HCIT Team Biography Summaries

HCIT CONSULTING STAFF

Jim Alland – Strategic Market Advisor

Background: Former President of Enterprise Systems at McKesson HBOC, Former Senior Vice President at Allscripts, current Chief Sales Officer at OnShift, and Chief Advisor at Healthcare Solution Market Strategies.

Expertise: Enterprise level Acute and Long-Term Care organizations, as well as Physician providers in all practice sizes from small, independent organizations through Enterprise level, multi-specialty practices. Former clients include Northwell (NSLIJ), Baylor, Scott & White, Orlando Health, and University of Kentucky as well as some of the largest and most successful Physician Practices and ACOs in the U.S.

Tammy Harriss – Chief Marketing Officer

Background: 2O years of experience in Healthcare IT marketing with a proven track record in developing successful lead generating campaigns and collateral for post-acute and acute services and solutions.

Expertise: Case Management, Utilization Management, Referral Management Discharge Planning, Homecare, Hospice, Population Health, Electronic Medical Records and Emergency Department

CONSULTANTS FOR CASE MANAGEMENT and UTILIZATION MANAGEMENT 

Wilfred Barut, RN – Utilization Review Nurse

Background: Registered Nurse with extensive experience in the ER and ICU, Clinical Trainer for Utilization Management teams, Utilization Management Auditor, Inter-Rater Reliability Support to ensure accuracy and efficiency in the application of standardized review criteria.

Expertise: Utilization Review, Resource Utilization

Joseph Burke, RN, MPH – Senior Consultant for Clinical Process Improvement

Background: Former Regional Executive Director of Clinical Quality Improvement and Case Management for Tenet Healthcare, Nursing Administrator at Barnes-Jewish Hospital/BJC Health System, Master Certificate Lean Six Sigma

Expertise: ED, Readmissions Management, LOS, Denials, Throughput, Quality, Case Management Operations and Redesign, Project Management, Value Based Care, Compliance with Regulatory & Operational Clinical Standards and Process Redesign/Improvement Implementation

Marianne DiMola – Executive Recruiter for Direct Hire Placement Services

Background: More than twenty-five years of experience in healthcare human resources management and career development. Former Director at Bayada Nurses and Nursefinders. She is a founding member of CMSA’s TriChapter New York Conferences and is the former Executive Director of the New York City Chapter of CMSA (20 years). Founder of Pathway Medical Staffing, a nationally recognized leader providing case management recruitment and retention advisory services, HEDIS staffing, and project management.  Former Senior Vice President of National Sales and Operations for Medical Staffing Network, Care Management and Vice President of Care Management at Cross Country.

Expertise: Healthcare Recruiting, Human Resources, Case Management, Physician Advisory, CM Redesign, and Process Improvement. Ms. DiMola presented “Essential Strategies” at the CMSA National Conference and CMSA, NYC Chapter in 2O11, Long Island CMSA Conference 2O12, “The Secret Victory of Case Managers” at CMSA National in 2O13 and has authored and coauthored, “Essential Strategies to Cultivate Your Career” for the Professional Case Management; Vol. 17/No. 5 “Next Level Case Management Guide Book, Co-Authored “The Great Exodus Hitting Case Management” in CMSA today March 2O22 and in 2O21 presented multiple times to the Case Management Community.

Donna McLean, RN, BSN, MBA – Managing Consultant for Clinical Process Improvement

Background: 4O years of healthcare experience in critical care nursing and case management, 2O years in Case Management Consulting including Ochsner Health System, Grady Health System, Dignity Health, Beebe HealthCare, CareNewEngland, and CHI. Seasoned Interim Director of Case Management, PA/UR Trainer, and Data Integrity Specialist.

