A strategic marketing & CRM professional with results in both healthcare and direct-to-consumer retail, Jereme brings an innovative and contemporary approach to the healthcare vertical. His knowledge of consumer behavior, analytics, and operational delivery, aligned with a deep understanding of the Medicare Advantage market place, allows Jereme to relate to the challenges his clients encounter and partner to implement technology & analytics driven solutions to meet their unique needs.
Kimberlie Breu, MBA Product Manger - 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.
Paul Cotton is the National Committee for Quality Assurance Director of Federal Affairs. He works with Congress, the Administration and other stakeholders to improve health care quality. Previously he was a lobbyist for AARP on Medicare, Medicaid, CHIP, health reform, health IT and quality improvement issues. He has also worked at the Center for Medicare & Medicaid Services as Hearings & Policy Presentation Director in the Office of Legislation, and as a journalist for publications including the Journal of the American Medical Association.
Ryan is a Medicare aficionado with over eleven years of experience having been employed by some of the country’s largest managed care entities. Since 2014, Ryan’s responsibilities include oversight of Part D benefit implementation, claims adjudication, the Medication Therapy Management Program, and the Opioid Over-utilization Program for a health plan with over 90,000 Medicare enrollees. Ryan background is comprised of Medicare centric roles with some of the country's largest Pharmacy Benefit Managers. As a Senior Consultant with CVS/Caremark, he managed cross-functional initiatives related post sanction remediation efforts for member communications. At Express Scripts (formerly Medco Health Solutions) Ryan operated as the point-of-contact for multiple Medicare employer group plans to ensure successful benefit administration and client satisfaction.
Dr. Shannon Decker is Vice President of Clinical Performance for Brown and Toland. Dr. Decker has more than 19 years of experience in healthcare--13 of which include working with risk adjustment 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 of Higher Education & Adult Learning (HEAL) and chief methodologist 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, she consults in both the fields of healthcare and education. Her interests include the study of human behavior and how theories on motivation and learning may be brought to bear on population health management.
Julia has served many types of organizations in her time with Milliman. Her areas of expertise are managed healthcare programs, including Medicare Advantage (Parts C and D) and Medicaid. She has assisted organizations with capitation rate development, benefit analysis, premium rate development, estimation of the impact of legislation reform, estimation of reserves and liabilities, and general actuarial projections. In addition, she is a key team member in the development of the Milliman MACVAT and MACBOX tools.
Julia’s primary area of expertise is consulting with organizations who operate in the Medicare Advantage program. Specifically, she has developed over 200 Part C and Part D bids for a number of Medicare Advantage health plans, ranging from small to mid-size mature Medicare Advantage organizations, as well as PDP specific bid development. She works with EGWPs to help them understand the implications of proposed rate changes on these plans as well.
She has also assisted health plans in strategic planning, benefit design and analysis, product development, risk adjustment, experience to fee-for-service level comparisons, profit and loss analyses, and feasibility analyses.
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.
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.
Sion Hughes Consultant - Market and Provider Strategist
Wakely Consulting Group
Sion Hughes has over 15 years of healthcare experience with time spent in both the provider and payer space. He has worked for payers such as Blue Cross Blue Shield of Michigan and HealthPlus of Michigan primarily focused on Medicare Advantage. Sion's Medicare Advantage experience includes product development/management, compliance/program oversight, and marketing/sales. During Sion’s career on the provider side, he worked for Trinity Health as the Director of Regulated Products. His responsibilities included organic growth of lives in the system for Medicare and Medicaid lines of business. Additionally, Sion was responsible for analyzing and negotiating alternative payment model arrangements with payers. Currently, Sion works for Wakely where he provides consulting services for market and provider strategy, benefit designs, contract negotiation support, and is the co-architect of Wakley Health Operations and Analytics tool that drives profitable growth for plans and providers.
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 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.
Naomi Irvin is a California native who relocated to North Carolina in 2006. She earned her undergraduate degree (BSBA with a Management concentration) from East Carolina University (ECU), graduating Magna Cum Laude. Subsequently, she completed her MBA (with a Marketing Certificate) at ECU on full academic scholarship.
With over a decade of health insurance experience, Naomi currently leads a team of Compliance Consultants within the Sales, Marketing and Communications division of Blue Cross and Blue Shield of North Carolina.
At home, Naomi has 3 children (an ECU Sophomore, a high school senior, and a second grader) and two dogs. In her free time she enjoys reading and collecting books.
Aditya is an analytics professional with expertise in marketing and strategy. He has primarily been responsible for Product Management and Strategy, Marketing Analytics and Solutioning. His focus lies in design, development and delivery of analytical solutions to Healthcare clients. He currently helps companies with insights on Medicare Advantage plan designs and marketing.
Aditya earned his MBA from the prestigious Indian Institute of Technology, Madras. He is also an Engineer and has learnt classical music.
Nick has served many types of clients in his time with Milliman. His main area of expertise is Medicare Advantage. Nick also has experience with state Medicaid capitation rate development, retiree prescription drug plans (individual and employer), preparation of year-end Statements of Actuarial Opinion, estimating reserves and liabilities, and various other actuarial projections and analyses.
Clinical Pharmacist for the past eight years at Network Health, a local health insurance provider in Northeast and Southeast Wisconsin. I am currently one of three pharmacists involved making MTM calls in-house. My responsibilities also involve NCQA, pharmacy appeals, P&T Committee, Member and Provider relations.
