Christina Byrne ASA, MAAA
Dani Cronick, FSA, MAAA
Denise Doucette-Ginise, MSN, RN, CCM, CHPN,
Jamie Galbreath, PhD, MPH, CHES
Keith Gaetano, PharmD
Nikki Hungate, MS, MHA
Elizabeth Klodas, MD, FACC
Sharon Kuhrt, RN, DNP
Dr. Rob Mordkin, MD, FACS
Dr. Claude Pinnock
Cindy Aguglia is the Medicare Stars & quality manager at The Health Plan (THP), one of the
largest locally managed care organizations in West Virginia. They offer a complete line of
managed care products and services, including Medicare Advantage HMO, PPO and DSNP plans
that provide coverage to West Virginia and eastern Ohio.
Cindy has worked in the health insurance space for over 30 years, holding various positions in sales, operations, Medicare compliance, quality, and appeals. Cindy joined THP in March 2021 as their first Medicare Stars & quality manager and has used her insight and experience in working in Stars for the past for 10 years to initiate many programs to improve the Star ratings at THP. She believes connecting with members proactivity when they least expect it, sends a message to the member that they matter.
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.
Liz has spent the last 8 years working with health plans to help them achieve their HEDIS and Quality objectives as a consultant with Health Data Decisions. She’s recently transitioned to an exciting new opportunity, bringing the member experience analytics to market as a software product with a new team. Liz is dedicated to finding the best solutions for her clients and is focused on achievable, incremental progress.
Daniele is an entrepreneur, senior consultant and executive with 25+ years of experience in business process management, operations and information technology. She is a proven and decisive leader focused on helping organizations transform, innovate and grow. Daniele has worked for over a decade exclusively in the Healthcare industry leading transformation projects spanning Customer Service, Authorizations, Billing, Claims and Complaints, Appeals and Grievances.
Automation leader providing high levels of collaboration, communication, consultation, and versatility to identify, design, and deliver process improvement solutions via Business Process Automation and Lean Six Sigma methodology while using Real-World Data to drive organizational change.
Dani Cronick, FSA, MAAA
Dani Cronick, FSA, MAAA is a Senior Consulting Actuary in the Denver office of Wakely Consulting Group, LLC, an HMA Company. Prior to joining Wakely she worked for Humana on Medicare Advantage plan pricing. Since joining Wakely in 2017, she has supported providers within the Medicare Shared Savings Program, through risk sharing arrangements with payers, and in contract evaluation. She has also worked with payers within their Medicare Advantage bid pricing—including pricing of Employer Group Waiver plans—and both Individual and Small Group Commercial filings. Outside of pricing, Dani has supported clients in various strategic and competitive analysis efforts, including support for and development of the Wakely Medicare Advantage Competitive Analysis dashboard. She also has experience in the quality space working with Medicare Advantage Star Ratings, including evaluating the latest regulatory changes to Star Ratings and dissecting emerging trends in the Star Rating program.
Kacey Dugan is an experienced health policy analyst with deep knowledge of CMS rules and insurance programs. As a director at Faegre Drinker Consulting, she works primarily with health plans, providers, and vendors to provide strategic advice and help navigate regulatory and compliance issues regarding the Medicare, Medicaid, and ACA markets. Prior to joining Faegre Drinker, Kacey served as a senior analyst at the Medicaid and CHIP Payment and Access Commission — Congress's advisory agency on Medicaid and CHIP issues — where she led numerous qualitative research projects and policy discussions on a wide range of issues affecting access to care for Medicaid and Medicare-Medicaid dually eligible beneficiaries.
Julianne Eckert is the Senior Director of Clinical Quality Programs at Clover Health, a physician enablement company focused on seniors who have historically lacked access to affordable, high-quality healthcare. She is responsible for creating an innovative data driven strategy that breaks the traditional model of healthcare to make it easier for providers and patients to deliver and receive healthcare.