Expertise: Case Management Design, Utilization Management and Denials, Strategic planning, Compliance, CM Education and Service Quality Assurance, Physician Advisory Program build, Education, and Training

Betsy Mazzoleni, MA, BSN, ACM-RN – Senior Consultant for Case Management, Coding and CDI

Background: Former Alicare Management Nurse Helpline Director, Change Healthcare Clinical Content Developer for prototype Hospital in the Home project/InterQual criteria and co-lead for Home Hospital pilot project in academic community setting. Former Content Developer for Dartmouth-Hitchcock’s web team, Recent CDI, and Case Management experience, serving on the ACMA MA Chapter’s Board and Co-Chair of its Marketing and Social Media committee.

Expertise: Decision-tree support product/content development for case management/telehealth, Hospital at Home case management criteria, telehealth training, health content development for Internet and social media platforms, marketing for healthcare systems. Recent working knowledge of case management and CDI practice. Master’s in Media Arts from Emerson College.

Frances Horner – Senior Consultant for Patient Access

Background: Former Founder and Managing Partner of Singola Consulting, former Sr. Director Patient Access, and Epic Principal Trainer at NorthShore University Health System, and current President of VoC Consulting Group. Has completed large digital transformation projects and contact center implementation work with clients such as Jefferson Health, CHOP, Rochester Regional Health, and Mount Sinai Medical Center.

Expertise: Unique knowledge, understanding, and ability to integrate patient engagement with healthcare operations, IT, business processes, marketing/advertising, contact centers, and electronic medical record systems is invaluable to healthcare organizations.

Marsha S. Masten, RN, BSN – Senior Consultant for Care Coordination

Background: Nurse executive with 3O+ years of healthcare experience, specializing in payer relations (BCBS, Humana, and Anthem, Medicare & Medicaid) to support quality, VBC, Population Health and Disease Management in acute and post-acute settings.

Expertise: Assessment, redesign, and implementation of operational process improvements and change management. Healthcare innovation and Information Technology, Call Center Design, and strategy development to decrease readmission outcomes.  Building Client Service teams, Post-Discharge Care Coordination), centralized scheduling, and patient experience and retention.

Ruth McNaughton, BSN, MHM, CCM, ACM-RN – Senior Consultant for Clinical Process Improvement

Background: Former Senior Director of Care Management, Administrator for Hospitalist, and Mid-Level Groups, ACO Program Development, Acute Care Case Management Consultant, Home Care Owner, and Geriatric Case Management.

Expertise: Acute Case Management, Utilization Review, Transitions of Care, Readmission Reduction Programs, ACO and Community Case Management Development, Hospitalist Management and System Integration, Sub-Acute, SNF, and Home Care Development for Quality Outcomes.

Andrea Rich MSN, RN, CEN– Consultant for Case Management

Background: Clinical Optimization Consultant: Responsible for process improvement projects or enhanced interim leadership positions for the healthcare transformation division. Projects include a Level 1 trauma center in Texas, a project focusing on emergency department throughput, patient experience scores, and new leadership mentoring; Enhanced Interim Leadership project at a large community hospital/trauma center in Washington State focusing on team stabilization, leadership development, and responsible for all department operations. Successfully led team through regulatory immediate threats.

Expertise: Acute Care, Emergency Services, Emergency Medicine, Quality Improvement, Critical Care Nursing, Patient Safety, Nursing Education, Pediatric Advanced Life Support (PALS), Advanced Cardiac Life Support (ACLS), Employee Engagement, Consulting, Healthcare Management, Nursing, Emergency Nursing, Nursing Management, and Leadership.

Kathy Seward, MD, CHCQM-PHYADV – Physician Advisor Subject Matter Expert

Background: extensive experience providing Physician Advisory Services in a variety of settings including teaching hospitals, community hospitals large and small, and Women’s and Children’s hospitals, served as both an external and internal Physician Advisor and has worked in a consulting capacity helping health systems implement and optimize Physician Advisor programs nationally.

