Rise

Liza Arias Vice President

Segal Medicare Experts

Liza Arias is a seasoned healthcare executive with over 20 years of experience establishing, developing, and motivating results-oriented audit and compliance teams for healthcare operations. She has experience in all aspects of Medicare plan operations, compliance, marketing and sales oversight, ethics, and privacy including executive management, associate training and development, data analysis and reporting. Prior to working as a consultant, Liza held a management position with a Special Needs Plan (SNP) where she was responsible for the organization’s day-to-day operations, benefit design and bid development, call center, enrollment, and appeals and grievances. Liza has also served in various roles with several Medicare Advantage organizations in the greater Los Angeles markets in the areas of call center, credentialing, regulatory compliance, SIU, and internal audit. Liza’s areas of expertise and focus are new plan implementations, MA, and SAE applications, creating and implementing compliance programs for the healthcare industry, vendor demos and systems implementation, call center operations, grievances, and appeals, creating detailed compliance and operations trainings, and developing policies and procedures. Liza also brings experience with CMS program audits during her time with Medicare Advantage organizations and in her current role as a consultant. 

Tricia Beckmann Principal

Faegre Drinker

Jennifer Del Villar Director of Government Programs Compliance / Medicare Compliance Officer

Cambia Health Solutions, Inc.

Director of Government Programs Compliance / Medicare Compliance Officer Cambia Health Solutions (Regence)

Jennifer Del Villar is the Director of Government Programs Compliance and the Medicare Compliance Officer for Cambia Health Solutions (Regence BlueCross/BlueShield). Jennifer joined Cambia in October of 2012.  Jennifer has been involved in the Health Insurance industry with a primary focus on Medicare Advantage Prescription Drug since 2006.

She and her team are responsible for the overall Medicare Care Advantage Prescription Drug Compliance Program as well as Medicare Supplement and the Federal Employee Program. The team is tasked with auditing, monitoring, reporting, remediation, detection, training, FDR oversight, material reviews, oversight of external and regulatory audits and other tasks relating to the seven elements of compliance. Jennifer states her motto is Compliance is Everyone’s responsibility, never forgetting, everything we do touches a member.

Jennifer holds a Certification in Health Compliance through the Health Care Compliance Association and a Professional, Academy for Healthcare Management designation from AHIP.

Jennifer lives in Portland, Oregon.

Kacey Dugan Director - Policy & Regulatory Affairs

Faegre Drinker

Kacey Dugan helps clients in the health care industry navigate state and federal policy issues and respond to new legislative and regulatory developments. She is an experienced health policy analyst focused on the major government health programs: Medicare, Medicaid and the Affordable Care Act. She offers deep knowledge of these programs, including how they function and their underlying regulatory structures, how decisions are made and their unique roles in providing health coverage to Americans. She helps clients interpret their complexities and identify strategies to achieve their mission or business goals. Prior to joining Faegre Drinker, she served as a senior analyst at the Medicaid and CHIP Payment and Access Commission — Congress's advisory agency on Medicaid and CHIP issues – where she worked on numerous issues including those affecting dually eligible beneficiaries. She has also held positions with the U.S. Department of Health and Human Services and Senator Edward J. Markey. 

Colleen Gianatasio Director, Clinical Documentation Integrity and Coding Compliance

Capital District Physician's Health Plan

Colleen Gianatasio CPC, CPCO, CRC, CDEO, CPC-P, CPMA, CPPM, CCS, CCDS-O, and AAPC Approved Instructor has over 20 years of experience in the health insurance field. She has experience in customer service, claims, quality, and coding. As Director, Clinical Documentation Integrity and Coding Compliance, Colleen’s primary responsibilities are provider engagement and clinical documentation improvement for accurate coding and reimbursement. Colleen specializes in developing innovative coding curriculum and instruction to support compliance with federal guidelines and appropriate reimbursement processes. She is a certified AAPC instructor and enjoys teaching a variety of coding, documentation, and auditing classes. Colleen serves as President of the AAPC National Advisory Board.

