Eve Anderson Assistant Director, Actuarial Services
Johns Hopkins Health Plans
Eve Anderson is a leader in the Actuarial & Analytics space, focused primarily on Medicare Advantage. In her role at Johns Hopkins Health Plans, she focuses on risk adjustment, the Medicare bid process, and Medicare Stars & commercial quality ratings. Eve is a natural problem solver, skilled in informing business strategy through innovative analytics and solutions.
Eve is a Fellow of the Society of Actuaries and currently resides in Baltimore, Maryland.
Jonathan Cho
Vice President, Medicare Product, Strategy, and Execution
Jonathan Cho Vice President, Medicare Product, Strategy, and Execution
Healthfirst
Jonathan Cho currently serves as the Vice President of Medicare Product, Strategy, and Execution with Healthfirst and is responsible for the future direction and implementation of the Medicare product portfolio. With over 300,000 members in market-leading duals and individual Medicare products in New York, Jonathan is responsible for the development and execution of the product strategy. Prior to Healthfirst, Jonathan worked in leadership roles across health plans and providers such as Healthcare Services Corporation (BCBS of IL,TX, OK, NM, MT), Kaiser Permanente Health Plan, and Molina.
Laura Cummins Manager, Product Strategy & Marketing
Clever Care Health Plan
Laura has been a strategic leader in the California healthcare industry for 18 years. Her background includes product development, marketing, communications, and digital content development. She has extensive experience in healthcare including product launches for Commercial, Medicaid and Medicare Advantage lines of business for several leading health plans. Laura held a key role in the development and implementation of the exclusive UC Blue & Gold plan and provider network for the University of California. While at Blue Shield of California, Laura was part of the core team who successfully expanded HMO products into new counties and implemented a new PPO plan.
During the start of the pandemic in 2020, Laura joined the start-up Medicare Advantage company Clever Care Health Plan as the Manager of Product Development and Marketing. She was instrumental in launching new products, on-boarding vendors, in addition, she developed sales tools and mandated materials. Through innovative product design and creative marketing strategies, Clever Care has seen membership soar to over 28 thousand members. Since 2021, Laura has been supporting all aspects of the CMS bid development and filing process working closely with Actuary, Finance and other key stakeholders to design competitive products that align with the company’s fiscal goals.
Her collaborative working style, extensive knowledge of CMS rules, and communication requirements made launching new product, implementing product enhancements, and vendor management worry-free.
Laura resides in the San Fernando Valley of Los Angeles. She is an enthusiastic baseball fan and also enjoys attending the theatre and international travel.
Omar joined Community Health Plan of Washington, CHPW, as the Director of Pharmacy in 2019 after sixteen years with Walgreens Co., where he led Specialty Pharmacy operations for the Pacific Northwest Region.
Omar has extensive experience in Specialty Pharmacy, Managed Care including government programs, and Clinical Pharmacy quality initiatives. Omar’s current role is focused on PBM relationship oversight, clinical pharmacy integration, and utilization management of medical and prescription drug benefits.
Omar received his Doctorate of Pharmacy Degree from the University of Washington in 2005 and continues to reside in the beautiful Pacific Northwest.
Dr. Shannon Decker is Founder & CEO at VBC One, a consulting firm assisting physician groups, health plans and vendors maximize the performance of their value based contracts and offerings. Dr. Decker has more than 25 years experience in health care and most recently led teams in risk, quality, data and analytics, telehealth, COVID response and delegation compliance. Of her more than 25 years of experience in healthcare--17 include working with risk adjustment, quality and Medicare. Dr. Decker has a PhD. in Interdisciplinary Studies, dual MBA degrees--in Finance and in Marketing, as well as an M.Ed. in Secondary Education and a M.Ed. in Administration and Leadership. Dr. Decker is on the faculty at Arizona State University and is also an associate professor in the social and behavioral sciences for Walden and Capella Universities where she chairs and oversees the dissertations of doctoral students. An author of two books and several peer-reviewed articles, and a prolific national public speaker, her interests include the study of human behavior and how social and behavioral theories may be brought to bear in value based care and population health management as a whole.