She has spent her life using her personal and clinical career experiences to help drive her mission as a patient advocate by leading health plan quality improvement strategies to prevent vulnerable populations from falling through the cracks with data stories and forward thinking programs which enable patients to easily navigate the complex matrices of healthcare and insurance. She has sweeping subject matter experience in accreditation, CMS Innovation models, Stars QI programming, NCQA HEDIS/CAHPS/HOS, health equity, as well as, national and international leadership in driving laser focused strategies to improve health plan performance and member outcomes/experience.
She currently serves on the Board of Advisors for curriculum development for Pace University’s Design Thinking Executive Program which meets high academic standards, with a challenging interdisciplinary curriculum designed to prepare top executives to solve real-world challenges in designing innovative practices. She holds multiple certifications in Organizational Change Management, Case Management and also Managed Care. She is an avid mentor and career coach believing it is her mission to develop our next generation of leaders.
Allie El-Tawil has spent that past 7 years in the healthcare industry focused on quality improvement for the Medicare Advantage population. Allie’s true passion for making healthcare easy and accessible to the aging population brought her to her current role as the Stars Business Analyst for Blue Cross Blue Shield of Arizona, the state’s largest locally owned insurer. In this role Allie focuses on improving the member experience while project managing multiple quality improvement initiatives throughout the year.
Allie earned a Bachelor of Science degree in Nutrition from Arizona State University, and a Master of Public Health degree from the University of Arizona. Allie is also a member of the Arizona Public Health Association.
Andy provides strategic focus to healthAlign, ensuring that the work of the team is properly aligned with the goals of payers, patients and caregivers. He brings over 20 years of healthcare experience to the job. As Senior Vice President of Strategic Solutions at Maxim Healthcare Services, Andy oversaw the company’s nationwide Business Development across strategic accounts as well as program implementation and management for large-scale strategic engagements. His work driving the Product Development function there brought about a Community Based Care Management offering that has been shown to reduce readmissions by over 65% while also driving a 35% reduction in in-patient spending.
Andy came to Maxim from Medco Health Solutions where he worked on the development of the Medicare Part D drug benefit, the early launch of the internet pharmacy marketplace and the regulatory environment for mail service pharmacies. Andy began his career as an aide to former New Jersey Governor Christine Todd Whitman.
Denise Doucette-Ginise, MSN, RN, CCM, CHPN,
Denise Doucette-Ginise, MSN, RN, CCM, CHPN is the Director of Care Management Senior Products at CarePartners of Connecticut in Rocky Hill, CT. CarePartners is a new Medicare Advantage plan created via a joint venture between 5-STAR Tufts Health Plan and integrated provider system Hartford HealthCare. Denise has held numerous leadership roles in the managed care industry, spanning Medicare Advantage, Medicaid, Duals, and Commercial lines of business. She has a history of developing targeted programs and collaborative strategies to align the plan and provider stakeholders of matrixed organizations, from C-suite to front-line teams, resulting in optimal clinical and quality performance. Her current plan, CarePartners of Connecticut, received 4.5 STARS in their first year of rating and Tufts Health Plan, CarePartners’ parent organization, received 5-STAR for its seventh year in a row.
Jamie Galbreath, PhD, MPH, CHES
Jamie Galbreath is the Quality Improvement Associate Director for UCare where she provides oversight and manages the HEDIS chart abstraction team, NCQA Accreditation (both Health Plan and Health Equity Accreditation), Star Ratings (Medicare, Marketplace and Medicaid), and regulatory quality improvement projects. Additionally, she leads clinical and public health performance improvement projects designed to improve member health outcomes.
Jamie has received her doctorate in Public Health with a specialization in Community Health Promotion and Education from Walden University. She also has her Master’s degree in Public Health from Walden University and Bachelors of Science degree in Community Health Education from the University of Minnesota Duluth. She has completed a certificate program from St. Thomas University in Health Care Management. Further, she is a Certified Health Education Specialist and a member of the Minnesota Society for Public Health Education and the Minnesota Public Health Association. Jamie has almost ten years of health care industry work experience and 18 years of experience working in the mental health and substance use field.
