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Gaining control of CMS and state network adequacy requirements meant connecting the silos for this large Blues regional plan.
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Decrease the complexity and time spent on creating your Exception narratives for regulators. In this session, you’ll learn tips & tricks for using your Quest Analytics solutions to complete the long list of items for your Exception request.
Presenter(s):
Neal is a passionate healthcare technology executive with nearly 3 decades of experience in designing and delivering innovative healthcare technology solutions and platforms to drive key business outcomes within various health verticals. Prior to joining Quest Analytics, Neal spent 20 years within UnitedHealth Group and Optum where he served as a distinguished engineer and technology leader with a strong focus on technology strategy, innovation, leadership, and business enablement.
A proven, results-oriented leader with deep experience in health delivery and managed care, Jim has spent his career focused on using analytics and insights to ensure better patient and caregiver outcomes. At Quest Analytics, Jim collaborates with our clients and teams to develop new and innovative network measurement analytics designed to meet emerging industry challenges, drive performance and create differentiated networks. Previously, Jim served as VP, Market and Provider Analytics at Highmark Health, where he led actuarial and analytic teams.
Scott is a seasoned executive with deep experience across the payer, provider and regulatory space. Most recently, he served as market president for AmeriHealth Caritas New Hampshire, where he was responsible for the plan’s strategic direction, growth, and leadership. His prior experience includes working at Anthem, Inc. as a vice president of provider joint ventures and national accounts, and he has also held senior roles within leading healthcare providers, directing a Medicaid health plan, and driving national health strategy for multiple Fortune 50 corporations.
Bill is a senior healthcare executive and visionary with more than three decades of expertise across several healthcare verticals. Prior to joining Quest Analytics, Bill served in leadership roles at Healthgrades, MediMedia, WebMD, Merck-Medco and Medical Marketing Group. Bill also founded The Kleinfelter Group, where he provided consultation, advisory and healthcare data management services.
An engineer by training, Barbara has more than 20 years of experience bringing innovative technology solutions to the market that address key challenges in healthcare. She has a track record of driving value to customers and clients that drive exceptional growth to the business. At Quest Analytics, Barbara helps drive the expansion of current solutions as well as new innovations off of Quest Analytics’ core offerings. Previously, she has served in leadership roles in companies across all facets of healthcare – from population health analytics, medical devices, speech recognition, and radiology imaging. Barbara holds Bachelor’s and Master’s Degrees in Electrical Engineering from Tufts University.
Jim is an experienced financial and operational leader for technology-driven, growth-oriented healthcare and software development companies. Prior to joining Quest Analytics, Jim was the Chief Operating Officer of Asynchrony, the software development arm of World Wide Technology, based in St Louis, Missouri. Previously, Jim served as the Chief Financial Officer of Gateway EDI, a healthcare technology company.
As part of the original visionary team at Quest Analytics, Linda has spent more than a decade ensuring Quest Analytics’ focus is customer driven. She laid the foundation for strategic growth and is accountable for the 98% client retention. Linda managed the launch of the Quest Enterprise Services platform and has been instrumental in implementing automated network adequacy processes at the federal and state level.
Brent is a proven pioneer and leader in the development of emerging healthcare technology, and for more than 30 years has led high-growth companies in EHR, eprescribing, clinical data exchange and payment integrity. Prior to joining Quest Analytics, Brent developed and oversaw HMS’ commercial team, achieving 400M+ growth over five years. Previously Brent served in senior executive roles at Allscripts and Zix Corporation and served as CEO of Task Technologies, Inc. and President/CEO of Staffing Solutions.
John has brought visionary solutions to the healthcare market for decades. He pioneered the industry’s first accessibility tools and developed partnerships with federal, state and commercial markets. He has evolved the idea of simple access standards to comprehensive automated network adequacy solutions that connect the dots between network adequacy and data accuracy. His foresight focuses on giving our customers a competitive advantage in the market with new tools and services.
As a strategic entrepreneur in healthcare, Steve has more than two decades of experience leveraging data and workflow technology to drive innovation in healthcare. He brings a broad range of experience working with providers, health plans and health systems, initially as a management consultant, then as founder and CEO of a pioneering predictive analytics company, and most recently as head of strategy and mergers & acquisitions for a leading revenue cycle technology platform. Steve is a graduate of Dartmouth College and Harvard Business School and is a member of the board of directors of LifePoint Health.