Kelly Backes, FSA, MAAA Principal and Consulting Actuary
Kelly is a principal and consulting actuary at Milliman, joining the firm in 2014. Kelly’s experience includes seventeen years in the actuarial health field, including both consulting and health insurance company experience.
Kelly’s expertise lies in all areas of the Medicare Advantage market including strategic planning, bid pricing support, product design, desk review and audit support, organizational start-up assistance, forecasting, Part D settlement analysis, and reserving. She conducted bid desk reviews and audits on behalf of CMS for several years.
Kelly also has experience in the Medicaid market developing rates for a variety of Medicaid programs and populations.
Kelly began her actuarial career at Assurant Health, where she spent six years working extensively in its individual commercial actuarial department leading pricing and filing, managing form discontinuance and roll over support, and providing statistical analysis related to corporate retention and application placement initiatives. She then moved to Oliver Wyman, where she provided pre and post-ACA pricing support for individual and group products. Kelly also provided other services including reserving, forecasting, assisting federal and state governments with ACA compliance and initiatives, and state filing review.
Kelly has presented at industry conferences and published a number of publicly available papers and articles spanning a variety of Medicare topics.
Anirudh is a Data Scientist at TEG Analytics and is primarily responsible for researching, ideating and building product modules on the Healthworks platform. He has experince working on data engineering and predictive modeling projects in the healthcare space.
Anirudh holds a Bachelor's degree in Computer Science from BITS Pilani, India and has worked in software development, robotics and process automation in the past.
Kimberlie Breu, MBA Product Manager – Senior Care Products
BlueCross BlueShield of Tennessee
Kim is the Product Manager for Senior Care Products at BlueCross BlueShield of Tennessee and has been in the health insurance industry since 1989.
Building on a foundation of enrollment, billing and benefit set up for commercial groups, Kim moved on to work in sales and account management for all lines of business across all segments. Kim moved into the Medicare space in 2008, working as a point of contact for Field Marketing Organizations and most recently as the Product Manager for Senior Care Products at BCBST. In this role, Kim is responsible for competitive analysis to support product design, annual bid submission, and coordination between internal departments to price, implement, and educate both internal and external customers.
Kim earned her MBA from the University of Tennessee at Chattanooga earlier this year and in her free time, she enjoys running, cycling and spending time with her dogs.
Puneet Budhiraja Chief Actuary and Senior Vice President
Capital District Physicians Health Plan
Puneet is a Chief Actuary at the Capital District Physicians Health Plan (CDPHP) with over 15 years of health actuarial experience working with insurers as well as with consulting firms. Puneet is currently responsible for all lines of business, value based contracting and population health management initiatives.
Puneet is an Electrical Engineering graduate and found interest in Actuarial science while pursuing his master’s program at the University.
Paul is a career product management professional, having worked in many industries including consumer packaged goods, pharmaceuticals, healthcare information and Medicare Advantage. Currently he is AVP for Medicare Advantage products at Cigna Medicare where he oversees product management across all markets.
Paul has experience in new product development, product strategy and planning, competitive analysis and data and analytics. He has an MBA from St. Joseph’s University and lives in the Philadelphia suburbs with his family.
Ryan Davis is a Medicare aficionado with over eleven years of managed care experience. For the past five years he has held the role of Manager of Pharmacy Medicare Programs within the Washington region of Kaiser Permanente. In this role he provides oversight of benefit implementation, the medication therapy management program, and opioid management. His past experience in Government Programs is vast as he has held Medicare centric roles for some large industry players such as CVS Health & Express Scripts.
Amy Garrow, ASA, MAAA, manager, actuarial services, is responsible for all major actuarial functions for the Medicare line of business. Her duties include annual support for the Centers for Medicare and Medicaid Services (CMS) Medicare Advantage bid submission and pricing for the EGWP product portfolio.
She plays a key role in the development of the annual corporate budget, monthly forecasts and longer-term forecasts for the Medicare line of business by providing data, analysis and strategic input. Additionally, Garrow is responsible for setting IBNR claims reserves, establishing accruals and medical trend setting for all Medicare Advantage products.
Garrow joined Independent Health in 2012 as an actuarial analyst, and has been in her current role since 2017. Prior to joining Independent Health, she worked as an analyst for Meritain Health, an Aetna company.
She holds a bachelor’s degree in mathematics, with a concentration in accounting, from Daemen College and a master’s degree in mathematics from the University at Buffalo. She is an associate with the Society of Actuaries and a member of the American Academy of Actuaries.
