11^th Annual Medicare Star Ratings & Quality Improvement Summit

Jennifer Callahan

President and CEO

ATRIO Health Plans

Jen Callahan is the Chief Operating Officer of ATRIO Health Plans. For the past 19 years, Jen has established herself as a trusted thought leader and helped shape the managed care industry with her innovative ideas and expertise. Jen has dedicated her career almost exclusively to managed care and is an industry leading expert in all areas of Medicare Advantage and Medicare Supplement programs.

Prior to joining ATRIO, she co-founded a field management organization, Keen Insurance Services, Inc. to create a provider-centric Medicare focused sales and distribution organization from the ground up. Prior to that, she held the position of Vice President, Medicare Product at Aetna, a CVS Health company where she oversaw the product development and implementation Aetna’s entire Medicare portfolio, contributing over $24 billion to Aetna’s revenue. Throughout her career, Jen has also held various leadership positions at Healthfirst, Inc. and Anthem, Inc. focused exclusively on Government sponsored business.

Jen received her Bachelor of Science degree from Fordham University and MBA from North Carolina State University. Jen currently resides in Waxhaw, a suburb of Charlotte, North Carolina with her husband, their three kids and fur baby, Vivi. Jen loves spending time with her family and friends and hosting them at their home.

Jim Carlough

Chief Sales Officer

mPulse

Author

The Six Pillars of Effective Leadership

Jim Carlough is a transformational executive and elite strategist with over 30 years of proven leadership success in healthcare technology and SaaS. He currently serves as Chief Sales Officer at mPulse, where he is leading explosive revenue growth, post-merger integration, and go-to-market strategy following mPulse's acquisition of HealthTrio in December 2023.

As President of HealthTrio, Jim spearheaded a sweeping revitalization that expanded the company’s client base by 156%, restructured operations around KPIs and accountability, and tripled revenue in just three years. His success in scaling growth, reshaping the sales organization, and driving record-setting client acquisition positioned HealthTrio as an acquisition-ready innovator in digital health.

Since joining mPulse, Jim has continued his legacy of results—architecting a performance-driven sales culture that has contributed to increasing new company revenue. His work integrates strategic sales leadership with operational rigor and a deep understanding of payer dynamics, provider networks, and healthcare SaaS.

Jim’s core philosophy—that leaders aren’t born, they’re developed—guides both his leadership approach and his bestselling book, The Six Pillars of Effective Leadership: A Roadmap to Success. Through keynotes, workshops, and executive coaching, Jim shares how traits like Integrity, Focus, Empathy, Compassion, Humor, and Stability build high-performance cultures and unlock leadership potential across industries.

A compelling speaker and sought-after advisor, Jim is known for blending real-world insights with charisma, humor, and tactical clarity. His work inspires transformation—from the boardroom to the front lines of execution.

Keslie Crichton

Chief Sales Officer

BeneLynk

Keslie is the Chief Sales Officer for BeneLynk. In her role, she is not only responsible for new business development but also works on innovative partnerships to improve outreach strategies and health outcomes for our client’s members. At the core of BeneLynk’s services, Keslie and her team work to identify, document, and solve members' social determinants of health (SDoH) challenges by “leading with help.” This increases BeneLynk’s engagement rates across our integrated services while also providing our clients with crucial information they need to deliver care and improve their quality metrics. Keslie has worked in managed care for over 25 years with a focus on SDoH solutions that improve members' lives but also provide a return on investment for our clients. Keslie's passion lies in working on strategies that put members at the center while ensuring we deliver accurate risk-adjusted revenue, quality performance, and member retention. Keslie holds a B.S. in Business Administration from Regis University and worked toward her MBA and Masters in Healthcare Administration at Sacred Heart University in Fairfield, CT.

Tricia K. Elliott, DHA, MBA, FNAHQ

Vice President, Quality Implementation

National Committee for Quality Assurance (NCQA)

Dr. Tricia K. Elliott is an accomplished healthcare executive and Vice President of Quality Implementation at the National Committee for Quality Assurance (NCQA), where she leads national initiatives to advance evidence-based quality measurement, digital transformation, and value-based care. At NCQA, Dr. Elliott plays a pivotal role in driving the strategic implementation of digital quality measures and improving health outcomes through innovative, data-driven approaches. With a Doctorate in Health Administration specializing in Quality and Data Analytics, and a career spanning roles at Northwestern Medicine, the National Quality Forum, and The Joint Commission, she brings deep expertise in performance measurement, accreditation, and patient safety.