Expertise: Progression of Care, Medical Necessity, Level of Care, Resource Utilization, Physician Documentation Requirements, Physician Practice Patterns, Denial Management with Peer to Peer, Collaboration among Medical Staff, Case Management, Social Work.

CONSULTANTS FOR VALUE BASED CARE

Kathy Scott, RN, MPA, PhD., FACHE – Clinical Operations Executive Consultant

Background: A seasoned healthcare executive, consultant, speaker, and writer and has served in the capacity of CNO, COO, Chief Innovation Officer, and Chief Integration Officer for several health systems.

Expertise: Expertise in designing, implementing, and managing wide-scale change utilizing a high-reliability systems framework. Clinical Innovation and ACO clinical integration, operational oversight of hospitals, case management, information technology/systems, informatics, research, quality and performance excellence, education, post-acute and outpatient programs.

Sunil Joshi – Senior Consultant for Finance and Managed Care

Background: Nearly 30 years of health plan, provider, managed care expertise in all market segments including commercial, Medicare, Medicaid with a focus on top line growth, cost of care, business development, network management, operations, P&L management, and Account Management. Worked at Anthem, managed a $125MM P&L of an IPA, Senior Vice President at a $8.5B Provider/Care Management firm focused on expansion via Value Based Care contracts. Consulting experience with clients ranging from health plans, specialty providers, business process outsourcing, care management, telemedicine, substance abuse, lab, home health, hospice, health tech, not-for-profit advocacy group.

Expertise: Top Line Growth initiatives including Network Development, Business Development, Program Development and Cost of Care strategies via Quality or Care Management Projects to bend the cost curve.

Marie London, RN BSN CMAC CPHIMS – Senior Consultant for Value Based Care

Background: Former VP of Care Management at Healthcare Partners (Now Optum), formerly in UM/CM/DM product design at Anthem, former Director of Nursing for a large national home health company, current Principal Marie London Consulting.  Has completed large redesign and transformation projects and IT implementation work with clients such as Anthem, Healthcare Partners, Agilon health, and LA Care Health Plan.

Expertise: Registered Nurse with 14 years of hospital, clinic and ambulance experience including ICU, ED, outpatient, and psyche. Have specialized expertise in UM/CM/PHM platforms.  Conducted multiple assessments for UM and CM operations. Led special transformation projects on Cal AIM, Expanded Primarily Health-Related Benefits (EPHRB), Special Supplemental Benefits for the Chronically Ill (SSBCI) with a focus on the operationalization and IT implementation of the SDOH benefits.

Kevin D. Moran – MBA, MSM- Senior Consultant for Managed Care

Background: Former Executive Director of Physician Engagement at CHS, Health Management Associates, and the Arkansas Oklahoma Healthcare Consortium. Selected by Governor of Arkansas to lead design and implementation of the State’s Health Insurance Exchange.

Expertise: Advisory Services, Managed Care contracting responsibilities for Medicare, Medicaid, and Commercial Payors. Business development, marketing, change management, staff training and development, corporate vision setting, and fiscal policy and control.

CONSULTANTS FOR TRANSFORMATION

Kathy Jermain, RN, BSHM, ACM-RN – Clinical Operations Executive Consultant

Background: Kathy is a healthcare consultant with over 3O years of industry and advisory experience in healthcare. Kathy is an accomplished case management and care coordination leader and has led Case Management Transformations in both academic hospitals, community health systems, and payer settings.

Expertise: Case management transformations, transition of care, coordination of care, patient throughput, quality, performance improvement, medical necessity, denials management, staffing, training, and education.

Nikki Kuna, MHA – Clinical Operations Consultant

Background: Nikki has several years of experience in healthcare consulting. She has provided engagement support focused primarily on process improvement and process optimization in the provider space and has worked with clients to implement changes related to the optimization of clinical operations in the inpatient setting.

Expertise: Progression and coordination of care, care variation, resource utilization, collaborative care, data analysis, and data visualization.