Keith Gaetano, PharmD
Keith directs numerous clinical initiatives in the health plan practice at Rx Savings Solutions. A charter member of the RxSS Pharmacy & Therapeutics Committee, he helps curate and review clinical suggestions that drive the company's proprietary savings engine. He also serves as subject matter expert for all clinical discussions with prospective health plan clients. Born and raised in Chicago, he is a graduate of Purdue University College of Pharmacy.
With more than 30 years of progressive experience in the health care industry, Renée S. Golderman, MS,
RN, NE-BC, is the Senior Vice President and Chief Quality Officer at CDPHP. In this role, Golderman
provides the strategic leadership needed to design, implement, and manage quality improvement
programs at CDPHP, and is responsible for the plan being named a 5 Star plan by the Centers for
Medicare and Medicaid Services (CMS). Golderman was recently named as one of the Top 100 Women
Leaders in New York by Women We Admire.
Golderman is responsible for directing HEDIS,QARR, NCQA, and Medicare Stars initiatives at CDPHP, which includes collaboration among Medicare risk, medical management, care management and network providers to drive innovative initiatives to improve quality outcomes and ensure member satisfaction. She has led health care transformation initiatives, including tools for population health and clinical integration strategies, and assists in design and operational aspects of primary care incentive programs.
Golderman is skilled at fostering relationships while executing on strategic plans to drive quality outcomes focused on the Quadruple Aim. Golderman demonstrates sound understanding of and has broad experience with hospital operations, health care finances, board responsibilities, physician relations, and knowledge of how all entities are interdependent, along with current knowledge of the trends and challenges in health care.
Prior to joining CDPHP, Golderman has held various positions in the health care industry and has a record of accomplishments in a range of health care settings, including both the clinical and administrative aspects of inpatient and outpatient care, quality and risk management, hospital and primary care business operations, as well as health plan leadership and administration. Golderman has served as the director of nursing for Seton Health System, part of the Ascension Health System where she was a recipient of the NYSNA Nursing Excellence Award in Administration/Management. In addition, she held clinical management positions at New England Baptist Hospital in Boston, Mass., and New Britain General Hospital in New Britain, Conn. She has also served as a clinical educator for The Eddy in Troy, N.Y.
Golderman earned a Bachelor of Science degree in nursing from SUNY Buffalo, and a Master of Science degree in health care management from Rensselaer Polytechnic Institute. Golderman is a nurse executive-board certified, by the American Nurses Credentialing Center (ANCC), and is a member of the National Association for Healthcare Quality.
Nikki Hungate, MS, MHA
Nikki Hungate, a long-time resident of the Western New York region, currently serves as the Senior Leader of Medicare & Government Programs Product Strategy at MVP Health Care. Utilizing the 17 years of experience in the health plan industry she is accountable for leading a team of product innovators that create and deliver a suite of high-quality government products that address the needs of the community in a customer-centric fashion, placing emphasis on those populations that are most vulnerable and underserved.
Nikki holds a Bachelor and Master of Science in Health Administration from Roberts Wesleyan College. She is currently a doctoral candidate at the University of Charleston in the Executive Leadership program. Nikki has a passion for sharing knowledge, and also serves as an adjunct professor in the health sciences degree programs at Monroe Community College and Roberts Wesleyan College. In her free time, she volunteers as fundraising coordinator for the local Vietnam Veterans of America chapter in Rochester, NY.
Katharine is the President of Healthy People, an NCQA-licensed HEDIS audit firm and CMS Data Validation firm. She is a member of NCQA’s Audit Methodology Panel and NCQA’s HEDIS Data Collection Advisory Panel. Katharine has been a Certified HEDIS® Compliance Auditor since 1998 and has directed more than two thousand HEDIS audits.