Gary’s also has experience as pharmacy manager for a national long term care company, pharmacy manager for retail pharmacy chain, and Pharmacy Director for a National Health Care provider. He has also been a pharmacy instructor at local medical college family practice clinic.
Dave Neiman, FSA, MAAA Principal and Senior Consulting Actuary
Wakely Consulting Group
Dave Neiman, FSA, MAAA, is a Director and Senior Consulting Actuary out of the Denver office. He joined the firm in 2012 and has worked as a health actuary for fifteen years. He assists multiple clients on Medicare Advantage strategy and bid development. Dave has developed and certified Medicare Advantage/Part D bids since 2006. In addition, Dave leads Medicaid projects across multiple states with the primary focus on rate negotiations, risk adjustment, alternative provider payment models and strategic analytics. Prior to joining Wakely, David spent 5 years in a senior actuarial role at a Midwest HMO/ Integrated Delivery System. He led a team focused on Medicaid and Medicare Advantage financial management and reporting. David’s experience is comprehensive and includes financial modeling and risk management for Medicaid, Medicare, Commercial and Dental lines of business, as well as, development of financial models for alternative provider payment and accountable care organization shared risk models.
In her role at Network Health, Hannah supports product design and strategy, vendor management, and member experience management of the plan’s Medicare Advantage and other government-sponsored health insurance products. Hannah is also involved in the plan’s government relations and political advocacy work, and manages the Network Health Political Action Committee (NH PAC).
Network Health is the largest provider-owned Medicare Advantage plan in Wisconsin, serving more than 65,000 Medicare Advantage members. For over 35 years, Network Health has offered a different kind of health insurance that puts customers first.
Before joining the health insurance industry, Hannah worked extensively in politics and state government. Hannah is a graduate of Loyola University Chicago and the John Felice Rome Center. In her free time she enjoys spending time with her husband, two young children, and one very mischievous dog.
Hank Osowski, a Founding Member and Managing Partner of Strategic Health Group, is an experienced health care executive and strategist who has provided leadership to commercial, Medicare and Medicaid health plans for more than three decades. He has led several engagements for the firm’s clients on the key challenges of Medicare and Medicaid Managed Care programs in diverse markets, such as California, Wisconsin, Michigan, Illinois, New Mexico, Florida, Texas, West Virginia and Hawaii. He has also provided leadership to more than a dozen client plan development undertakings for commercial, Medicare Advantage and Medicaid business startups in multiple states.
A frequent speaker and resource on critical issues facing the Medicare and Medicaid programs, including the opportunities for strengthening a Medicare Advantage plan’s market position, the challenges of supporting programs for the Dual Eligible populations, as well as the principles for structuring effective long term care programs. His insights on some of the challenges facing the healthcare industry have been published in “Managed Care”, “Healthcare Marketing Report”, “Managed Care Contracting & Reimbursement Advisor”, “Payers and Providers” and “Becker’s Hospital Review” among other publications.
Formerly the senior vice president of corporate development for SCAN Health Plan, Hank was a key member of the senior leadership team that turned the company around from a “near death experience” into an exceptionally strong financial position and one of the largest nonprofit Medicare Advantage plans in the country. He led SCAN’s expansion into seven additional California counties and as well as its first out-of-state expansion into Arizona where Hank then served as CEO of SCAN Health Plan Arizona and SCAN Long Term Care. He has also led the organization’s strategic planning efforts and initiated an innovation development regimen to seek improvements in care coordination practices and future care outcome protocols.
Prior to SCAN, Hank served as a Principal in a national health care consulting organization providing a range of strategic, financial and development services for health plans, physician groups and hospitals. He also served as vice president International Operations for American Family Life Assurance Corporation where he directed the development of start-up operations in the United Kingdom, Germany and Italy, as well as the financial turnaround of the company’s Canadian operations.
Hank began his California career as a member of the senior management team responsible for the turnaround and financial survival of Blue Cross of California. In this capacity, Hank led the financial improvement of the individual and small group division and provided leadership to the organization’s strategic planning efforts.
Mohammed is a healthcare industry veteran with extensive experience of having delivered innovative technology solutions leading ISVs and Enterprise customers. He is a thought leader and a subject matter expert with deep understanding of Payers IT landscape. As a Solution Architect, Mohammed has driven more than 50 different payer application development initiatives with 45,000+ hours of solution, design, and technical oversight. Under his leadership, Simplify Healthcare has established itself as a market leader in the Benefit Plan Management space and developed deep expertise in Provider Data and Contract Management and Value-Based Reimbursement space.
Dr. Dominic Vu, Pharm.D. joined USI in 2019 as the Pharmacy Practice Leader in the Southwest region. Dr. Vu has extensive clinical and administrative leadership experience in medication adherence, population health initiatives, and PBM pharmacy operations from his previous role as Director of Pharmacy for Memorial Hermann Health Plan. His work has focused on leveraging population health data to design clinical programs to reduce healthcare cost through pharmacy and medical benefit design, formulary management, and negotiating with PBMs for lowest unit cost price.
Dr. Vu’s formal education includes completing an AMCP managed care pharmacy residency with Kelsey-Seybold Clinics, Doctor of Pharmacy from University of Houston, and Bachelor of Computer Science from Midwestern State University.