Tina Dueringer, BSN, RN, CCM, PCC, is the CEO and Principal Advisor at Dueringer Advisors Inc., a distinguished consulting firm dedicated to supporting health plans, vendors, and leaders in the health insurance and provider sectors. With a robust background spanning Medicare Advantage, Medicaid, Duals, ACA, and commercial markets, Tina brings extensive expertise in care management, utilization management, clinical quality, Model of Care development, Stars ratings, HEDIS measures, and accreditation standards such as NCQA and URAC.
Tina's career is marked by strategic insights into health plan operations, including strategic planning, joint ventures, partnerships, delegated relationships, and the advancement of value-based care models. She is deeply committed to advancing Health Equity, Population Health, and integrated care initiatives across the industry.
Previously, Tina served as Vice President of Clinical Quality and Stars at Rebellis Group, specializing in Medicare Advantage and government consulting. Her leadership journey includes pivotal roles at Cityblock, Blue Cross Blue Shield of Arizona, and the Wisconsin Department of Health Services, Medicaid Policy Division.
Tina earned her Bachelor of Science in Nursing and holds a post-graduate certification in Population Care Coordination from Duke University. She is also a Board-Certified Case Manager (CCM), underscoring her dedication to enhancing healthcare delivery and outcomes through comprehensive care coordination strategies.
Craig Fisher
Director, Product Development & Growth Initiatives
Craig Fisher Director, Product Development & Growth Initiatives
Jefferson Health Plans
Craig Fisher is an enterprise product leader and current director at Jefferson Health Plans who oversees Medicare Advantage and Individual & Family plans as it relates to product strategy & design, implementation and management. Also, Craig manages and ushers strategic direction and execution to achieve the enterprises overarching targets and goals. Upon alignment and execution, provides leadership across both portfolios for all implementation and go to market efforts. Prior to joining Jefferson Health Plans, Craig managed the Cross Segment Product Strategy Team while also leading enterprise roadmap efforts at Highmark Health. These programs and products aligned care journeys, member experiences with digital and non-digital solutions which created synergies to drive member satisfaction, better care outcomes, and an ROI on key benefits. These roadmap workstreams spanned commercial fully insured, ASO, Federal ACA, and MA plans. During Craig’s time at Highmark, he held several leadership roles in Medicare product development and strategy in order to design and build market competitive products to achieve enterprise enrollment targets and support all aspects of CMS bid development and new contract filing. Located in Pittsburgh, Pennsylvania, Craig stays busy with his wife and two young children attending sporting events, golfing, and hosting cook outs with friends and family.
Sharon Fletcher is President of Birdsong Hearing Benefits. In addition, she serves as President to Birdsong’s subsidiaries, AudioNet America (ANA), Your Hearing Network (YHN) and Advanced Hearing Providers (AHP) and Great Lakes Provider Network (GLPN). She is a highly accomplished three-time Chief Executive Officer (CEO) with a history for being thrust into completely new businesses, quickly determining the leverage points, developing a plan to grow shareholder value, staffing the organization for success, and motivating the team to deliver the Plan. She has deep experience in the Healthcare sector but has also demonstrated the same approach and results in industries ranging from technology, to consulting, and even airlines. Sharon is focused on awakening people to the sounds of life through better hearing healthcare. She is an outstanding coach by the thousands of people she has touched.
With over 18-years of managed care experience, she has served as the President of Fluent Health, a technology-enabled application platform delivering cost effective value to the healthcare sector.
Her numerous achievements include being nominated to be a member of Women Business Leaders of the U.S. Health Care Industry Foundation and was also recognized as one of Oklahoma’s Outstanding 2018 Chief Executive Officer of the Year. Her extensive Board experience includes several United Way chapters, The American Heart Association, Tulsa’s Chamber of Commerce, and the Healthcare Advisory Board. She is also a member of The National Association of Corporate Directors.
She serves on JAX Chamber Board of Directors and as Vice President of Programs for JAX SHRM, including serving on the Board of JAX Society of Human Resources.
Fletcher holds a PhD from Northcentral University, MBA from University of Mary, MS from La Roche College, and a Bachelor of Science from Point Park University. She also obtained an Executive Leadership Program Certificate from Cornell University in Finance. She enjoys time with family, travel, and reads five books a month.