Bridget Sarikas – Operations Expert, Leadership Consultant and Author

Background – An experienced operating executive, author, and consultant on transformational leadership. Held COO and CAO roles in complex organizations including healthcare.

Expertise – Process effectiveness, project management, employee engagement, operational excellence, customer experience, systems implementation, facilities management, supply chain and real estate.

CONSULTANTS FOR

FINANCE, CODING, and CDI

Cari O’Leary, RN, BSN, CCDS – Senior Consultant for CDI

Background: Clinician with over 3O years of industry and advisory experience in healthcare.  Has led engagements in hospitals nationwide through Clinical Transformation and Clinical Documentation Improvement to support improved quality and revenue optimization.  Cari has led transformational engagements on both payer and provider clients to improve clinical operational effectiveness, particularly in the areas of quality and margin/revenue optimization.

Expertise: Case Management, Patient Throughput, Clinical Documentation Integrity staffing, education, and technology optimization. Payer and provider focus to improve clinical operational effectiveness, Quality and Revenue optimization, CDI program implementation and training with detailed analysis of hospital case mix index and DRG data.

Andretta Reed, RHIA, MHA – Executive Consultant for Health Information Management and Coding

Background: Former Vice President of HIM & Coding at Capella Health and Faculty at Rasmussen College. Expertise in Ambulatory Coding and provided HIM SME Services to organizations such as DaVita Kidney Care, American Physician Partners, and Community Health Systems.

Expertise: Health Information Management SME to include HIM strategic leadership, benchmark planning, coding, and billing regulations, health data analytics, system implementation, adjunct professor, training, and mentorship, as well as CDI Program development and optimization.

Robert Tarola – Executive Consultant for Finance and Interim CFO

Background: Has extensive experience as a public company director, CFO, and auditor. He brings a unique perspective to address business and professional challenges of accountants, auditors, attorneys, governance bodies and finance professionals.

Expertise: Advisory Services; Personnel Development; Investment Management; M&A Transactions; Value Creation and Capital Raising; Corporate Governance.

PHYSICIAN CONSULTANTS FOR ACUTE SERVICES

James Bergmann, MD – Physician Executive, Medical Director, and CMO

Background: Physician Executive with extensive experience in the Electronic Health Records (EHR) and Health Information Exchange (HIE) and Population Health markets in the US and abroad. Has served as a Physician Executive at Allscripts and Cerner as well as a former faculty member and Medical Director at the University of Vermont School of Medicine.

Expertise: Experience enhanced by over 28 years of clinical and academic medical practice. Board Certified in Family Practice, Internal Medicine, and Sports Medicine. Extensive Surgical and sub-specialty experience in Critical Care, Cardiology, Orthopedics and OB/GYN.

Christopher Haines DO, MBA, FAAP, FACEP, FACHE – Senior Physician Consultant

Background: Board Certified in Pediatric and Pediatric Emergency Medicine and Lean Six Sigma. Deep experience with financial, quality, and safety outcomes in the hospital & health care Industry. CEO & Founder of Unlock Health. Author of “Guns, Monkey Bars and Hayholes – A Journey Through Pediatric Emergency Medicine”.

Expertise: Pediatrics, Emergency Medicine, Healthcare management, Finance, Physician Relations.

Robert Leviton, MD, MPH, FACEP ABPM-CI – Senior Physician Advisor

Background: Physician Practice Management Senior Administrator with expertise in relationship management, operations, strategic planning and financial management for health care and not-for-profit organizations.

Expertise: Advisory Services, Physician compliance education, Case Management, Physician Advisory Services, Emergency Department Medicine.

Michael Marron-Stearns, CPC, CFPC, MD – Senior Physician Advisor

Background: Former CMO, Physician Informaticist, Accomplished Author, Health Information Technology and Healthcare Compliance Consulting, Subject Matter Expert on APMs, CCM, TCM, MACRA, HEDIS Measures, and Physician Coding as well as Educator for Clinical Informatics. One of the original Subject Matter Experts for the creation of SNOMED CT.