Ana Handshuh Principal

CAT5 Strategies

Ana Handshuh, Principal at CAT5 Strategies, is a government programs executive with expertise in creating and implementing corporate programs for the healthcare industry. Her background includes Quality, Core Measures, Care Management, Benefit Design and Bid Submission, Accreditation, Regulatory Compliance, Revenue Management, Communications, Community-based Care Management Programs and Technology Integration. Ms. Handshuh 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. She is a sought after speaker on the national healthcare circuit in the areas of Quality, Star Ratings, Care Management, Member and Provider Engagement, and Revenue Management. Her recent consultancy roles have included assisting organizations create programs to address the unmet care management needs in the highest risk strata of membership, 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 possesses sophisticated business acumen with the ability to build consensus with cross-functional groups to accomplish corporate goals. Ms. Handshuh served as the Vice President of Managed Care Services at Central Florida Inpatient Medicine (CFIM). In this role, she provided leadership and strategy on CFIM projects and collaborations with physicians, risk entities, hospital health care systems, and health plans. CFIM is the largest Hospitalist group in Central Florida, with 70 providers discharging over 50,000 patients annually from multiple hospitals across two health care delivery systems and 24 skilled nursing facilities. At CFIM Ms. Handshuh previously served as the Vice President of Operations. Prior to those assignments, she worked with Precision Healthcare Systems as their Vice President of Quality Improvement. In that capacity, she led the IPA’s Quality efforts and collaborated with payers on implementing programs to move the needle on Quality and Star Rating initiatives. Ms. Handshuh also served as the Director of Corporate Program Development at Physicians United Plan. In this role, she led the Quality Management and Corporate Communications departments and spearheaded the development of innovative integrated technology solutions to drive business excellence and Star Rating achievement initiatives. For the past fifteen years Ms. Handshuh has taken an active role in redefining and implementing changes that have led to improvements and greater efficiency within Government programs and healthcare delivery. Prior to joining Physicians United Plan Ms. Handshuh was the founder of I-Six Creative. Under Ms. Handshuh’s vision and leadership, I-Six Creative 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.

Patricia Henderson Director, Compliance

Jefferson Health Plans

Mary Inman Partner

Whistleblower Partners

Mary Inman is a partner in Constantine Cannon’s London and San Francisco Offices. After 20+ years representing whistleblowers in the U.S., she moved to London in July 2017 for four years to launch the firm’s international whistleblower practice and now splits her time between the London and San Francisco offices. She specializes in representing whistleblowers from the U.S., U.K., Europe and worldwide under the American whistleblower reward programs, including the federal and various state False Claims Acts and the SEC, CFTC, IRS, DOT and Treasury Department AML and sanctions whistleblower programs. Ms. Inman’s efforts to export the American whistleblower programs to the United Kingdom, including her efforts on behalf of a successful British whistleblower, were featured in a recent New York Times article “Law Firm Sees Britain as Hunting Ground for U.S. Whistleblower Cases.”  Ms. Inman’s successful representation of three whistleblowers exposing risk adjustment fraud in the Medicare Advantage program was featured in the February 4, 2019 issue of the New Yorker magazine in an article entitled “The Personal Toll of Whistle-Blowing.” Ms. Inman represents renowned SEC whistleblower Tyler Shultz who exposed the now infamous Silicon Valley blood testing start-up Theranos, and regularly speaks on lessons to be learned from this scandal surrounding corporate governance.    

Tracy Jones Interim Chief Compliance Officer

Summa Care

Tracy Jones is Interim Chief Compliance Officer for SummaCare Health Plan in Akron, Ohio. She has been with SummaCare for over 19 years and has a background in database management and operational process evaluation. Tracy is also responsible for the implementation of compliance initiatives such as dashboard reporting, policy management, and internal compliance department oversight. 

Angela Keenan Compliance Officer

Network Health

Angela has been with Network Health, a progressive and fast-growing health insurance company in the Midwest, for more than 13 years. She is certified in healthcare compliance (CHC) and healthcare privacy compliance (CHPC) and has a master’s degree in Leadership and Organizational Development through Lakeland University. Over the past several years, Angie has been instrumental in the development, maintenance and execution of all aspects of the organization's compliance program. Throughout her tenure at Network Health, Angie has had a key role in the establishment of the Corporate Training department which provides training resources organization wide as well as the creation of a centralized Quality Assurance Program to enhance the monitoring of controls within the organization.