Ana Handshuh, CHC, is a government programs executive with expertise in creating and implementing corporate programs for the healthcare industry. Ms. Handshuh is the Principal at CAT5 Strategies, a healthcare advisory practice specializing in Regulatory and Operational Compliance, Revenue Management, Communications, Quality, Care Management Programs, Benefit and Formulary Design, Program Bid Submission, Accreditation, and Technology Integration. She recently founded TRACSCOUT, a technology startup SaaS platform for managed care processes.
Her recent consultancy roles include conducting compliance risk assessments, performing Compliance Program Effectiveness audits, conducting FDR and PBM pre‐delegation audit, preparing for CMS program audit, and writing and implementing post‐audit corrective action plans. Ms. Handshuh has also assisted government program sponsors achieve higher Star ratings, create and implement care management programs, document their processes and procedures, achieve accreditation status, design and submit government program bids, institute corporate‐wide programs and create communications strategies and materials. She is a member of the Health Care Compliance Association and is Certified in Healthcare Compliance by the Compliance Certification Board. Ana currently serves on the Board of the Resource Initiative and Society for Education (RISE), the preeminent national professional association dedicated to managed and accountable care financing and delivery.
Ms. Handshuh previously served as the Vice President of Managed Care Services at Central Florida Inpatient Medicine (CFIM), providing leadership and strategy on CFIM projects with physicians, risk entities, hospital systems, and health plans. Prior to that assignment, she worked with Precision Healthcare Systems as their Vice President of Quality Improvement, leading the IPA’s collaborations with payers to implement Quality and Star Rating initiatives. Ms. Handshuh also served as the Director of Corporate Program Development at Physicians United Plan (PUP), leading the Medicare health plan’s Quality Management and Corporate Communications departments and spearheading the development of innovative integrated technology solutions to drive business excellence and Star Rating achievement. Prior to joining Physicians United Plan Ms. Handshuh was the founder of I-Six Creative. Under Ms. Handshuh’s vision and leadership, I-Six provided expertise in the areas of managed Medicare benefit design, MSO/IPA operations, provider network strategy, new market launches, technology integration, corporate communications and quality improvement.
Kaleb began his career in health insurance in 1999 when he first joined the Select Health customer service team. He has worked in claims, provider relations, coverage policy management, product management, product development, and pretty much anything else they would let him get his hands on. In 2011 when the decision was made for Select Health to launch an MA plan, Kaleb enthusiastically joined the team and has never looked back. Medicare Advantage has been an incredibly challenging and rewarding field and he isn’t sure he could ever leave it. Kaleb has been described by work colleagues as a true Medicare Advantage nerd, which essentially just means he is really fun at parties.
Kaleb spends most of his personal time with his wife and best friend, Sarah Jean. They have four children in total. None yet show any inclination toward Medicare Advantage, but there is still time. They like to watch movies, go on picnics, and take the occasional road trip when they can get everyone together.
Nikki Hungate Principal Product and Quality Strategy Consultant
Brightstar Health Solutions
Nikki is an accomplished professional with over 17 years of experience in the healthcare industry, specializing in Medicare and Medicaid product strategy. With extensive knowledge and expertise in the field, Nikki is a trusted leader who has consistently contributed to the growth and success of various organizations.
Nikki holds a Master's degree in Health Administration. Additionally, she has pursued a Doctorate in Executive Leadership.
As a passionate advocate for accessible and affordable healthcare, Nikki remains dedicated to driving innovation in the Medicare and Medicaid sectors.
Eddie Maria is the Head of Sales for Birdsong Hearing. In his role, Eddie provides leadership of Birdsong Hearing Benefits, LLC Sales while partnering with clients to make their plans more impactful, personal, and meaningful for members. He is passionate about improving peoples’ lives by bringing a whole health focus to hearing benefits that also helps health plans bring additional value to their members.
Eddie is a client-focused leader with extensive experience bringing solutions to Commercial, Medicare Advantage, and Managed Medicaid plans. He is passionate about the customer experience, focuses on nurturing relationships, and appreciates the importance of understanding the customer’s needs.