Dr. Elliott also contributes to the next generation of healthcare leaders as a faculty member at University of Phoenix, South College and DeVry University and serves on the advisory board for Harper College’s Health Information Technology Program. Her professional credentials include certifications in change management, quality improvement, and team-based care, underscoring her commitment to excellence and transformation in healthcare. Dr. Elliott is a certified professional in healthcare quality (CPHQ) and a Fellow with the National Association of Healthcare Quality (NAHQ).

Eden Anne Encarnacion, MHA

Sr. Manager, HEDIS – Medicare Star Program

Blue Shield of California

Eden Encarnacion, MHA is currently the Sr. Manager, HEDIS for Medicare Stars Program at Blue Shield CA. She manages the member and provider-facing engagement programs to drive improvements in HEDIS performance. She has 8 plus years of experience leading Quality Improvement programs across multiple Lines of Business in both provider and payer settings. Her experience includes Risk Adjustment, Encounter Data Submission, and Member Experience (CAHPS, HOS). In her previous role as Director, Quality and Medicare Stars for Clever Care Health Plan, she led the development and implementation of the provider incentive program, transitions of care program, and multiple initiatives across HEDIS, Pharmacy, and CAHPS measures. Her previous roles also include Director of Quality Improvement and Physician Operations at Tenet Healthcare. In this capacity, she worked directly with multiple provider groups as well as with various health plans to manage end-to-end efforts and oversee performance on value-based care programs focused on Quality and Risk Adjustment improvement.

Brendan Generelli

Director of Medicare Stars & Quality

Johns Hopkins Health Plans

Brendan Generelli is the Senior Program Manager for Stars and Quality at Blue Cross Blue Shield of Rhode Island. In his 11 years at BCBSRI, Brendan has had a variety of roles ranging from Customer Service to Operations to Strategy, but has always maintained focus on member and provider experience. Under his management of the 5 Star program, BCBSRI became the first and only plan available to all Rhode Islanders to achieve a 5 Star rating and now has repeated that rating in back to back years.

Anne Kovacs Morisseau

Vice President, Healthcare Quality, Patient Experience and Stars Performance

Tandigm Health

Mark Newsom

formerly, Deputy Group Director, Medicare Drug Benefit and C&D Data Group

Centers for Medicare & Medicaid Services

Managing Director

Avalere Health

Mark Newsom provides policy analysis and strategic business advice to stakeholders across the healthcare continuum, with a focus on government health programs. Before joining Avalere, Mark recently served as deputy director of the Medicare Drug Benefit and C&D Data Group (MDBG) at the Centers for Medicare & Medicaid Services (CMS). MDBG drives Medicare Part D benefit policy and the Stars quality program for both Medicare Advantage (MA) and Part D. Mark has held several other payment focused policy and operational roles at CMS. In industry, he has held senior policy and compliance roles at Coventry, CVS Health and Humana.

Caroline Paes Leme Pires

Press Ganey: Patient Experience Certified, Care Consultant Sr.- Medicare Quality, East Region

Elevance Health

Caroline Pires is an experienced Care Consultant in NY with a comprehensive background in Population Health and Change Management in healthcare. In my current role I have proven ability to implement value-based quality programs, strategize based on market trends, and collaborate with various stakeholders for effective resource allocation to support quality and cost improvement. She leverage her strong skills in data analysis to provide targeted solutions for HEDIS stars and CAHPS enhancement. In her free time she loves to play and dance with her daughter, read and try diferent cusines.

Edo Paz, MD,

SVP, Medical Affairs

Hello Heart

Dr. Edo Paz is board certified in cardiology, internal medicine, echocardiography and nuclear cardiology, as well as fellowship trained in cardiology and advanced cardiac imaging. He achieved his medical degree from Columbia University, where he was recipient of the Loeb Award for excellence in Clinical Medicine. He went on to complete his internship, residency, and fellowships at New York Presbyterian Hospital-Columbia University Medical Center. Previously, Dr. Paz graduated magna cum laude with a bachelor’s and master’s degree in chemistry from Harvard University. Dr. Paz practices cardiology at White Plains Hospital in New York while also leading clinical strategy and affairs at Hello Heart.

Jason Sloan

VP of Medicare Stars and Risk Programs

BlueCross BlueShield of South Carolina

At BlueCross BlueShield of South Carolina, Jason leads the strategic vision and daily operations for Medicare Advantage quality improvement activities, risk adjustment procedures, and value-based provider partnerships. Under Jason’s leadership the MA program has markedly increased quality outcomes through innovative member engagement programs, robust analytic systems and by establishing strong partnerships with local healthcare providers.

