2018 Speakers

BlueCare Tennessee

Frances Martini, BSN, MBA

Director, Clinical Programs
Harvard Pilgrim Health Care

Noreen Hurley

Program Manager, Star Quality & Performance
UPMC Insurance Division

James Schuster, MD, MBA

Chief Medical Officer, Medicaid and Behavioral Services, and VP, Behavioral Integration
Texas Children's Hospital

Angelo P. Giardino, MD, PhD, CMQ

Senior Vice President/Chief Quality Officer
Community Health Network of Connecticut

Richard Albrecht

Executive Director, Telehealth Network
Gateway Health

Gabriel L. Medley, MHA, MBA

Vice President, Quality and Risk Revenue
Kaiser Permanente Information Technology

Joseph Crimando

Population Health Solutions Manager
Centene Corporation

Laura Sankey

Staff Vice President Operations - Complex Care
Blue Care Tennessee

Dr. Jeanne James

Chief Medical Officer
Blue CrossBlueShield of South Carolina

Michelle Thomsen

Vice President, Population Health & Medical Management
Blue CrossBlue Shield of South Carolina

Jennifer Dowell

Executive Director, Population Health
Molina Healthcare of New Mexico

Katarina Powdrell

Senior Specialist, Quality & Population Health
Speakers Biographies


Frances Martini, BSN, MBA

Director, Clinical Programs
BlueCare Tennessee

Frances Martini is the director of government clinical programs for BlueCare Tennessee, the Medicaid subsidiary of BlueCross BlueShield of Tennessee. She is responsible for overseeing integrated population health management and utilization management. Prior to joining BlueCare, she was the senior director of medical management at Emblem Health in New York and the Vice President of Medical Management for Health Net. She has extensive experience in medical management in multiple states and for multiple lines of business. Ms Martini is an RN with a Bachelor’s degree in Nursing and a Master’s Degree in Business Administration. She is a member of the American Society for Quality, the America’s Health Insurance Plans (AHIP), the Case Management Society of America and the Association of Managed Care Nursing. She is a board member and past board chair of the A Step Ahead Foundation, Chattanooga. She Lives in Chattanooga, Tennessee.

Noreen Hurley

Program Manager, Star Quality & Performance
Harvard Pilgrim Health Care

Noreen has spent her career in the healthcare arena. She blends operational, strategic and technology perspectives as well as payer and provider expertise to lead major initiatives and strategies. She started in hospital operations and was Director of the Admitting & Registration department in the New England Deaconess Hospital, a Harvard teaching hospital in Boston. Transitioning to IT, she implemented the EMPI (Enterprise Master Patient Index) when the Deaconess merged with the Beth Israel Hospital to form what is now the Beth Israel Deaconess Medical Center. From there she moved to the vendor world and ran implementations of EMPI’s, HL7 integrations and HIPAA EDI transactions for SeeBeyond Technologies. Most recently, she has focused on the payer space. She started and oversaw the Star program at Tufts Health Plan, as well as working in IT, developing a senior products PMO and managing the member call center. Moving back to technology, she developed data driven solutions in the healthcare space while working at Informatica. Her current role is developing the Star program at Harvard Pilgrim Health Care, which has recently re-entered the Medicare Advantage market. As a leader in the Clinical Informatics Division, the program focuses on leveraging non-traditional data and analytics to craft targeted initiatives to improve performance in the Star program and the Harvard Pilgrim Stride product

James Schuster, MD, MBA

Chief Medical Officer, Medicaid and Behavioral Services, and VP, Behavioral Integration
UPMC Insurance Division

In his role at the Insurance Division, Dr. Schuster has led development of multiple programs designed to address wellness and physical health concerns for individuals with serious mental illness and other disabilities. He is currently a principal investigator on a contract from the Patient Centered Outcomes Research Institute (PCORI) focused on health homes in behavioral health settings, and an investigator on another PCORI contract focused on shared decision making.

Dr. Schuster is board certified in psychiatry and in the subspecialties of geriatric and addiction psychiatry. He obtained his medical degree from the University of Louisville and completed his psychiatric residency at the University of Pittsburgh. He also received an MBA from the University of Pittsburgh. He is currently a Clinical Professor of Psychiatry at the University of Pittsburgh and has published numerous articles and book chapters.