Previously, as CEO of the company Acumetrics, Katharine provided consultancy services to NCQA which helped their initial development and eventual launch of the NCQA Measure Certification Program.
Katharine is a frequent speaker at HEDIS conferences, including NCQA’s Healthcare Quality Congress and RISE HEDIS conferences. She is featured on an NCQA podcast, discussing the HEDIS Electronic Clinical Data System Measures: https://blog.ncqa.org/inside-h...
She received her BA from Columbia University and her MPH from UC Berkeley School of Public Health. She is a member of the National Association for Healthcare Quality and is published in the fields of healthcare and public health.
Kimberly brings over 15 years of healthcare, health plan, and consulting experience to Healthmine.
Kimberly most recently came from Network Health Plan, where she led her MA plan to a coveted 5-star rating and ran nationally top-ranked quality programs for over 6 years. She had oversight of Stars/HEDIS®/NCQA/QRS, population health programs, clinical integration, and value-based care programs (both SNP and non-SNP). She was responsible for the integration of quality, performance improvement and patient/member satisfaction initiatives across the Health Plan and provider systems.
Kimberly developed innovative member/provider interventions and population health programs to support successful quality programs, MLR initiatives, and value-based care initiatives. Prior to Network Health, Kimberly served in several consulting leadership positions with Valence Health, APS Healthcare, and the New York City Department of Health.
As a consultant, Kimberly evaluates quality, value-based care and population health programs and develops custom and comprehensive improvement strategies for Star Ratings, HEDIS®, CAHPS and HOS surveys, Heathy Equity and NCQA accreditations. Kimberly is a graduate of Vanderbilt University and holds a Master of Public Administration from the Robert F. Wagner School of Public Service at New York University.
Terri Kitchen is the Divisional Vice President of Enterprise Quality & Accreditation for Health Care Service Corporation (BCBS of IL, TX, NM, OK, MT). She obtained and MBA from University of Chicago. Terri consulted with Deloitte for top tier health plans such as HCSC, Anthem and Humana. During her tenure as a consultant, Terri gained deep knowledge around health plan data analytics and operations. In 2013, she became an Executive Director of Analytics and Information Management at Health Care Service Corporation. Today, Terri is responsible for the five state’s HEDIS regulatory reporting, Health Data Acquisition and Exchange, Population Health, Accreditation Analytics and HCSC’s Physician Efficiency, Appropriateness and Quality (PEAQ) performance measurement.
Elizabeth Klodas, MD, FACC
Elizabeth Klodas MD, FACC is Founder and Chief Medical Officer of Step One Foods, based in Minneapolis, Minnesota. Dr. Klodas completed her Cardiology fellowships with both the Mayo Clinic and Johns Hopkins School of Medicine, and founded Preventive Cardiology Consultants, where she continues to see patients. She is the author of a book for patients: Slay The Giant: The Power of Prevention in Treating Heart Disease, and served as the Founding Editor of Cardiosmart, the patient education website of the American College of Cardiology. Having authored multiple scientific articles, serves as a member of the Nutrition Workgroup of the ACC, and a medical editor for webMD.
Dean is a clinical pharmacist that has his career designing and overseeing medication therapy management and quality intervention program operations. Dean has had exposure to a wide array of practice models for quality interventions. Dean has directly managed teams of pharmacists to deliver high volume, performance driving programs for large health plan clients. Dean is a subject matter expert in intervention execution and Medicare program requirements that impact the delivery of MTM and quality services. Dean is an expert in overcoming barriers to member and provider clinical service engagement. He has trained hundreds of pharmacists and technicians in motivational interviewing and overcoming resistance to participation in services.
