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Jennifer Dupee
Director, Audit & Vulnerabilities Group, Center for Program IntegrityCMSJennifer Dupee, Director. Audits & Vulnerabilities Group. Center for Program Integrity
In her role as the Director of the Audits and Vulnerabilities Group, Ms. Dupee identifies and develops comprehensive mitigation strategies addressing program integrity risks for all of CMS' programs, provides oversight of Medicare Part C and Part D plans and the Federally Facilitated Exchanges, and implements CMS’ Comprehensive Medicaid Integrity Plan. Prior to her current role at CPI, Ms. Dupee worked on such initiatives as the improper payment rate measurement for the Medicare fee-for-service program, Open Payments, and the Healthcare Fraud Prevention Partnership. Ms. Dupee also completed a Congressional detail with the House Committee on Ways and Means, responsible for a portfolio of Medicare fee-for-service and program integrity issues. Ms. Dupee has a Bachelor of Science Degree in Nursing from the University of Wisconsin, a Master of Science in Nursing and a Master of Business Administration from Johns Hopkins University, and a Juris Doctor Degree with a Health Law Certificate from the University of Maryland.
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Monique Pierce
Payment Integrity LeaderDevoted HealthMonique is a Strategic Executive Healthcare Leader with proven ability to develop solutions and maximize the benefits of Payment Integrity programs. She is known for having excellent domain knowledge and being driven, high performing, and having a deep dedication to recruiting and developing top talent.
Monique started her Payment Integrity career at Oxford HealthPlans in the COB and Subrogation Department after spending time in Payment Policy. When United Healthcare acquired many health plans in the early 2000s like Oxford, Monique was tagged as part of the Optum team to integrate the processes and people into the COB systems that she had built at Oxford. She led systems development, quality, reporting, operations, vendor management and was responsible for creating innovative proactive programs that more than doubled savings to $1.4B in three years.
Monique developed a successful program that reduced interest expense on late claims for UHC, assisted a communication company to develop COB tools and assisted in strategic system projects before joining SCIO Health Analytics in 2014 to develop new products - specifically prepayment programs.
In 2015 she became the product owner of SCIOMine, the company’s internal audit application and managed the roadmap. Monique also owned
strategic direction for operational metrics and reporting including executive scorecards. Monique was promoted to VP of Business Opportunities and Client Engagement where she improved Audit Recovery TAT by 39% and reduced client implementations TAT by 11% and the Level of Effort by 18% while increasing the count of implementation projects by 126%.
In 2020 Monique joined Devoted Health, a startup company with the goal of building the first ever integrated Payment Integrity Program. The company has one system, great data, and a great mission; to change health care by treating every member as if they are family.
In her spare time, Monique volunteers her time in the community on the Board of Directors of SCARE NH and works in her family business LARP Portal with her husband Rick.
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Phillip Churchill
Assistant General CounselBlue Cross Blue Shield of Michigan -
Dave Cardelle
Chief Strategy OfficerAMS -
Conor McCauley
Director, Payment Integrity Clinical CapabilitesHighmark HealthMy name is Conor McCauley. I am the Director of Payment Integrity Clinical Capabilities at Highmark. Being a Critical Care nurse, it is easy to see there are issues surrounding healthcare funding. Inserting clinical insights into reimbursement methodologies can lead to affordability and improved patient outcomes. Clinicians are well positioned to make a difference here. My passion is developing an engaged team, effective processes, and surrounding clinicians with the right technology, data, and market insights so they can work at the top of their licensure.
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Andrea Beatrice
Director of Payment Integrity and FWAHealth New England -
Mahi Rayasam
PhD., PartnerMcKinseyMahi Rayasam is a Partner in McKinsey’s Healthcare practice and leads a large analytics team focused on Healthcare Affordability, Quality and Outcomes. Mahi serves payers, healthcare technology & services companies and private equity institutions on topics related to transformations, operations and innovation. Specifically, Mahi has extensive experience in serving payers across 30 states on topics including Payment Integrity, FW&A, Medical Management and Out-of-Network cost management. Mahi also leads the development of McKinsey’s knowledge and product development efforts on AI/ML/NLP and other transformative technologies for healthcare.
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Pooja Singh
PartnerMcKinseyPooja Singh is a Partner in McKinsey’s Healthcare practice and a leader in the domain focused on Healthcare Affordability, Quality and Outcomes. Pooja serves payers, healthcare technology & services companies and private equity institutions on topics related to transformations, operations and innovation. Specifically, Pooja has extensive experience in serving payers on topics including Payment Integrity, FW&A, Medical Management, Care Management and Network management.
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Vladimir-Ducarmel Joseph
CDI Program ManagerLahey Hospital & Medical CenterVladimir-Ducarmel Joseph is the CDI Program Manager at Lahey Hospital & Medical Center, where he spearheads a dedicated team of CDI professional experts to optimize clinical documentation best practices. With almost a decade in CDI leadership across diverse healthcare environments, Vladimir-Ducarmel holds a Master of Health Administration from George Washington University and is ECFMG-certified as a foreign-trained physician. His expertise encompasses physician leadership, team dynamics, CDI provider education, and program management. A fervent advocate for healthcare excellence, Vladimir-Ducarmel is adept at bridging the gap between clinical and administrative roles. He is proficient in various healthcare-oriented analytical and business tools, leveraging them to drive impactful CDI outcomes.