Thomas Grivakis, ASA, MAAA is a Consulting Actuary with Wakely Consulting Group. Since joining the firm in 2013 he has worked in areas such as Medicare Advantage, Risk Adjustment, State rate filings, Management of Medicare Plan Benefit Packages (PBPs), Claim liability analysis, Diagnosis-related group rate analysis, Monthly reserves, and Contract Analysis.
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.
Matthew's experience includes 15 years in the actuarial field working in both the health and life sectors. Matthew's expertise lies in all areas of the pharmaceutical space including formulary and rebate analysis, policy research, PBM analysis, benefit design, and Part D pricing. Matthew also has extensive experience in Medicare Advantage pricing, research, experience analysis, and regulatory & compliance review. Prior to joining Milliman, Matthew spent seven years at a large national insurer, helping to double PDP member during that time while honing his leadership, management, and technical actuarial skills.
Allison Hess is the Vice President of Health Innovations for Geisinger. She has been part of the Geisinger family for 13 years and is responsible for the oversight and implementation of health and wellness programs for Geisinger patients and insured members, employees and community members. She started her career in community health education/corporate wellness and has continued to expand to include community-based population health initiatives driven by data analysis and clinical outcome measurements.
Ms. Hess has earned a Bachelor of science in Health Education with a concentration in Psychology from Bloomsburg University. She recently received her MBA and has been recognized for her leadership within the organization. She has been the recipient of several awards focused in various areas of health including health equity, worksite wellness and supply chain. She has also been recognized nationally for her work with the Fresh Food Farmacy program.
Ms. Hess has 20 years of experience in the health and wellness field. Her most recent work involves community based strategies impacting food insecurity and other social determinants of health. She is deeply committed to the health and wellbeing our patients, members and communities.
Dani is a Medicare Product Manager for Regence (Cambia Health Solutions). She has been working within the health insurance industry since 2005.
Dani has been working primarily with Medicare products since 2014, with a focus on Medicare Advantage plans. Regence covers the four states of Washington, Oregon, Idaho and Utah, and includes HMO, PPO, and PDP types of plans. Dani has an MBA from George Fox University, and a BA from Willamette University. Prior roles in the health insurance industry include sales, marketing communication, benefit management, and product management. She has worked with all lines of business including large group, small group, individual, and government programs, as well as ancillary products such as dental, vision, and hearing products.
Lucretia Hydell, MS, MFA, ASA, MAAA, is the Director of Actuarial Services at Johns Hopkins HealthCare. She is a healthcare actuary with many years of experience working with and for providers in Medicare, Medicaid and value based care delivery. Lucretia is a thought leader and subject matter expert with a deep understanding of Medicare Advantage analytics and bid strategy. As an actuary, she has worked for some of the largest healthcare organizations in America, including United, Wellcare, Coventry and Willis Towers Watson as well as for innovative solution driven companies, such as Evolent Health. As a Sr. Director at Evolent, she spent four years working with a wide range of clients across the country creating paths to risk, building out a Medicare Advantage strategy team and supporting strategic blueprints. Since joining JHHC as the leader of the newly formed actuarial department, her responsibilities include growing the actuarial team and developing the tools and capabilities to support JHHC’s 400,000 lives across four lines of business.
Prior to starting a career as an actuary, Lucretia toured as a Dancer with Garth Fagan Dance, taught at Alvin Ailey Arts in Education and worked at Carnegie Hall in administration.
Vice President of Healthcare Solutions Sales & Marketing
As the Vice President of client implementations, Kiran will work alongside our partner organizations to ensure successful product implementations and integrations.
A Proven Leader Kiran Kuchibotla is a proven executive and bringing more than 19 years of experience in healthcare payer services, with 15 years as a progressive global leader. Throughout her career she has cultivated deep expertise in effectively implementing technology and strategies designed to create growth for payer organizations. In her previous role she was Vice President, Client Partner at HPS, a Wipro company, responsible for the management of all Blues accounts. Prior to HPS, she was Vice President, Strategy at Xerox for their government healthcare business.
Kiran’s broad perspective is rooted in working with functionally diverse groups across global teams and design thinking. She began her career as a programmer/analyst and was quickly given project management responsibilities. She has managed large global teams (100+ people) located in 21 cities throughout the USA, Philippines, India, Guatemala, and Mexico.
Kiran has a passion for helping business leaders take a wider view of their organizational objectives and help them achieve their goals by implementing operational and technology initiatives that improve processes, reduce expenses and drive bottom-line profitability. She has consistently achieved year over year growth in terms of revenue, gross margin, and customer satisfaction while managing payer accounts. She has a proven track record of turning around businesses and formulating a successful strategy.
