all of ACFC’s health plans and ancillary businesses.

Karen was instrumental to the development and implementation of ACFC’s Integrated Health Care Management model, which address patients’ medical, behavioral, pharmacological, and social needs. Most recently, she led the development of ACFC’s person-centered community-based program. This data-driven program connects members with their primary care physician, specialty physicians, and community resources to improve care coordination for super-utilizers.

Under Karen’s leadership, numerous ACFC quality programs received external recognition and awards, including URAC’s gold award for innovation for payer-provider care management collaboration.  Karen’s programs also resulted in continuous health outcome and HEDIS improvement for the ACFC health plans. 

Prior to joining ACFC, Karen worked at Horizon Blue Cross Blue Shield of New Jersey and QualMed Plans for Health where she was responsible for utilization management and case management activities serving commercial, Medicare, and Medicaid populations. In addition, she has clinical experience as a patient care coordinator for a hospice/home health agency and a critical care nurse. She has published in nursing texts and journals including Health Affairs and serves on the board of Community Learning Center, a Philadelphia-based adult literacy provider.  She earned her undergraduate degree from Trenton State College and holds a MBA from Eastern University and a MS in nursing science from Widener University.

Dominick Pallone

Dominick Pallone

Executive Director
Michigan Association of Health Plans

Dominick Pallone is the Executive Director for the Michigan Association of Health Plans (MAHP), a Lansing based organization that represents 13 health plans in Michigan.

Prior to joining MAHP, Dominick was a Partner at Midwest Strategy Group, a multi-client lobby firm where he specialized in health care, state appropriations, Medicaid, higher education, transportation, and state procurement.  He has also served as staff within the state House and Senate, most notably as Committee Clerk for the Senate Appropriations Committee and the Joint Capital Outlay Subcommittee.

Currently, Dominick volunteers his time by serving on the Board of the Michigan Transportation Connection and was appointed by Governor Snyder to the Michigan Municipal Services Authority Board.

Dominick earned his Bachelor’s Degree in International Relations from Michigan State University, James Madison College.  During his academic years, he served on the NCAA Student Athlete Advisory Council representing Division 1 student-athletes.

Laurel Pickering

Laurel Pickering, MPH

Executive Vice President of Enterprise Solutions
WellDoc

Laurel Pickering is the Executive Vice President of Enterprise Solutions for WellDoc and is responsible for managing and broadening relationships with key stakeholders to expand use of WellDoc’s FDA-cleared, proven BlueStar® digital therapeutic.

Laurel is a leader and visionary, devoted to transforming healthcare at both regional and national levels. Before joining WellDoc, Laurel served as president & CEO of Northeast Business Group on Health (NEBGH) for nearly 25 years. There, she built an employer-led coalition of healthcare leaders and other stakeholders with the mission of empowering members to drive excellence and value in healthcare and the patient experience. NEBGH has 170 members comprised of national and global self-insured employers based in New York, New Jersey, Connecticut and Massachusetts; plus national health plans, major consulting organizations, regional hospital systems and other key stakeholders. Under Laurel’s leadership, NEBGH became one of the most active and influential healthcare-focused business coalitions in the country, focused on moving toward a value-based delivery system.

Laurel serves on the Board of Directors of The Leapfrog Group and HealthPass. She is Co-Chair of the Advisory Council of the Center for Workplace Mental Health and Chair of the Appeals Board of the National Quality Forum (NQF).  She previously served on the Boards of the National Alliance of Health Care Purchaser Coalitions and NQF.  Laurel received her BA in Anthropology from SUNY Albany and MPH from Emory University.

Sponsors & Exhibitors

 

Opening Reception Sponsor

  • TMED

Gold Sponsors

  • Allergen
  • DST Master Complexity
  • Lilly
  • Novo Nordisk

 

 


2018 innovations Sponsors