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Stuart Epling
Assistant Director, Office of Program IntegrityWest Virginia -
Michael Taylor
Senior Fraud Analyst, Medicaid Fraud Control UnitWest Virginia -
Dale Carr
DirectorMissouri Medicaid Audit and Compliance (MMAC)Dale Carr currently serves as Director of the Missouri Medicaid Audit & Compliance (MMAC) unit, which
has overall responsibility for Medicaid program integrity efforts. Dale has worked for the State of
Missouri since 2011. Director Carr was previously a Police Officer in Fallon, NV; an Investigator for the
U.S. Office of Special Counsel; and a Supervisory Special Agent with the Coast Guard Investigative
Service. Dale holds a Bachelor’s degree in Administration of Criminal Justice and is a graduate of the158th Session of the FBI National Academy.
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Lacey Crowl
Director, Claims OperationsLongevity Health PlanLacey Crowl is the Director of Claims Operations for Longevity Health Plan, responsible for the accuracy of claims processing focused on Medicare members. Lacey has experience in the Commercial, Medicare and Medicaid environments, developing prospective and retrospective payment integrity solutions for both clinical and claim coding reviews. She has operated within various claims processing platforms to develop, code and implement new audit concepts while operating within the Managed Care space.
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Niobis Queiro
CEOThe Queiro GroupNiobis (Nio) Queiro is the founder of The Queiro Group offering transformation, integration, advisory and leadership development services. Nio formerly was the SVP of Revenue Cycle Tufts Medicine, in Boston Massachusetts.
She brings vast experience in both the hospital and physician revenue cycle industry. Nio uses her expertise in Lean and Six Sigma to drive change across diverse healthcare delivery channels, hence, bridging the chasm between finance and clinical care. As a change agent she has been able assist health systems transition to an integrated revenue cycle that met or exceeded HFMA KPI standards. Nio has presented in front of Congress as an industry expert for the digitization of the military service men medical records as the lead of a proof-of-concept project that is now the standard healthcare data exchange for the military. Nio was named as one of the top 25 Innovators of 2021 by Modern Healthcare.
Niobis continues her dedication to education as an adjunct Professor with Tufts University’s Masters in Public Health program and as a Professional Coach, business advisor. For fun its all about family and spoiling her grandson, Cylas.
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Dutch Noss
Chief Operating OfficerPrecision GXDutch Noss, COO of PrecisionGx is a highly versed Operations leader with 20+ years in Payment Integrity, Revenue Cycle Management, and Product Development. Dutch is an expert in the operational use of Artificial Intelligence, Machine Learning, Predictive Analysis, and Gaming Theory. Dutch’s specialties span both clinical and non-clinical audits including Contract Compliance, Duplicate Payments, IBill & DRG Review, COB, TPL, Retro-term, FWA and RAC audits in pre and post pay settings for Commercial, Medicare, and Medicaid payers.”
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Ritesh Ramesh
Chief Executive OfficerMDAudit -
Ankur Verma
Vice President, HealthcareEverest -
Aaron Browder
PresidentCarelon SubrogationAaron Browder is Staff Vice President, Elevance Health and President, Carelon Subrogation, formerly Meridian Resource Company (Meridian), where he and his team are responsible for overseeing the successful implementation and execution of our clients’ end-to-end subrogation programs. With a nearly 20-year career in subrogation, Aaron possesses a deep knowledge of healthcare subrogation. He has held a wide range of management positions throughout his tenure at Meridian, most recently serving as Staff Vice President. Prior to joining Meridian, Aaron gained experience in the financial services and insurance industries with Arthur Andersen, LLP/KPMG, LLP, and Travelers Property Casualty.
Aaron holds a Bachelor of Arts degree from Indiana University and a Master of Business Administration from Butler University. He served on the Board of Directors for the National Association of Subrogation Professionals and has been a national presenter and author on issues related to subrogation.
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Kyle Pankey
Sales & Growth LeaderCarelon Subrogation -
Morgan Tackett
Vice President ProductCAQHMorgan Tackett is Vice President Product at CAQH. Over the last nine years, he has worked to build the portfolio of member and provider data solutions that CAQH offers to the industry. Prior to joining CAQH, Morgan spent 18 years at Blue Cross and Blue Shield of North Carolina, where he led teams in Member Service Operations, EDI Services, and Network Management. Morgan holds an MPH from the University of North Carolina at Chapel Hill.
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Karen Weintraub
Executive Vice PresidentHEALTHCARE FRAUD SHIELD -
Kathy Gonzales-Byrd
Chief Strategy OfficerMedReviewKathy Gonzales is the Chief of Staff, collaborating with the CEO and other senior leaders on revenue growth, process improvement and organizational effectiveness. Kathy oversees new client implementations and operations for key strategic accounts; manages the organization’s strategic planning process; and oversees interdepartmental accountability processes to ensure operational efficiency.
Before joining MedReview’s senior leadership team, Kathy served as Vice President, Payment Recovery for Cotiviti, Inc. overseeing claim audit operations and client management for Blue Cross Blue Shield accounts. She also has a long-standing consulting career, which include leadership roles in healthcare revenue cycle and organization effectiveness with Accenture and Ernst & Young.
Kathy has a bachelor’s degree in psychology from West Chester University of Pennsylvania, and a master’s degree in business administration (MBA) and Health Care Administration and Finance from Widener University.
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William O'Neill
Vice President – Product Management, Payment IntegrityEXL -
Sherri Richardson
Strategy, Growth and Program DirectorCarelon -
Toni Case
Vice President, National SalesCERIS -
Rajeev Ronanki
Chief Executive OfficerLyric -
Timothy Wilson
Senior Vice President of Population Health ManagementP3 Health Partners -
Michael Brown
Data Mining ExpertMedReview -
Katreece Baker
VP of Clinical OperationsDRG Claims Management -
Bob Starman
SVP Payment Integrity SolutionsSagility