Education Kiran Kuchibotla earned an executive MBA from Kellogg School of Management from Northwestern University and a Master of Science in Computer Science from the University of Louisville. She also holds a master’s in computer applications and a bachelor’s in commerce from Osmania University.
Angela Moczan is the Chief Financial Officer, Medicare Products, for University of Pittsburgh Medical Center (UPMC). Angela’s role as CFO serves as a business partner for Medicare Advantage and Special Needs Plan leadership, closely collaborating on the continuous development, implementation and evaluation of short and long-term strategic plans. Angela leads a team of analysts, as well as works cross-functionally, to provide all financial planning and reporting, budgeting/forecasting, business planning, related processes and analytics (including SOX 404 controls), vendor contracting, FTE planning, and internal/external sales commissions. She also provides significant advisory management for all major operational areas, including product development, bid submissions, risk adjustment, marketing, network, contracting, compliance and audits.
Angela began her career at UPMC in 2002 as the Manager, Consolidated Financial Reporting, within the Corporate Services Division. She held several successive roles, including Director, Financial Planning and Analysis within Corporate Services and moved to support the Insurance Services Division in 2009, most recently serving as Sr. Director, Strategic Initiatives in the finance team.
Angela is a CPA, holding a BA in Accounting with a minor in Business Administration from Westminster College and a Data Analytics Certificate from Carnegie Mellon University. Her early career includes various accounting and audit roles with Deloitte and the Pittsburgh Penguins.
Rajesh Munjuluri is an actuary with Capital District Physicians Health plan in NY. He has over 15 years of experience as a Health Actuary and has extensive experience in developing MAPD bids and in designing and in evaluating value based contracts for health plans and healthcare provider organizations. He has served both health plans and reputed consulting firms which allows him to appreciate different points of view. He has also served as CMS desk reviewer for Medicare bids.
Raj is a member of the American Academy of Actuaries and an Associate of the Society of Actuaries. He is a frequent speaker and has co-authored various articles for the Society of Actuaries.
Tim Murray, FSA, MAAA Director and Senior Consulting Actuary
Wakely Consulting Group
Tim Murray, FSA, MAAA, is a Director & Senior Consulting Actuary based in Wakely's New York office. He joined the firm in 2017 and has worked as a health actuary for more than fifteen years. Over the course of his career, Tim has consulted to and served health plans on matters of pricing strategy, product design, forecasting, financial reporting, and Merger & Acquisition due diligence. Prior to joining Wakely, Tim spent 4.5 years leading the actuarial forecasting and budgeting functions of a Medicare Advantage-focused health plan, encompassing a wide array of traditional (e.g. Medicare bidding, M&A due diligence) and less traditional (e.g. payment policy lobbying) project work. Tim also spent 2 years in an equity research role covering publicly traded managed care and health care facility stocks, providing investment/industry guidance to institutional investors.
Benjamin Nadler, director, actuarial services, oversees Independent Health’s actuarial processes related to Medicare and state products. This includes pricing, budgeting, long term forecasting, financial accruals and regulatory reporting. Nadler also plays a key role in assessing regulatory guidance for the organization and provides strategic input for the portfolio.
Additionally, Nadler supports risk adjustment efforts for Medicare, Affordable Care Act and State lines of business, including overseeing analytics, risk suspecting, and reporting as well as operational activities around data submission, chart retrieval and vendor management.
Nadler joined Independent Health in 2010 as an analyst, and was later promoted to Manager, Actuarial services. Prior to joining Independent Health, he worked as an actuarial analyst for BlueCross BlueShield of Western New York.
He holds a bachelor’s degree in mathematics from the University of Pittsburgh and a master’s degree in business administration, with a concentration in finance, from the University at Buffalo.
Kathryn Y. Qin, FSA, MAAA Corporate Vice President and Chief Actuary
SCAN Health Plan
Kathryn Qin is Corporate Vice President and Chief Actuary of SCAN Health Plan. She leads all aspects of actuarial analysis for SCAN, including Certifying for Medicare bids, Medicaid rate filings, financial forecasting, reserving and contract negotiations. Kathryn and her team work to ensure that SCAN is able to offer consistent, value-added benefit packages that support healthy, independent aging and meet members’ wants and needs when it comes to their health plan.
