Medicaid Matters MESC Bio’s

MESC Medicaid Matters Guest BIOs

Terry Dougherty | 12:30 Guest

Terry Dougherty joined UMass Medical School’s Commonwealth Medicine division in December 2011
as Executive Director, Health Systems Transformation, to launch a new business line that will serve as a platform to improve health outcomes, enhance cost effectiveness, and maximize operational efficiencies.
His impressive career has traversed both the public and private sector. Terry previously served a dual role as Assistant Secretary for Administration and Finance at the Massachusetts Executive Office of Health and Human Services (EOHHS) and as Mass Health Director (2007 -1011). He also served as EOHHS Deputy Budget Director (2000-2001) and Manager of Acute Hospital Services (1998-2000) at the Division of Medical Assistance.
Prior to his time with EOHHS, Terry was Vice President for Payer Relations and Managed Care for the
Caritas Christi Health Care System (now Steward Health Care). In this role, he had oversight responsibility for a $900 million net revenue budget for a six-hospital and 1,600 physician integrated health care delivery network; he also was responsible for all advocacy efforts with federal, state, and local governments and regulatory agencies. From 2001-2004, Terry was Director of Government Finance at Children’s Hospital, where he advised executive management on a host of issues, ranging from state budget advocacy efforts to uncompensated care pool reform and Medicaid reimbursement.
Terry received his Masters in Public Health from Boston University School of Medicine, and a
B. S. degree in Civil Engineering from Wentworth Institute of Technology.

Corbin Petro | 12:30 Guest

Chief Operating Officer, Office of Medicaid |Massachusetts Executive Office of Health and Human Services

Corbin Petro is the Chief Operating Officer (COO) of the Massachusetts Department of Medicaid (MassHealth). In this role, she oversees all operations including eligibility, enrollment, member services, provider services, and Medicaid IT functions. Current initiatives she is involved with include: building HIX/IES, implementing a Pre-Payment Predictive Modeling application for program integrity, transitioning to ICD-10, developing ACO models, and improving data analytics.
Previously, Corbin has worked extensively in the healthcare and the public sector, most recently as a management consultant at Bain and Company. Other leadership experiences in healthcare include advising a US Senator on health reform and roles at Goldman Sachs Investment Banking, Deloitte Consulting, and American Management Systems. Corbin received a BA in History from Yale University and an MBA from the Wharton School at the University of Pennsylvania.

Julie Boughn |12:50 Guest

Deputy Director, Center for Medicaid & CHIP Services |CMS

Julie Boughn joined the Center for Medicaid & CHIP Services in August, 2011. In this role, Julie leads information and data activities, systems development work, MMIS and eligibility and enrollment systems work in the states, Medicaid IT Architecture and business operations activities for the Center. Just before joining the Center for Medicaid & CHIP, Julie served as the Deputy Director for Operations and helped to launch the CMS Innovation Center.
For 5 years, from 2006 through 2010, Julie served as Chief Information Officer and Director of the Office of Information Services at CMS. She was responsible for the Agency’s major information technology (IT) development projects, maintaining mission critical operational systems and supporting the largest repositories of health care information in the world. She provided oversight of CMS’ information security and privacy programs, investment management for the agency’s $1 billion annual budget, and compliance with government-wide and department standards for IT.
Julie joined CMS in September 2000, and has held various positions including leading the agency’s Information Security Program and the CMS IT Revitalization Program. She also served as Program Manager for the Agency’s IT systems to implement the Medicare Part D prescription drug benefit. Prior to joining CMS, Julie spent 15 years in the Social Security Administration’s Office of Systems.
Julie was recognized with a Presidential Rank Meritorious Executive award in 2009 and is a 2010 Fed 100 award recipient. In 2011, Julie was named to Information Week’s Health Care CIO 25 list.
Julie holds an M.S degree from Johns Hopkins University and MBA and B.S. degrees from the University of Maryland.