Sharon Kuhrt, RN, DNP
Sharon Kuhrt is an innovative healthcare leader with experience in health plan quality, acute, post-acute, and outpatient healthcare settings. She is currently Director of HEDIS and Data Analytics at Priority Health in Grand Rapids Michigan. She has 13 years of experience in HEDIS and many years of experience with Medicare Stars and Medicaid. Sharon is an RN and holds a doctorate in nursing from Northeastern University. She is passionate about the quality of care delivered to members and the data and analytics that support those efforts.
His first hand experience witnessing his grandmother (and next-door neighbor) age with the support of his parents led Eric to a career in healthcare and, ultimately, to DUOS. Eric leads DUOS’ growth strategy focused on market insights, value delivery, customer- centric commercial capabilities and product strategy. Eric brings rich industry experience from his time as Chief Growth Officer at Myriad Genetics, Inc.; Chief Revenue Officer at Rally Health, Inc.; and various leadership roles within UnitedHealth Group. Outside of work, you might find Eric spending time with his family, fly fishing, mountain biking or working on his golf game.
Melissa Smith is the Executive Vice President of Consulting and Professional Services at Healthmine, bringing over 25 years of experience in Star Ratings, strategy, sales, and marketing for health plans, providers, pharmacy benefit managers, and industry vendors. Melissa has extensive experience developing strategic and tactical solutions to meet client needs and a strong background of building productive partnerships across internal teams and with external vendors to improve performance on clinical, medication, patient survey, and administrative quality measures.
Most recently, Melissa was Senior Vice President of Sales, Marketing, Strategy and Stars at Gorman Health Group. She is a well-known thought leader and healthcare strategist with proven success developing enterprise-wide solutions to improve Star Ratings, quality performance, health outcomes, and the member experience. Melissa’s team helps clients improve performance within quality ratings systems, evaluate market dynamics and opportunities, optimize distribution channels, and support our clients’ strategic planning needs.
Prior to Gorman Health Group, Melissa served in a leadership capacity at Cigna-HealthSpring. Before working in Medicare Advantage and quality ratings systems, Melissa was an Associate Director at Vanderbilt University Medical Center. Melissa received her degree from Purdue University and began her career at KPMG, LLP. Melissa’s unique background of business process, regulatory compliance, and healthcare quality offers our clients unique access to healthcare strategy, quality performance, revenue optimization, and more.
Reva has more than 15 years’ industry experience ranging from long term care and compound pharmacy management to health plan operations and quality. As an avid collaborator, Reva engages internal and external stakeholders to improve processes for optimal outcomes while keeping the member’s experience at the heart of every conversation.
Brandon Solomon is Convey's vice president of client advisory and business development. Brandon has over 15 years of healthcare experience as a strategic advisor and partner to health plans and providers, mainly operating government markets (MA, ACA, Medicaid). In his current role, Brandon focuses on developing strong partnerships with our Convey customers to help them attract, retain, and better manage members through supplemental benefit management and advanced analytics.
Dr. Rob Mordkin, MD, FACS
Dr. Mordkin is a graduate of the University of Southern California Keck School of Medicine where he earned Alpha Omega Alpha academic honors. He completed his surgery and urology training at Georgetown University and then spent 6 years on full-time faculty. He is a former reserve officer in the U.S. Navy and is certified by the American Board of Urology. He is also a Fellow of the American College of Surgeons and leads a robotic surgery program. Dr. Mordkin’s passion for LetsGetChecked stems from his belief that empowering individuals to live healthier lives starts with moving from a traditional “reactive” medicine approach into a more proactive, preventative strategy by allowing people direct access to the tools and knowledge they need to understand their individual health journey.
Mallory provides clinical leadership in the quality department over various population health and quality programs including condition management, wellness, NCQA, HEDIS, clinical appeals review, and Stars. In addition, Mallory works with the clinical integration team to ensure members are receiving the right care at the right place and the right time.
