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.
Kimberly Detuccio leads the Enterprise Data Governance Office at GuideWell, a mutual insurance holding company inclusive of Florida Blue, the oldest and largest health insurer in the State of Florida serving over 5 million members. She is accountable for development and execution of strategy, organizational structure, processes and technology that ensure data is available, assured and managed as a strategic corporate asset. Kimberly is passionate about helping the enterprise apply data and information management standards, principles and processes to increase the value and quality of their data, resulting in improved financial performance, service and operational levels, and competitive positioning in the health insurance and solutions market. She brings high energy and enthusiasm for her work, leading with business context; she leverages data management best practices to drive actionable insights fueled by high-quality, relevant, and timely data, on solutions that balance strategic direction with pragmatic needs.
She has over 20 years of experience in the Health Insurance industry in various operational areas, serving as a liaison between the business and IT for many data related and system development projects.
Mrs. Enright has been with CVS Health over 18 years. Her experience and expertise includes operational leadership for several BCBS health plan account management teams to successfully leading multiple clients through the CMS Program audit experience for delegated services on behalf of CVS Health.
After years of supporting these audits herself, Mrs. Enright developed a ‘best in class’ audit support structure and developed a team of high performing leaders. This team travels onsite to client locations in support of their CMS audits.
During her tenure, Mrs. Enright’s team has supported hundreds of CMS program and delegation oversight audits. She has a robust ability to lead and execute in a fast paced, constantly changing environment. Mrs. Enright has extensive experience working with health plan clients, consultant firms and CMS auditors to meet and exceed client goals and offer innovative solutions leading to positive audit outcomes.
Collaborating with clients to mitigate potential audit risk and to deliver outstanding audit results is of the utmost importance to Mrs. Enright and her team!
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, competitive analytics, network 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 and compliance review.
Prior to joining Milliman, Matthew spent seven years at a large national insurer, helping to double PDP membership during that time while honing his leadership, management, and technical actuarial skills.
Aldiana Krizanovic, MPH, CPH Senior Health Policy Consultant
Florida Blue
Aldiana Krizanovic is the Senior Health Policy Consultant for Federal Government Relations at Florida Blue. In her prior role she served as a Health Policy Analyst for the Florida Blue Center for Health Policy. She holds a Master's in Public Health with a concentration in Health Policy from the University of North Florida. She specializes in Medicare regulation, with a focus on Medicare Advantage and Part D. In her role she monitors and analyzes Medicare regulatory changes and their impact to the business. Aldiana is passionate about advancing development of health policy that improves access to care for vulnerable populations, decreases cost of care, and improves individual's quality of life. She serves as an advisor to the Age-Friendly Public Health System Advisory Committee led by Trust for America's Health and the John A. Hartford Foundation.
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.
David is a consulting actuary with the Milwaukee office of Milliman. He joined the firm in 2016.
David has more than 10 years of health actuarial experience in managed care pricing, financial reporting, strategic analysis, and regulatory analysis and compliance. His areas of expertise include Medicare Advantage, Medicare Prescription Drug, and general prescription drug market analytics.
In the Medicare market, David has assisted clients in the design and pricing of Medicare Advantage and Prescription Drug plans, analyzing the impact of proposed legislative and regulatory changes, projecting and analyzing risk adjustment payments, and various other strategic engagements.
In the prescription drug industry, David has worked with manufacturers, insurers, and other entities, advising them in the areas of payment strategy and regulatory issues affecting the market.
Prior to Milliman, David worked at a large managed care organization as a certifying actuary for Medicare Advantage and Medicare Prescription Drug plan bids. He also worked in roles in commercial pricing, corporate strategy, and regulatory analysis.
Cody Olsen, PharmD, BCPS Pharmacy Operations and Quality Manager
SelectHealth
Cody Olsen is the Pharmacy Operations and Quality manager at SelectHealth. Cody earned his PharmD from the University of Utah followed by a managed care pharmacy residency with SelectHealth. Cody works to improve pharmacy related quality measures, assist in formulary management, and manages several therapeutic areas including opioids. Outside of work, Cody enjoys spending time outdoors.
Athena Patrikios is the Director, Pharmacy-Medicare at Horizon Blue Cross Blue Shield of New Jersey and has been at Horizon for 13 years. She obtained her PharmD from Rutgers University, Ernest Mario School of Pharmacy in 2007.