Mary Scanlon |1:00 Guest

Senior Vice President, Business Development, Government Healthcare Solutions at Xerox

Mary Scanlon has more than 22 years of experience in health insurance, government health, and health IT, introducing innovative health insurance products and technology solutions. Mary joined ACS in August 2010 and leads our business development team, which includes new market development, solutions and proposals, and marketing. Mary also leads our business development efforts around healthcare reform and actively supports our insurance exchange, long-term care, and accountable care organization pursuits. Prior to ACS, Mary was senior vice president of eBusiness and consumer innovation at WellPoint, the nation’s largest commercial health insurer, where she delivered the industry’s first integrated on-line personal health record to more than 35 million consumers and launched WellPoint’s consumer-directed product portfolio and on-line retail market. Mary also has extensive experience in health care product management, marketing, and network operations from her leadership roles at CIGNA Healthcare and Kaiser Permanente.
Mary has won many eHealthCare Leadership and Webby Awards and was selected as one of Twenty Noteworthy Women by the New Haven Business Journal in 2008. Mary has a Six Sigma Green Belt, is a Certified Web Usability Analyst, and a member of HIMSS.

Susan Ackley | 1:15 Guest

Director Standards and Compliance

Susan Ackley leads the Standards Compliance practice at Cognosante. She has more than 25 years of health care experience as a clinician, patient advocate, business process engineer, project manager and change agent. Ms. Ackley currently serves the Workgroup for Electronic Data Interchange (WEDI) as a co-chair of the Strategic National Implementation Planning (SNIP) Steering Committee and as a co-chair of the ICD-10 Implementation sub- workgroup (SWG). She is also a current co-chair of the Codes SWG and MITA SWG for the National Medicaid EDI Healthcare Workgroup (NMEH) and former NMEH chair.

Gwen Williams | 1:25 Guest

Business Development Executive | Molina Medicaid Solutions

Ms. Williams’ professional career includes more than 25 years of state government service, highlighted by management of two of the largest and most complex state agencies in Alabama, Medicaid and the Department of Human Resources. Her extensive experience in program management provides significant insight into the forces and issues driving state agencies, and honed her skills in problem solving and leadership.

Upon retiring from state service, Ms. Williams joined First Data Corporation, providing Subject Matter Expertise in state Health and Human Services programs. She provided project management and leadership to all Government Health Care projects and led First Data’s Health Care business development efforts, including building its Health Insurance Exchange consulting and Health Information Exchange practices, as well as its continued support of the MMIS consulting practice.

In October 2011, Ms. Williams joined Molina Medicaid Solutions as a Business Development Executive. She works closely with states to understand their individual needs and, using Molina’s Health PAS and Pathways solutions, structure a solution to address those needs.

Ms. Williams continues to actively support State Medicaid programs through thought leadership and active involvement in industry organizations. She currently serves as Chair of the Private Sector Technical Group, a broad-based group of information technology companies and professionals working in partnership with CMS and states providing solutions in the health information systems environment.

Stacey Harris | 1:35 Guest

Office of Health Information Technology |Georgia Department of Community Health

Stacey Harris, a Senior Executive Medicaid Business Analyst for Georgia Department of Community Health, Division of Health IT, has 23 years of experience in health care areas including: Medicaid Policy and Medicaid Management Information Systems, health care delivery systems including hospital services, professional services, and ancillary services. She has extensive knowledge of functional requirements, data management and reporting, and claims management. Mrs. Harris has participated in the design and implementation of two MMIS and several state implementations including Managed Care, PBM, and Medical Management for the state of Georgia.
Mrs. Harris was the Georgia Medicaid Policy Lead for Georgia’s MMIS implementation in 2010 and served as the subject matter expert for multiple subsystems during this implementation. She recently retuned back to the Georgia Department of Community Health after working as a Consultant for Deloitte Consulting LLP, on the New York State Department of Health Medicaid Data warehouse project.
Stacey holds a B.S. in HealthCare Management and a Masters of Health Administration both from Clayton State University.

Andrea Danes |1:45 Guest

CSG Government Solutions
Director Healthcare and Human Services

Elizabeth Reed |1:45 Guest

Senior Consultant |CSG Government Solutions

Elizabeth Reed is a Senior Consultant with CSG Government Solutions, providing support for Medicaid clients’ most important healthcare initiatives. Prior to joining CSG, she was a Health Information Technology Specialist with CMS, managing technical assistance nationally for the states through the 5010/ICD 10 project and provided expertise for ACA provisions such as operating rules and Eligibility and Enrollment Expansion. She was the EDI Manager for the state of Ohio. She has over twenty years extensive healthcare experience which includes managing various IT implementations, serving as practice manager for physician offices, as well as instructor for Medical Billing and Coding.