Mallory graduated from UW-Green Bay and is a registered nurse with background in long term care and nursing administration. She lives in the Fox Valley with her husband and three children. She enjoys reading and spending time watching her kids sporting events
With over 20 years of experience in the rewards and incentives industry, Jacilyn Bennett has partnered with a multitude of different healthcare plans, corporations, organizations, and platforms to design rewards and incentive programs aimed at increasing member engagement and mutually beneficial activity and behaviors. As the VP of Healthcare and Research Incentives with Blackhawk Network, she works to design programs that boost member engagement and increase CMS Star Ratings and HEDIS scores through a variety of Blackhawk Network reward card solutions.
Tracy Parris-Benjamin is a master’s-level licensed Social Worker, integrator, and equity
champion, who works to sustain support for advancing diversity, equity, accessibility, inclusion,
and development. Ms. Parris-Benjamin holds a distinguished record of health care innovation
and transformation. With the primary goal of achieving equitable health for all, Ms. Parris-
Benjamin works with Horizon’s extensive value-based network to lead the development of
innovative health programs targeted toward marginalized populations. As the current Director of
Clinical Design, Community Health at Horizon Blue Cross Blue Shield of New Jersey, she
translates executive strategy into tactical implementation, for a broad variety of community
health initiatives and care models. Ms. Parris-Benjamin is responsible for leading payer/provider
integration work and addressing social determinants of health. She also works with provider
systems that are positioning themselves toward assuming global risk.
Ms. Parris-Benjamin’s experience demonstrates her work as an advocate for community-based programs and other healthcare initiatives. She leads several workgroups and discussions around increased awareness and stigma reduction of substance use disorders and has championed programs for HIV-positive pregnant teens and their families, survivors of domestic violence, individual and group counseling, parenting workshops to reunite families, and care coordination for underserved and chronically ill persons. She promotes the need for increased cognizance on the impact of health disparities and inequities in healthcare, for underserved populations and persons of color.
In 2019, Ms. Parris-Benjamin received distinguished honors from Diversity MBA as one of the Top leaders under 50 and was featured in the 2020 inaugural issue of the top 100 Women of Influence. She has led the development and implementation of Peer-Recovery models and served as a key speaker for the Partnership for a Drug Free NJ’s ‘Knock Opioid Out of New Jersey’ Initiative. She is a fellow of the New Jersey Healthcare Executives Leadership Academy and was voted into Horizon Blue Cross Blue Shield of NJ 85th Anniversary Hall of Fame. Ms. Parris-Benjamin was featured on WBGO radio, where she led a discussion on trauma informed care and has often served as a panelist for discussions related to impending social determinants of health. She was featured on NJ Spotlight where she raised awareness on the importance of community engagement to mobilize health education, specifically around COVID- 19 and access to resources in high-risk communities.
Ms. Parris-Benjamin is recognized, by her colleagues, as a strong leader and role model. She has engaged in several formal and informal mentor relationships. She is passionate about helping others and bringing awareness to topics and challenges that affect the lives of many. Ms. Parris-Benjamin currently serves on the boards for the Northern NJ Region American Heart Association and the Greater Newark Healthcare Coalition. In her role as President of the Northern NJ Region Board of the American Heart Association and Chair for the Go Red for Women 2021-2022. She is responsible for raising awareness on the importance of Heart and Stroke health through various speaking engagements, fundraising and developing innovative collaborations to expand treatments opportunities, research and prevention with a keen interest in vulnerable communities. She is also an active member of Horizon’s Diversity Counsel where she leads efforts to raise awareness of racial injustices and systemic structures that continue to promote healthcare disparities and racial inequities.
Through her work, Ms. Parris-Benjamin has witnessed the importance and value of investing in a community and devotes time to volunteering. She has supported many projects, such as community garden restorations, fundraising to support homeless teens, women’s empowerment seminars and other activities in conjunction with local churches and community board organizations, to name a few.