Angelo P. Giardino, MD, PhD, CMQ

Senior Vice President/Chief Quality Officer
Texas Children's Hospital

Angelo P. Giardino, MD, PhD, CMQ, is Senior Vice President/Chief Quality Office at Texas Children’s Hospital. Prior, Giardino served as the Chief Medical Officer for Texas Children’s Health Plan, a provider-sponsored HMO that serves over 430,000 Medicaid and CHIP enrollees in Texas. He earned a Master’s in Public Health from the University of Massachusetts, and is a Certified Physician Executive (CPE) within the American Association for Physician Leadership. He completed the Patient Safety Certificate Program from the Quality Colloquium, is certified in medical quality (CMQ) as designated by the American Board of Medical Quality and is a Distinguished Fellow of the American College of Medical Quality. A Professor of Pediatrics and Section Head of Academic General Pediatrics at Baylor College of Medicine (BCM). Dr. Giardino is a member of the American Academy of Pediatrics’ Committee on Child Health Finance and he recently completed a three year term on the Quality Improvement committee for the Children’s Hospital Association and worked on quality measurement and the role of value- based alternative payment models in the pediatric setting. Dr Giardino received his medical degree and doctorate in education from the University of Pennsylvania, completed his residency and fellowship training at The Children’s Hospital of Philadelphia (CHOP). He received his Master’s in Public Health from the University of Massachusetts. He holds subspecialty certifications in Pediatrics and Child Abuse Pediatrics by the American Board of Pediatrics. He is a recipient of the Fulbright & Jaworski L. L. P. Faculty Excellence Award. His academic accomplishments include publishing several textbooks on child abuse and neglect and presenting on a variety of pediatric topics at national and regional conferences.

Richard Albrecht

Executive Director, Telehealth Network
Community Health Network of Connecticut

Gabriel L. Medley, MHA, MBA

Vice President, Quality and Risk Revenue
Gateway Health

Gabe Medley brings over 15 years of progressive healthcare experience leading diverse multidisciplinary teams and projects in the most challenging settings to achievement. Gabe’s background includes a combination of healthcare, business, and data analytic leadership roles and is currently serving as the Vice President of Quality and Risk Revenue for Gateway HealthSM headquartered in Pittsburgh, PA. He is the executive owner and department head for all quality improvement and risk adjustment related activities covering the Medicare and Medicaid populations in six states. Prior to Gateway, Gabe’s previous professional experience includes Sr. Director of Quality and Risk Revenue (Gateway Health), Director of Risk Revenue, Manager of Risk Adjustment Program (Horizon Blue Cross Blue Shield of NJ), Manager of Healthcare Data Analytics (Inovalon Inc.), Senior Manager of Patient Access (Military Health System, National Capital Region), and Captain (Medical Service Corps, U.S. Army). Gabe’s education includes the following: Master of Science in Healthcare Administration (MHA) and a Master of Business Administration (MBA) from the University of Maryland University College in Adelphi, Maryland; Bachelor of Science in Psychology with a minor in Military Science from Grambling State University in Grambling, Louisiana

Joseph Crimando

Population Health Solutions Manager
Kaiser Permanente Information Technology

Joseph provides operational and analytic solutions to identify and address patient care needs for preventative and disease management. He works closely with clinical teams to build programs that complement our Electronic Health Record (EHR) bringing relevant patient data together for action. The analytic products provide insight into patient care across different dimensions to improve patient outcomes. At Kaiser Permanente, he has implemented patient risk scores to prioritize patient care for the most needy. He has worked closely with disease care teams to build an order management system for lab and radiology based on carefully crafted protocols helping care teams save many hours of manual order entry. While he has worked in Healthcare for only the past 5 years, he has decades of data analytics expertise in many different industries. He has worked to bring advanced research technologies to meet operational needs within that industry. Joseph is a graduate of the State University of New York, College at Fredonia with a BS in Computer Science with a minor in Physics.

Laura Sankey

Staff Vice President Operations - Complex Care
Centene Corporation

Laura Sankey has more than twenty-five years’ experience in the managed care industry across a wide range of functional areas including commercial and government claims, training and auditing and health plan operations.

Ms. Sankey has been at Centene for fourteen years and joined the Complex Care team in May of 2014 to lead the Duals Demonstration product. As Staff Vice President of Operations for Centene’s Complex Care Department she has implemented three of Centene's six Medicare- Medicaid Plans (MMP) and continues to serve in an oversight role over the MMP Product in the Illinois, Ohio, South Carolina, Texas, Michigan and California markets. She leads the MMP Membership Operations team focusing on enrollment and call center support. In addition, she is tasked with identifying and sharing best practices across the organization, working with the federal and state regulatory bodies to provide feedback on the integration efforts of the program and testing care management models to improve the health outcomes and reduce costs for this vulnerable population.

Dr. Jeanne James

Chief Medical Officer
Blue Care Tennessee

Michelle Thomsen

Vice President, Population Health & Medical Management
Blue CrossBlueShield of South Carolina

Jennifer Dowell

Executive Director, Population Health
Blue CrossBlue Shield of South Carolina

Katarina Powdrell

Senior Specialist, Quality & Population Health
Molina Healthcare of New Mexico

Katarina Powdrell, born and raised in Albuquerque, New Mexico began her career in healthcare over two years ago with Molina Healthcare of New Mexico. While receiving her Master of Science in Psychology with an emphasis in Clinical Psychology/Counseling from New Mexico Highlands University she worked with members and providers throughout the state to support behavioral health interventions for two key HEDIS measures. Overtime with more experience and knowledge of the health plan's deliverables, Katarina now functions as the Sr. Specialist for Quality Interventions overseeing several other measures and managing vendor interventions throughout the state.