Helen Liu Former Vice President of Pharmacy Operations

ATRIO Health Plans

Dr. Liu is the former Vice President of Pharmacy Operations for the ATRIO Health Plans, where she was responsible for the management and oversight of all Part D related operations. Dr Liu has an extensive background in clinical pharmacy, managed care operations, and data outcome analysis.  Prior to this role, she has developed and implemented the inpatient Drug Use Management program at Kaiser Permanente.

Angela Lloyd Associate Compliance Officer

Jefferson Health Plans

Angela Lloyd is the Associate Compliance Officer at Jefferson Partners Plans of Philadelphia (JHP). She oversees all functions under Compliance which encompasses the audit program, day-to-day incidents/inquiries, the risk program, regulatory interpretation, and regulatory reporting for all lines of business (Medicare, Medicaid, CHIP). In addition, her oversight includes operations and processes, analyzing data, and reviewing Policies and Procedures.  Fostering collaborative relationships with the leadership of operational units, and partners with vendors to ensure compliance with state and federal regulatory statutes.

Angela has worked for JHP for 17 years and possess over twenty years of product, compliance and operations experience in CHIP, Medicaid and Medicare programs. Her creative and result focused program has proven successful in driving compliance throughout the organization. Her expertise in the execution of regulatory contractual requirements with the understanding of policy in various channels has improved the companies understanding and awareness of the products offered under the Centers of Medicare and Medicaid Services, the Department of Human Services and the Office of CHIP especially the Special Needs product. Angela truly strives for excellence in everything she does keeping the JHP communities and membership in mind. Angela received a bachelor’s degree in business law, a master in  public health from Drexel University and certified in HealthCare Compliance.

Donna Malone Director Risk Capture, Population Health Management

Mass General Brigham 

Donna Malone, CPC, CRC, CRC-I, AHCCA, RAP: Director Ambulatory Clinical Documentation Quality Improvement (CDQI) with Mount Sinai Health System, Adjunct Professor with MassBay Community College, Chair of the RISE Risk Adjustment Academy HCC Coding Faculty Advisory Group and President of the Watertown AAPC Chapter 

Previously, she worked for Tufts Health Plan in their enterprise risk adjustment division for seven years with as Director Enterprise Risk Adjustment Coding and Provider Education, and was responsible for audit and coding review management, development and implementation of department and vendor policies and procedures, development of provider and coding training materials, implementation of provider system education and process review, government audits (CMS RADV, HHS RADV, OIG), coding team performance management. 

Additionally, Donna serves at the MassBay Community College in Framingham, where she has been an advisor and adjunct professor currently in her 17th year. Her specialty area is the Medical Coding and Medical Office Administration Programs. Prior to Tufts Health Plan, Donna worked for ENJOIN as the Director of Ambulatory CDI – Risk Adjustment, Blue Cross Blue Shield of Massachusetts as an HCC Professional Audit III for four years. Earlier, she worked for AM B Care for 9 years and other healthcare settings previously. Donna also has served as Education Officer (2016) and President (2017 – current) for the AAPC chapter in Watertown, MA. 

Donna speaks nationally for RISE, AAPC and AHIMA 

Ann Maxwell Deputy Inspector General for Evaluation and Inspections

HHS Office of Inspector General

Ann Maxwell is the Deputy Inspector General for Evaluation and Inspections in the Department of Health and Human Services (HHS) Office of Inspector General. As the head of the Office of Evaluation and Inspections (OEI), she leads more than 150 professionals who provide objective, reliable, data-driven evidence to HHS, Congress, and the public on significant issues. Ms. Maxwell leads the office in producing results-oriented evaluations that provide valuable insights into the efficiency and effectiveness of HHS programs as well as offer actionable recommendations to drive positive change in HHS programs so that they can better serve and protect the American people. Ms. Maxwell also leads OEI in its oversight of the State Medicaid Fraud Control Units (MFCUs), which investigate and prosecute providers for Medicaid fraud as well as for abuse and neglect of patients in health care facilities. In fiscal year 2021, the MFCU grant program recovered $1.7 billion—a return of $5 for every $1 invested.

