● Reconciliation of RAPS vs. Encounter Data Submission

● Data Collection: Reconciling Sources, Decreasing Costs

● Machine Learning Tools and Strategies

● Prospective Analytics & Retrospective Analytics

● Benchmarking Practice Comparison With Other Plans

● CMS – What’s Coming and Interpreting the Call letter

● Value Based Purchasing Contracts: Integrating Cost Management, Care Coordination & Quality

● Implementing Changes in HCC model

● Capitalizing on Synergies Between Stars & HEDIS

● Understanding the Impact of Pivotal Court Cases

● Case Study: Provider Intervention Programs

● Improving Quality of Business Processes

● Case Study: Gaps in Care Closures

All-Star Speakers 2018
Health Alliance

Dawn Peterson

Director of Utilization Management and Risk Adjustment Solutions
Capital District Physicians' Health Plan, Inc.

Puneet Budhiraja ASA MAAA

Medicare / Chief Actuary
Island Doctors

Tara A. Russo

VP of Medicare Risk Adjustment and HEDIS Quality Initiatives, VP of Navigate Directorate
MCS Healthcare Holdings LLC

Linda Lee

Vice President, Quality Improvement
Freedom/Optimum Health

Mital Panara

Vice President, Revenue Management
SCAN Health Plan

David Meyer

Vice President
Harvard Pilgrim Health Care

Gaurish Chandrashekhar

Director of Revenue Management, Finance Department
Novu Health

Jordan Mauer

EVP Marketing and Member Engagement
Episource

Sujata Bajaj

Vice President of Product Development
Gorman Health Group

Jessica Smith

Vice President, Analytics & Compliance
Foley & Lardner LLP

Michael Matthews

Partner
Geisinger Health Plan

Kristina Trafton

Director, Risk Adjustment Risk & Revenue Management, Actuarial Services
Tessellate

Sue Kuypers

Managing Director, Product Management
Gateway Health Plan

Jennifer Zucchero

Manager, Risk Revenue
Who Should Attend:

From Medicare Advantage Health Plans:

Senior Executives, Directors and Managers of:

  • Risk
  • Revenue
  • Finance
  • Health Services
  • Actuarial
  • Financial Operations
  • Financial Information Technology
  • Medical Management
  • And Solution Providers
Supporting Organizations
  • Strategic Solutions Network (SSN), based in Boca Raton, FL, is the parent company of the Medicare Risk Adjustment & Revenue Management Management, Plus Quality and Star Ratings and a series of related conferences.
  • Strategic Solutions Network (SSN), based in Boca Raton, FL, is the parent company of the Medicare Risk Adjustment & Revenue Management Management, Plus Quality and Star Ratings and a series of related conferences.
  • Strategic Solutions Network (SSN), based in Boca Raton, FL, is the parent company of the Medicare Risk Adjustment & Revenue Management Management, Plus Quality and Star Ratings and a series of related conferences.






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