Expertise: MIPS/MACRA, Advanced APMs, MSSP, BPCI, HCC, TCM, CCM, Software Design, Clinical Content & Regulatory Compliance.

CONSULTANTS FOR POST ACUTE SERVICES

Valerie Dewbre, RN – Senior Consultant for Post-Acute Services

Background: Principal of Owner of a Concierge Consulting Service that supports all aspects of hospice, including operations, business development, administration, clinical services, compliance, as well as interim executive staffing. Experienced Healthcare Executive with a demonstrated history of working in the healthcare industry with emphasis in community health. Proven record in C-Suite positions including Chief Operating Officer, Chief Nursing Officer, and Chief Compliance Officer.

Expertise: Skilled in Medicare, Medicaid, Hospice, Home Health, Physician Relations, Contract Management, Healthcare Management, Population Health, and Business Development. Strong operations professional with 2O+ years in hospice with multisite and multistate management.

Mary Ann Miller, RN BSN – Senior Consultant for Post-Acute Services

Background: Nurse executive with over 3O years of extensive and diversified leadership experience. Clinical oversight of over 14O long term care facilities in multiple states. Also oversight of over 4O locked dementia units, 15 acute care hospitals, 6 hospices, 5 assisted living centers and 5 MR/DD facilities. Assisted IT company with development of new clinical product lines. Past Director of Nursing and former lead instructor at a nurse aide training school.

Expertise: Assessing, redesigning, and implementing system transformation in multiple site environments. Analyze systems for compliance with state, federal, OSHA and JACHO agencies. Development and implementation of new systems and procedures in multiple states and settings. Establishes Quality Improvement procedures and guidelines for strong clinical outcomes. Strong background with leading clinical education.

Peter von Mechow, NHA, RN – Senior Living Consultant

Background: Former Nursing Home Administrator, Compliance Officer, and Director of Nursing of Skilled Nursing communities. Health Care administrator for Skilled Nursing, Assisted Living and Independent Living.

Expertise: Senior Living compliance, clinical operation efficiencies and optimizing reimbursement. Operational gap analysis expertise for identification of operational risks and development of action plans to mitigate those risks.

TECHNOLOGY, PRODUCT DEVELOPMENT, DATA, AND ANALYTICS 

Erica Crenlon – Product and Solutions Manager

Background: Former Solutions Manager and User Research and Design lead for Allscripts Care Management and Referral Management Solutions. Has worked with large health systems such as Tenet Healthcare, Cleveland Clinic, Northwell, & HCA.

Expertise: Acute Care management, Post-Acute and Ambulatory, Denials and Appeals, Business Intelligence/Reporting, and HIE, Patient/Member Experience.

Kristina Green, TOGAF – Business Analyst Consultant

Background: Mission-driven healthcare leader with twenty years’ experience developing strategic program initiatives and driving multi-million-dollar program outcomes for national health plans (Anthem), Local Initiatives (L.A. Care Health Plan), and value-based medical groups (HealthCare Partners – Now Optum).

Expertise: Health Plan & Medical Group Operational Strategy and Execution, Program Management, Business Architecture, NCQA Accreditation, and Quality Improvement and Risk Adjustment strategies.

Shahran Haider – Data & Analytics Advisor

Background: 2O+ years of experience helping Fortune 1OO organizations create teams, platforms and culture for data driven performance. Proven leader with executive experience in driving enterprise scale data transformation at L.A. Care Health Plan (2m members, $9B revenue) & United Health Group. Currently Managing Principal of CerebralEdge a Data/Analytics consulting firm.

Expertise: Advise clients and lead programs on business transformation and strategic performance improvements using modern data architecture and advanced analytics solutions. Specializations and previous leadership responsibilities included Data Strategy, AI/ML, Data Governance, Business Architecture, Data Warehousing, Business Intelligence, HEDIS/CAHPS and Regulatory Reporting. $1OOM+ of business value delivered through Analytics.