When she is not tackling social issues within healthcare, Ms. Parris-Benjamin enjoys spending time with her family. She is a cherished wife, and mother of two school-aged children. She is also an entrepreneur and proud business owner of a children’s entertainment venture that focuses on developing confidence in children and young adults.
Ms. Parris-Benjamin holds a bachelor’s degree in Psychology with a minor in Social Work from St. John’s University and a master’s in social work from Fordham University.
Christina Byrne ASA, MAAA
Christina Byrne works in the Tampa office of Wakely Consulting Group, LLC, an HMA Company. Christina joined Wakely in 2016. She specializes in supporting the submission of Medicare Advantage/Prescription Drug Plan Bids that project medical and pharmacy expenses for pricing and premium development. This includes analyzing detailed claims experience, performing trend analyses, and management of Medicare Plan Benefit Packages (PBPs). Her other experience lies in model development, Employer Group Waiver Plan pricing, evaluation of unpaid claim liabilities, and financial statement filings for managed care entities. Christina’s recent work has been focused on developing and managing Wakely’s suite of HEDIS products along with other internal quality initiatives.
Dwight Pattison is Vice President of Consulting & Professional Services at Healthmine with over twenty years of healthcare industry experience focused on healthcare quality management, performance improvement, data analytics, and reporting.
Fueled by a strong background in Medicare and Medicaid reporting and regulatory compliance, Dwight has directly led MCOs in achieving significant performance improvement results across numerous markets and product lines. He has consulted dozens of plans on improving their HEDIS® and Star Ratings programs. He has also served as the National Director of HEDIS for a leading organization where he was responsible for HEDIS and CAHPS© performance reporting and analytics, as well as supporting 18 health plans’ Medicaid and special needs plans quality reporting requirements.
Prior to his role as a Consultant, Dwight held numerous positions as a Director of Quality Improvement for multiple markets in the managed care industry. In these roles, he implemented member and provider outreach programs focused on targeting vulnerable populations and providing member engagement tools.
As an integral part of the Healthmine Consulting and Professional Services team, Dwight provides strategic guidance on process improvements for managed care organizations, provider groups, and ancillary services organizations. He continually uses his expertise in reporting, data capture, and analytics to evaluate programs, develop teams, and improve performance in Star Ratings, HEDIS, CAHPS and HOS surveys, and NCQA accreditations. Dwight also routinely performs mock readiness audits of Special Needs Plan Model of Care (SNP-MOC) and Coordinated Care Quality Improvement Program Effectiveness (CCQIPE).
Mark Pencek is Vice President, Customer Experience for Medical Mutual. In this role, Mark drives exceptional experiences across the member lifecycle. Mark and his teams lead strategy and drive continuous improvement to member experience, including Medical Mutual’s Medicare Stars and CAHPS performance, digital transformation, and the training and performance of Customer Care staff. For 2023, Medical Mutual is one of only six companies that have a 5-Star HMO and PPO contract. Prior to joining Medical Mutual, Mark held Customer Experience leadership roles in the banking and transportation industries. Mark is a graduate of Kent State University where he earned a BA in computer science and his MBA from the Terry College of Business at the University of Georgia – Go Dawgs!
Dr. Claude Pinnock
Dr. Pinnock is a healthcare industry veteran with deep clinical strategy and digital health experience and brings a strong passion for improving access and quality to improve health for all with a focus on social determinants of health (SDoH). As Chief Medical Officer at Wider Circle Dr. Pinnock is responsible for crafting, directing and overseeing the execution of the company’s clinical strategy for expanding its Medicare and Medicaid business. He supports the senior leadership team in their efforts to further shape and grow the organization which includes collaborating closely with Wider Circle’s product development, marketing, and sales teams. Dr. Pinnock began his clinical career in the United Kingdom where he earned his Bachelor of Medicine, Bachelor of Surgery (B.M.B.S.) at the University of Nottingham and his master’s in public health from Cambridge University. While he began his career as a practicing physician in rural Cambridgeshire, a personal interest in driving the adoption of value-based healthcare in EMEA eventually led to a position at International Consortium for Health Outcomes Measurement (ICHOM). Following a move to the United States he held leadership positions addressing service redesign, quality improvement, and strategy in both public and private health sectors (Stanford University School of Medicine, Clarify Health Solutions). Most recently, he managed global strategic partnerships in health at Meta, Facebook’s parent company and led their health partnerships innovation team driving global adoption of vaccines.