Prior to joining SCAN in 2012, Kathryn worked at Health Net as a director of actuarial services overseeing analysis in medical bids, risk scores, star and financial forecasting and reporting. She began her career at Towers Perrin, a financial services consulting firm, progressing from an actuarial student to a senior consultant helping US and international clients on the design, valuation and financing of employee retirement programs.
Kathryn is a Fellow in the Society of Actuaries and a member of the American Academy of Actuaries. She holds a Master of Business Administration from the Anderson School of Business at University of California, Los Angeles, and a Bachelor of Science from the University of Manitoba in Canada.
Tara Richardson currently serves as Director of Financial Analysis for the Actuarial team in Cigna’s Medicare division. She began her career with Cigna (formerly HealthSpring) in 2004 after graduating from Texas A&M University with a degree in Business Finance. During her 15+ years with the organization, Tara has witnessed the evolution first-hand of a small private healthplan to a publicly traded company and the acquisition of HealthSpring by Cigna into its family of product offerings.
Although her background is in Finance and Accounting, Tara has been involved in the actuarial pricing of the CMS bid process since it began in 2005. She transitioned to the Actuarial team to coordinate the bid submissions in 2012 and has since developed a team of twenty actuarial professoinals that internally prepares the Part C bid pricing for over 120+ plans. Through this role, she has been intimately involved in the analytic, strategic and regulatory aspects of the bid submissions, serving as a “CMS Bid” liaison to leadership and operational areas to promote clarity and compliance throughout the business.
Tara is a native Texan and is proud to call San Antonio, TX her home. She enjoys spending her free time having adventures and staying active with her three girls, two human and one canine.
Douglas’ main areas of focus are the Medicare Advantage and pharmacy markets.
Specific to the Medicare Advantage market, Douglas assists various health plans with pricing and preparation of Medicare Part C and Part D bids, desk review and bid audit support, strategic planning, market feasibility studies, risk sharing arrangements, risk score coding improvement, and analyzing the impact of Part D regulatory changes.
Specific to the pharmacy space, Douglas is a key contributor to internal research supporting the prescription drug rating components of the Milliman Health Cost Guidelines, for both commercial and over 65 populations.
Douglas has also authored publicly available papers and articles related to the Medicare Advantage market.
Ms. Michiru Shibata (Mitch) is the Consulting Actuary for Health First Health Plans in Rockledge, Florida. Mitch is responsible for Medicare bid preparation, risk score analysis, statutory financial opinion, and development of actuarial models. She serves as a subject matter expert for incoming actuarial analysts and facilitates training programs. Prior to joining the company, Mitch worked for Wakely Consulting Group for 9 years as a consulting actuary. Throughout her career at Wakely, she held similar responsibilities that also included Commercial filings, liabilities and reserve calculations, creditable coverage, and financial projections. Mitch graduated from University of South Florida with B.A. in Psychology and Ph.D. in Mathematics. Mitch is a Fellow in the Society of Actuaries and a Member of the American Academy of Actuaries. She loves eating healthy and talking about eating healthy. Her motto is Hippocrates’ “Let food be thy medicine"
Pritpal Virdee is the President of Covantage Health Partners, Inc., a newly formed business unit within Emergent Holdings, a for profit subsidiary of Blue Cross Blue Shield of Michigan. Covantage is focused on building strategic Blue-to-Blue joint venture partnerships with the purpose of growing the Medicare Advantage footprint in Blue States across the nation. In his role he is responsible for overseeing profitability, operations, growth, and strategy.
Most recently, Pritpal as Senior Vice President and Chief Operating Officer led the operational areas across all BCBSM’s Medicare product lines, fostering a strong matrix partnership across key operational functions. Previously, Pritpal held the position of Health Plan President, Medicare –Indiana, Kentucky and Missouri at Anthem Inc, holding profit and loss responsibility for all Medicare products within the regions.
He has also served in key leadership roles at Walgreens and Express Scripts. Pritpal earned a Bachelor of Science degree in Chemical Engineering from Southbank University in London, England and a Diploma in Marketing from the Institute of Marketing in the United Kingdom.
Gokce has eight years of experience as a healthcare actuary. Gokce’s primary area of expertise is with organizations who operate in the Medicare Advantage program. Specifically, she has developed Part C and Part D bids for a number of Medicare Advantage health plans, ranging from small to mid-size mature Medicare Advantage organizations. She has also assisted health plans in strategic planning, benefit design and analysis, product development, profit and loss analyses, and feasibility analyses.
Prior to joining Milliman, Gokce spent several years working for a large national health plan where she developed Medicare Advantage bids, and assisted in financial projections, trend analysis, and other activities to support Medicare bid operations.