Jason has spent his career managing local and national Medicare Advantage quality programs along with experience in medical research and physical therapy health programs. As an active member of the Board of Directors for Senior Resources LLC he helps promote food access and well-being for senior citizens enrolled in the Meals on Wheels program. He earned an MBA from the University of Notre Dame and a Masters in Biomedical Science from Midwestern University in Chicago.

Melissa Smith

Founder and Senior Advisor

Newton Smith Group

For more than a decade, Melissa Smith has been at the forefront of leading Medicare Advantage and Star Ratings teams. As the founder of Newton Smith Group and a Senior Advisor to Oliver Wyman, Melissa is a widely recognized thought leader and healthcare strategist. Her proven track record of success lies in developing comprehensive enterprise-wide solutions that enhance Star Ratings, quality performance, health outcomes, and the overall member experience. Melissa excels in crafting strategic and tactical solutions to meet client needs, forging productive partnerships across internal teams and external vendors, and improving performance on various quality measures. Her unique background in business, finance, regulatory compliance, and healthcare quality provides clients unparalleled access to healthcare strategy, quality performance, and revenue optimization. As the former Chief Consulting Officer at Healthmine and Senior Vice President at Gorman Health Group, Melissa's leadership spans across prestigious organizations like Cigna-HealthSpring and Vanderbilt University Medical Center. Graduating from Purdue University, Melissa began her career at KPMG, LLP and is a Certified Public Accountant.

Wendy Talbot, MPH

Vice President, Measure and Data Operations

National Committee for Quality Assurance (NCQA)

Wendy Talbot is the Vice President of Measure and Data Operations at the National Committee For Quality Assurance (NCQA). She is responsible for a portfolio of products that range from HEDIS content, digital implementation support, Measure Certification, HEDIS Audit and validation programs, data collection, Quality Compass and Health Plan Ratings.

Wendy has over 25 years of industry experience working with federal, state and local government, quality improvement, managed care and behavioral health organizations, and physician groups. Prior to working with NCQA, she worked as the Director of Performance Measure Validation and Audits for an External Quality Review Organization (EQRO) and one of NCQA’s HEDIS Licensed Organizations. While there, she was an NCQA Certified HEDIS Compliance Auditor and performed over 150 HEDIS, AMP and Performance Measure Validation audits. Before her time at the EQRO, she was an epidemiologist at the Arizona Department of Health Services.

Wendy completed her undergraduate education in Health Sciences at the University of Nevada, Reno. She also holds a Master of Public Health, Epidemiology degree from the University of Arizona. She has been a Certified HEDIS Compliance Auditor since 2007.

Jared Thornburg

Director, Stars & Quality Improvement

Ochsner Health Plan

Dan Weaver

Senior Vice President, Stars & Quality

Zing Health

Daniel Weaver recently joined Zing Health, a tech-forward health plan based in Chicago, as the Senior Vice President of Stars and Quality. With over 25 years of experience in Operations and Star Ratings strategy, Daniel has previously served as VP, Government Quality Programs at Highmark Wholecare (formerly Gateway Health Plan) and Director of Stars Programs at Highmark Health, helping both organizations achieve and maintain their first 4.5 Star Ratings. In his career, Dan has overseen the development and implementation of many analytics-driven and beneficiary-focused programs, has adopted continuous improvement and operational excellence philosophies for sustained success, and embraces innovation focused on overcoming socioeconomic barriers to achieving health equity and optimal quality outcomes. In his new role with Zing Health, Daniel will focus on implementing a high-performing Stars infrastructure to support the organization’s rapid growth with a focus on servicing special needs members in several states.

Sabrina Zerzouri

Lead Stars Program Manager

Blue Cross Blue Shield of Rhode Island

Sabrina Zerzouri is the Lead Stars Program Manager at BCBSRI. She has experience working with national, regional, and state health plans to manage the Star Rating program. In her current role, Sabrina provides strategic guidance to cross functional teams throughout the organization to positively impact member experience, health outcomes, and Star Ratings. She is particularly passionate about advancing health equity, ensuring that diverse member populations receive accessible, effective, and culturally responsive healthcare. Her strategic mindset and commitment to continuous quality improvement make her an invaluable asset in the evolving Medicare Advantage landscape.