Cynthia Pawley-Martin is a Senior Consultant at Healthmine. She brings a wealth of expertise from her long-tenured career as a healthcare quality improvement professional, where she has provided expertise to health plans and provider practices in a wide range of areas including Quality Improvement, the Centers for Medicare & Medicaid Services Quality Bonus Programs, Star Ratings, Quality Rating System (QRS), and Patient Centered Medical Home (PCMH). Cynthia is a Registered Nurse (RN) certified in Healthcare Quality with more than twenty years of experience in the healthcare industry. Her areas of expertise include CMS regulatory requirements (Quality/Star Ratings/Physician Quality Reporting System (PQRS), HEDIS®, CAHPS, HOS, Models of Care (MOCs), and providing support for Patient-Centered Medical Home (PCMH) and PQRS.
Cynthia has consulted with dozens of Medicare Advantage plans on their Star Ratings programs and comes with a solid record of success leading and supporting Quality Improvement programs across healthcare delivery systems, including health plans and large physician practices. Her leadership skills allow her to effectively communicate across all organizational levels and enables those teams to reach consensus among diverse stakeholders to deliver better services for the healthcare clients.
Cynthia has not only guided plans in CMS quality program assessment, implementation, organizational design, and MOC development, she has also supported provider groups in obtaining and maintaining PCMH recognition.
Prior to her consultant roles, Cynthia served as Director of Star Ratings for a leading organization and has held numerous positions in Quality and managing HEDIS® for multiple products in the managed care arena.
Cortney Resto is the Assistant Vice President of Grievances & Appeals at EmblemHealth with over 17 years' experience in the industry. Leading a team of 150+ associates, she is responsible for Grievances and Appeals across Commercial, Medicaid and Medicare lines of business, including ongoing compliance monitoring, audit preparation and readiness and driving action and process change across the organization. Cortney knows that partnering with internal and external business partners is the key to successful Grievance and Appeal operations, leveraging those relationships to drive change and improve the member and provider experience. Under Cortney’s leadership, her team recently completed a multi-year transformation, migrating their Grievance and Appeal platform as well as multiple other operational systems.
Hagy is the VP of Quality for Buckeye, a Centene health plan. She is responsible for HEDIS, Stars, CAHPS and HOS, and NCQA accreditation. Hagy coordinates with teams across Buckeye to develop, manage, and implement quality initiatives. She works with leaders across Centene, both at the corporate level and at other health plans to share best practices and drive improvement. Prior to Buckeye, Hagy worked at Molina and Gateway Health Plans and has a background in clinical counseling.
Daniel Weaver is the Executive Vice President of Product Operations and Stars Strategy at NationsBenefits, with nearly 25 years of experience in Operations and Star Ratings strategy. Daniel most recently served as VP, Government Quality Programs at Gateway Health, where he led the company to its first 4.5 Star Rating and an improved Medicaid NCQA Accreditation rating. In his career, Dan has overseen the development and implementation of many analytics-driven and customer-focused programs, and he advocates for continuous improvement and operational excellence philosophies for sustained success. In his new role with NationsBenefits, Daniel will drive strategic planning, facilitate execution, oversee product financial performance, manage operational performance across all products, and ensure strong internal controls are in place to enable efficiency in the growth of the business. Daniel will also help drive prospective and retrospective investigation into quality outcomes and customer engagement across the company’s distinct benefit management programs while continuing to innovate new solutions for health plan partners focused on growth and strong quality performance.