Ms. Maxwell’s two decades of leadership and evaluation expertise have resulted in significant improvements in HHS programs and protected millions of people. For example, under her leadership, OEI helped drive down inappropriate prescribing and utilization of prescription opioids in Medicare, accomplishing this by way of Congressional testimony, more than a dozen evaluation reports, an analytic toolkit, and referrals to law enforcement and HHS. She has also directed a variety of OIG-wide multidisciplinary teams—consisting of evaluators, auditors, lawyers, investigators, and data scientists—to accomplish high-profile, consequential oversight and drive positive change in numerous HHS programs. These programs include Medicare; Medicaid; emergency response, including the COVID-19 response; oversight of food and drugs; and child welfare programs such as Head Start, foster care, and the program for unaccompanied children who cross the southern border.

Ms. Maxwell began her career with OIG in 1997 as an evaluator in the Chicago regional office, where she rose to serve in a variety of leadership roles, including Regional Inspector General. Leading the Chicago regional office, Ms. Maxwell focused significant efforts on evaluating prescription drug benefits under Medicare, Medicaid, and the 340B Drug Pricing Program. This work led to substantial savings for Medicaid and strengthened protections for providers who serve underinsured and uninsured patients. Ms. Maxwell also served as Assistant Inspector General for 8 years before taking the helm as Deputy Inspector General.

Ms. Maxwell holds a Master of Social Work from the University of Chicago and a Bachelor of Arts in Sociology and Economics from Kalamazoo College, Michigan. Ms. Maxwell has received numerous OIG awards, including the Thomas D. Morris Leadership Award for her leadership, program knowledge, and analytical abilities, and the Bronze Medal for her exemplary leadership. She has also received numerous awards for excellence in evaluation from the Council of the Inspectors General on Integrity and Efficiency, including the inspector general community’s highest honor — the Alexander Hamilton Award for protecting the safety and welfare of migrant children in HHS custody.

Yavar Moghimi

Medical Director, Behavioral Health

Dr. Yavar Moghimi is the Chief Psychiatric Medical Officer at Amerihealth Caritas DC, where he has extensive experience working with Medicaid populations in Washington DC as a managed care executive and community psychiatrist. He has a track record of innovation when it comes to bridging gaps between behavioral health, physical health, and social services.  He is intimately familiar with the current challenges that our fragmented health system faces as an administrator and clinician and has implemented multiple interventions that address the social drivers of health, complex populations with comorbid substance use conditions, and improved transitions of care.   

Sarah Peix Compliance and Privacy Officer

ChenMed Family of Companies 

Ms. Sarah Peix is the Director of Compliance for the ChenMed Family of Companies, a Florida-based, integrated primary care practice focused on serving Medicare Advantage beneficiaries. ChenMed has a unique physician-led culture that provides coordinated care to moderate- to low-income seniors.  

Before joining ChenMed in 2015, Ms. Peix served as the Medicare Compliance Officer at Health New England, an HMO in Springfield, Massachusetts. Ms. Peix oversaw Medicare Compliance when HNE was a 5-star plan and CMS conducted a Best Practice Review to develop its audit protocol in 2012.  

Ms. Peix has 11 years’ experience in Medicare compliance and 16 years in health care compliance. Ms. Peix has her BA from Mount Holyoke College and MBA from the Isenberg School of Management at UMASS, Amherst.  

Shelley Segal CEO

SEGAL MEDICARE EXPERTS

A seasoned executive with more than three decades of experience in the Medicare managed care industry, Shelley Segal is an accomplished collaborator with the unique ability to listen and understand the dynamics of the industry aspects. Shelley’s extensive operational expertise provides clients the insight necessary to optimize operations and achieve better bottom-line results. Shelley is a nationally recognized compliance, regulation and training expert in the Medicare, Medicaid, managed care industry, whose services include day-to-day operational management, interpretation and implementation of Medicare regulations, guidance for CMS program audits, and more. Shelley has worked at various health plans leading such functional areas as: Compliance, Operations (Enrollment, Call Center/Member Services, Retention, Claims, Appeals and Grievances) and Sales and Marketing.  Her subject matter expertise provides the ability to work cross functionally, saving time and costs.