Lorrie Scardiono | 2:00 Guest

Senior Partner |Electronic Health Resources, llc

Lorrie Scardino is a Senior Partner at Electronic Health Resources. She specializes in the strategic application of MITA principles in MMIS proposals. She is a co-designer of ReadyCert, a new tool that state agencies and contractors use throughout the certification process, beginning with setting goals, through to the CMS certification visit.
Before joining EHR, Lorrie was a Vice President of Research and Distinguished Analyst at Gartner. She specialized in sourcing strategies and the processes for selecting IT and business process contractors. She created several branded products while at Gartner, including the annual Gartner on Outsourcing report and a model for the Total Cost of Software Quality.
Her Medicare, Medicaid and health care sector experience comes from her work with CSC and Group Health Incorporated, where she held operations and IT services management positions.

Kevin Walsh | 2:10 Guest

Senior Vice President, Senior Vice President and Managing Director, Eligibility and Insurance Exchange Services, Government Healthcare Solutions at Xerox

Kevin Walsh is responsible for the service excellence of the existing Xerox government healthcare eligibility accounts and business development for that entire line of business nationally. Kevin is a management professional with more than 25 years of progressive hands-on experience and specific accomplishments in healthcare technology and insurance operations. Previous to his current role, Kevin was a Director of business development with Perot Systems Corporation – now Dell Perot. He was responsible for the business development strategy and the profitable growth of the State Government Health and Human Services market sectors. His accomplishments included the refinement of the Perot Systems approach to State and Local Health Markets and well as Perot Systems first win in the State Health Care market, the sale of the Massachusetts Connector Exchange contract. Kevin also spent many years as a Client Delivery Executive for EDS- now part of HP. There he was responsible for the operations, growth and profitability of various Medicaid program administration contracts throughout New England. Kevin’s experience also includes more than ten years at Blue Cross and Blue Shield of Massachusetts, Inc. where he headed the National Accounts implementation group, was Director of the Federal Employee Program (FEP) account, lead Medicare A operations and managed the Medicare B quality control programs in 4 states.
Kevin earned a B.S. in Business Administration from Northeastern University, Boston, MA. He has served CMS on both the Medicare Quality Technical Advisory Group (TAG) and on the Medicare Systems TAG.

Jon Hager | 2:10 Guest Customer of Xerox

Executive Director of the Silver State Health Insurance Exchange, Nevada

Jon M. Hager became the first Executive Director of the Silver State Health Insurance Exchange in January 2012. Mr. Hager was appointed by unanimous vote of the Exchange Board in an open interview process because of his leadership skills, group insurance plan knowledge, and hands-on-experience launching and operating a health insurance exchange.
Prior to assuming his position with the Exchange, Mr. Hager was the Chief Financial Officer of Nevada’s Public Employees’ Benefits Program. As CFO, Mr. Hager was responsible for all aspects of the Program’s $476 million annual budget which served 72,000 state and local government employees, retirees and dependents.
Mr. Hager served in the U.S. Navy for nine years as a pilot and aircraft commander of the P-3C Orion in Operations Enduring Freedom and Iraqi Freedom and as an instructor pilot in the T-34C Turbo Mentor. He earned his Masters in Business Administration from Texas A&M and a Bachelor of Science in Physics from the United States Naval Academy.

Clint Furhman | 2:20 Guest

Clint Fuhrman is the Director of Government Health Care Programs for LexisNexis Risk Solutions. Mr. Fuhrman joined LexisNexis in 2009 after serving as Deputy Secretary of the Florida Agency for Health Care Administration. During his time at AHCA, Mr. Fuhrman helped direct Agency strategy and operations in the areas of legislative affairs, communications, Medicaid policy, and health information technology. He was appointed by Governor Charlie Crist to the board of the Florida Healthy Kids Corporation in 2008. Mr. Fuhrman has over 10 years of experience in the government, health care and political fields. He served as Special Assistant to Governor Jeb Bush from 1999-2002, and represented a wide range of clients before the Florida Legislative and Executive branches as Director of Legislative Affairs for The Rubin Group and President of Meridian Consulting Group. Mr. Fuhrman has extensive grassroots and statewide campaign experience, having served with the Republican Party of Florida, the Republican National Committee, and the Charlie Crist gubernatorial campaign, among others. Mr. Fuhrman began his career with the Florida Institute of Government at Florida State University, and is an FSU graduate. He currently resides in Washington, D.C., and is a native of Pensacola, Florida.

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