Kerri Denton, BSIT – Senior Certified Epic Consultant

Background: Former Analyst with Enterprise Licensed Epic Customer, Multiple Epic Clinical Case Management Installation Projects at large health systems such as Methodist, King’s Daughters and Sentara.

Expertise: Inpatient & Outpatient Care Management Reporting Work Bench Analytics, Workload Acuity Scoring and Data Analytics, Epic, Cerner CM ClinDoc and Epic Case Management.

Maggie Dick, PMP – Senior Project Manager

Background: Seasoned project manager with experience with large health systems such as Dignity, Asante, and Scripps. Led Project Management teams to support the COVID-19 Vaccine rollout to the greater San Antonio area.

Expertise: Project Initiation, Business Analysis, Agile/Sprint/Backlog Planning, Stakeholder Management, Workflow Design, Resource Planning, Vendor Management, Team Building and Mentorship, Systematic Problem Resolution, Operational Readiness/Transition, Risk Management and Mitigation, Quality, and Process Improvement.

Michelle McCleerey, PhD, MA, MEd, MBA, RN – Senior Product/Product Strategy Consultant

Background:  Over 15 years of experience working in healthcare technology including the roles of Chief Product Advisor, Senior Vice President of Product, Chief Clinical Officer, and Vice President of Strategy across several healthcare market sectors (care access, communication and collaboration, alert/alarm management, patient safety, and patient flow/command center).

Expertise:  Product strategy, product management, innovation, research, and Human Factors, the study of human limitations and capabilities and the utilization of that data to deliver enabling human-centered technology designs.

Leigh McCormack, MS – Data and Analytics Advisor

Background: Data scientist leader with former experience at BCBST and health care startups, AVP of Data and Science Strategy and has built large scale data science teams, products, and services.

Experience: Building and implementing data science solutions into payer and provider ecosystems, incorporating not-traditional data into healthcare analytics products. Go-to-market design for SaaS products, developing analytic strategy for large scale initiatives with respective ROI on population health and medical management programs.

Laura Montesantos, JD, LLM – Healthcare Software Product Consultant

Background: Current VP, Product Management for a Care Coordination Platform Product, former Senior Product Manager for Provider based solutions including Allscripts Care Management (now WellSky), Allscripts Referral Management (now CarePort), and Director of Product Integration for Payer based AIM Specialty Health, a subsidiary of Anthem (now Elevance Health).

Expertise: Leading and overseeing the product development and implementation for health care-based technology teams, focus on product integration of acute and post-acute systems to streamline provider workflow, improve user experience, and create software tools to promote efficiencies.  Health care legal document review and vendor contracting.

Dr. Olufemi “Femi” Osidele, Ph.D. – Senior Business Analyst

Background: Founder & Managing Director at Amojos Consulting, Inc. and serviced as Senior Research Engineer for the Southwest Research Institute. Has completed contract work for the Environmental Protection Agency.

Expertise: Managing networks, contingency planning for business continuity, Security Administration, data analyses, modeling and simulation, and proposal writing. Project management and business development.

David Shaffer – Chief Information Officer Consultant (and Interim CIO)

Background: Deep experience in healthcare informatics and technology operations leadership; Former division Director of Informatics at Baylor Scott and White Health, Sr. Corp Dir. ISD at Tenet Healthcare. Leading in Medical Informatics, Acute and Ambulatory EHRs, IT operations, Medical Staff IT services, Quality Reporting, Operations Alignment and Improvement of Physician and HIM Workflows.

Expertise: Enterprise Contracting, Implementation, and Optimization of complex EHR and HIT, Interoperability and Integration, Strategic IT planning, Risk Assessments, Program Management, Product Selection and Return on Investment.

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