Annie Shieh AVP, Compliance

Molina Healthcare 

Annie Hsu Shieh specializes in health care laws, reimbursement, compliance, fraud & abuse, privacy, antitrust, and contractual issues. Annie develops corporate-wide policies and procedures, administers HIPAA/HITECH privacy and compliance training, conducts internal audits, investigates complaints, and interprets CMS, HHS, OIG, managed care, and Medicare regulations and guidance.

Annie has received numerous publication credits, including “Legal Issues Concerning Retail Clinics,” a Reproductive Health Guide to the Medicaid Program, and a tutorial on Medicare Advantage Compliance Program Guidelines. Annie is a Citation Editor for the Journal of Health & Life Sciences Law. Annie spoke at the 2011 American Health Lawyers Association Annual Meeting on ethics and served as the Social Media Workforce Chair of the Young Professionals Council from 2010-2013.

Annie’s experience began with Lehman Brothers’ Washington Equity Research Group. There, she wrote weekly articles to institutional investors about expected changes in Medicare reimbursement and how they financially impacted the health care industry. In law school, she worked as the first Diversity Intern for the American Health Lawyers Association; Law Clerk for the Department of Managed Health Care; Summer Associate at a products liability law firm where she worked on the Merck Vioxx settlement; and Post-Bar Fellow at the National Health Law Program.

Annie obtained her B.A. in Public Health from Johns Hopkins University and her J.D. from Loyola Law School, where she completed the Health Care Law track and was President of the Health Law & Bioethics Association. In 2014, Annie was named the Alumni Honoree by the Loyola Law School Health Law & Bioethics Association for her contributions to establishing a health law externship for law students and post-bar fellows.

Beth Socoski Vice President of Compliance, Medicare Compliance Officer

Longevity Health Plan

Liz Soltan Associate

Whistleblower Partners

Liz Soltan is an associate at Whistleblower Partners LLP, a boutique law firm dedicated to representing whistleblowers under the various U.S. whistleblower reward programs.  She is a member of the case team working side-by-side with DOJ on United States ex rel. Poehling v. UnitedHealth Group, Inc., a pioneering Medicare Advantage risk adjustment fraud case launched by Whistleblower Partners’ whistleblower client. In addition to her work on healthcare-related matters under the False Claims Act, she helps whistleblowers bring tips to government agencies (SEC, CFTC, FinCEN) regarding financial fraud, money laundering, and sanctions evasion. 

Caroline Yaun Senior Consultant, Clinical

Rebellis Group, LLC

Caroline has over 25 years of experience in managed care, product strategy, and policy analysis with a background in the development, implementation, and execution of Special Needs Plans (SNP). She has hands-on experience creating Models of Care for D-SNP and C-SNP plans, addressing and meeting state and federal requirements, and navigating CMS corrective action plans.

Caroline’s experience includes serving as an Executive Director of SNP Programs, where she insourced the SNP care management program and built a multi-year SNP growth strategy. Prior to that, she held various roles at large health plans, where she was responsible for financial and clinical performance of the D-SNP for the Mid-America market and Director, Medicaid Eligibility and Program Policy in the National SNP Program Office. Caroline also served as a Senior Clinical Program Consultant, leading end to end clinical implementations for Medicaid, Group Retiree, and D-SNP products.

Caroline holds a BSN from the Catholic University of America and a BA in philosophy and religion from The University of the South-Sewanee.

Jessica Vander Zanden Vice President, Operations 

Network Health 

Jessica has a proven track record of taking skills that she mastered in one area and applying that mastery to new areas. She holds certifications in Health Care Compliance from the Health Care Compliance Association, Strategic Decision and Risk Management from Stanford University and Gerontology from the University of Wisconsin – Milwaukee. She holds a current Wisconsin license as an Advance Practice Social Worker and is also a Six Sigma Green Belt. She has close to two decades of experience in healthcare and business and organizational leadership.

Jessica is a graduate of the University of Wisconsin – Oshkosh and holds a Masters of Social Work from University of Wisconsin – Milwaukee and a Masters in Organizational Business and Business Leadership from Silver Lake College in Manitowoc, WI.