Eddie has 27 years of experience building client partnerships and leading sales teams in the healthcare industry, including the pharmaceutical, women’s healthcare, and hearing benefits sectors. He has a Bachelor of Arts in Communications Studies from California State University – Sacramento. Outside of work, Eddie volunteers with Blessings in a Backpack – an organization that provides children on a free-lunch program with food every Friday during the school year so that they have food for the weekend.
Michael O’Malley is AIDS Healthcare Foundation’s (AHF) Plan Administrator in its Managed Care Division. AHF’s Managed Care Division operates HIV/AIDS special needs Medicare Advantage and Medicaid managed care plans in California and Florida and Ryan White HIV specialty services programs nationally.
O’Malley is part of the Division’s executive leadership team and responsible for Member Services and Enrollment, Contracting and Provider Relations, Medical Staff Office and Credentialing, Enrollee Communications and Health Education, Third-Party Payer Contracting, and Contract Management operations. He also oversees AHF’s annual Centers for Medicare and Medicaid Services (CMS) bid development and submission including formulation of the plans’ benefit packages.
During his tenure at AHF, O’Malley played an instrumental role in the expansion of the Division to include establishing a Medicaid line of business in Florida and transitioning AHF’s Medi-Cal primary care and case management program to a full-risk managed care HMO plan.
Prior to joining taking on his current position, O’Malley served as AHF’s Chief of Marketing. Before joining AHF, O’Malley was Cedars-Sinai Medical Center’s Director of Marketing.
O’Malley holds an MBA from California State University, Los Angeles and a BA, International Business from California State University, Fullerton.
Spencer is the Chief Growth Officer at NourishedRx. He takes an innovative and customer-centric approach to ensure value creation and exceptional experience for healthcare organizations and members. Spencer has spent his career in healthcare building innovative solutions and frameworks around SDoH, health equity, member engagement, and quality improvement. Prior to joining NourishedRx, Spencer held leadership roles at Unite Us and Carrot Health and established a consumer insights solution at Optum.
Laura Sheriff is a highly experienced and skilled professional in the healthcare industry, with a wealth of knowledge and expertise in risk adjustment, quality improvement, and population health analytics. With her background in Medicare, Medicaid, and Marketplace Managed Care, as well as her leadership abilities and certifications as a professional coder and risk coder, Laura brings a unique set of skills to her consulting work with physician groups and health plans.
Dan Simenc is a consulting actuary with the Tampa Milliman office. His consulting work spans many facets of the US healthcare ecosystem, and he understands the perspectives of payers, providers, employers, manufacturers, and regulators.
He has extensive experience with the Medicare Advantage and Prescription Drug Plan program, supporting payer pricing and strategy along with contracting and market access strategy for life science companies. His current work is heavily influenced by the Inflation Reduction Act’s changes to Part D.
Dan works closely with Milliman’s many large data assets to support modeling and research. He enjoys building solutions and strategies to help clients succeed in this dynamic industry. Dan Simenc is a Fellow of the Society of Actuaries and resides in Boise, Idaho.
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.
Rex Wallace is the founder and principal of Rex Wallace Consulting, LLC, a firm that specializes in improving Star Ratings for Medicare Advantage health plans. Rex assesses plans and guides them in the development and implementation of-leading strategies to drive material Quality Improvement. Since its inception in 2017, RWC has helped multiple Medicare Advantage contracts achieve significant improvements in Star Ratings, including single-year full-Star improvements. Prior to launching RWC, Rex spent twenty-three years in strategic healthcare roles, with a strong focus on Medicare Advantage. Most recently, he led Stars for a large, multi-state plan that consistently achieved 4 and 4.5 Stars across its multiple contracts.
Kylie Zunkel is an Actuarial Manager at Milliman, where she has been contributing her expertise for nearly 5 years. With a decade of experience in healthcare data analytics, Kylie is passionate about providing top-quality service to her clients and, ultimately, their Medicare Advantage members. She specializes in Medicare Advantage bid pricing, benefit strategy, and PBP entry. Over the course of 5 bid seasons, Kylie has developed a deep understanding of the intricacies involved in the bid submission process. In addition to her Medicare Advantage work, Kylie’s expertise also includes employer benefits consulting. She currently resides in Brookfield, WI with her husband, Paul, their son, Milo, and their beloved four-legged family member, Buddy.