Athena’s team is responsible for Horizon’s Medication Therapy Management (MTM) program operations as well as the Part D pharmacy operations for Medicare and DSNP. She works closely with quality and clinical teams to develop initiatives that target Part D Star measures for improvement as well as resolving clinical gaps in care. Athena is actively involved in process improvements to enhance the Medicare member experience and optimize the delivery of care. She engages with Product and Sales teams to develop competitive Medicare offerings and facilitate the growth in that market. Her team ensures constant oversight of PBM activities and compliance with all regulatory requirements. Both clinical and operational Part D areas have active engagement and participation in the various audits throughout the year including most recently, the CMS Program audit in 2018 and validation audits in 2019.
Based in the firm’s Raleigh office, Amy Poe concentrates her practice on health care regulatory and compliance matters. Amy partners with a wide range of national and regional clients, including hospitals, health care systems, academic medical centers, large national organizations, pharmacies and medical device companies, to find practical, operationally attuned solutions while emphasizing compliance with the health care regulatory laws.
Amy’s experience running clinical research trials and providing patient care enables her to effectively assist clients with issues regarding federal and state regulatory and compliance issues such as Medicare and Medicaid requirements, fraud and abuse laws, human subject research, FDA-related issues and pharmacy laws. Amy advises clients with respect to clinical research, including clinical trial agreements, conflicts of interest, advice regarding research operations and structure and IRB issues. In addition, she also provides counsel regarding FDA regulations, as well as pharmacy regulations and operations, particularly those related to controlled substances and opioids.
Prior to joining Hall Render, Amy gained health care experience working for Blue Cross Blue Shield of North Carolina and the University of North Carolina Health Care System. She also worked as clinical research trial coordinator for Carolinas HealthCare System, now Atrium Health. She is an active member of the American Health Law Association, where she serves as Vice Chair for Member Engagement of the Life Sciences Practice Group; the American Society for Pharmacy Law; the American Bar Association – Health Law Section; and the North Carolina Bar Association. In her free time, Amy enjoys spending time outdoors, traveling and cooking.
With 20 years in healthcare, Yusuf has an extensive breadth of experience covering health plan managed care as well as direct patient care. As Vice President of Pharmacy and Vendor Relationship Management at Community Health Plan of Washington, Yusuf has enjoyed a wide range of responsibilities, including all aspects of the prescription and medical drug benefits, development of several clinical initiatives starting from strategic inception to budgeting, vendor contracting, implementation, and operations. Other vendor experience includes telehealth, nurse advice consultation services, utilization management, care management and population health programs. Yusuf’s competency with operations has allowed him to successfully lead several departments through highly regulated program audits. Yusuf is a recognized authority and thought leader in the area of emerging therapeutics, and he currently serves on the Washington State Emerging Therapeutics Workgroup.
David Reid
Senior Director, Operational Performance, Risk & Support
David Reid Senior Director, Operational Performance, Risk & Support
Florida Blue
David Reid is the Senior Director of Operational Performance, Risk & Support at Florida Blue with over 17 years of experience in the insurance industry. A Certified Information Systems Auditor (CISA), he is accountable for ensuring business processes across multiple divisions are operationally effective and adhere to regulatory and industry requirements for Commercial and Government market segments at Florida Blue as well as other entities under the GuideWell Mutual Insurance Holding Company. David’s background is in internal auditing, process improvement, operations management, regulatory/accreditation compliance, systems development and database administration.
Dominic Vu Senior Vice President, Pharmaceutical Strategies
USI Insurance Services
Dr. Vu Joined USI in 2019 as the Pharmacy Practice Leader in Texas and Louisiana. Dr. Vu’s breath of experience comes from his days of medication adherence counseling, population health initiatives, and PBM operation oversight from his former days as Pharmacy Director for a large provided owned health plan. His work has focused on leveraging data to design clinical programs to reduce healthcare cost through pharmacy and medical benefit design, formulary management, and negotiating with PBMs with their byzantine flow of contractual language.
Brian Wehneman Director, Compliance and Risk Management
Humana
Brian is currently Director, Risk Management and Compliance for Humana Healthcare Services. Brian is a registered pharmacist with experience in pharmacy benefits management (PBM) operations, pharmacy transaction standards development, pharmacy claim auditing for fraud, waste and abuse, and compliance related to the Medicare Advantage and Part D benefits. With Humana, Brian has held multiple roles involving pharmacy network contracting, pharmacy auditing, fraud waste and abuse investigation, and risk management and compliance for a wide variety of areas including coverage determinations, formulary administration, regulatory implementations and care management.