The National Managed Care Leadership Directory 2015

Transcription

1 TheNa t i onal ManagedCar e Leader shi p Di r ect or y 2015 KEYCONT ACTSI NTODAY S LEADI NG MANAGEDCARE ORGANI ZATI ONS

2 The National Managed Care Leadership Directory 2015 HealthQuest Publishers SM From MCOL Positioning you for a new kind of healthcare 1101 Standiford Avenue Suite C-3 Modesto, CA Phone: Fax: www,healthquestpublishers.com ISBN # Copyright 2015, MCOL All Rights Reserved Please be advised: No part of this directory may be reproduced in any form or incorporated into any information retrieval system, electronic or mechanical, without written permission of the publishers. The publishers of this directory have made every effort to provide complete and accurate information for our readers regarding the individuals and the organizations featured in this Leadership Directory. However, the publishers and editors assume no liability for errors, omissions, or damages that may arise from the use of the information provided in this publication. Additionally, the inclusion of a particular individual or organization herein should not be construed as a recommendation or an endorsement by the publishers or the editors of this directory MCOL All Rights Reserved

3 How To Use This Directory The National Managed Care Leadership Directory is designed to help you quickly identify key executive and staff. The Directory is organized alphabetically by company so you can easily find the contacts you need for the organizations you know. You may also use the indexes provided in the back of the Directory, including the State Index to find companies by their location, Company Type Index to find companies by their type, Parent Company Index to find companies listed by their Parent Company and Job Function Index to find companies with listings for specific job functions. Company Description 926 companies are listed in this edition. The information included has been provided by the listed organizations or through MCOL research. Companies from multiple industry segments are included to provide a single source of information on major managed care companies and their respective leaders. Parent Company information has been provided for many of the applicable organizations, and all companies have been classified according to the following Company Types: Administrative Organizations, Health Plans, PBMs, Provider Networks or Specialty Organizations. Specialty Organizations include Dental, Vision and Behavioral Health Networks. Administrative Organizations include major Quality Improvement Organizations, Utilizations and Disease Management Organizations, and TPAs. Please note the Parent Company field includes indication of independent Blue Cross Blue Shield affiliates. Executive Listing There are 7,909 employees listed in this edition of the Directory. The individuals listed for each organization are those with key positions in various functions of the company. 33 key functions were identified which apply to many managed care organizations. In some cases, persons are listed under two separate functions when applicable. Furthermore, some persons are listed in more than one company (under the same parent company) when they have responsibilities in more than one subsidiary. In addition to the general functional descriptions, the specific titles of executives are listed when provided by their organizations. However, some titles are abbreviated or truncated due to space considerations. Flash Drive and On-Line Database Availability The information contained herein is also available on Flash Drive, and via an on-line subscription. An adobe acrobat version of this Directory, plus the Directory database in multiple file formats are provided in the Flash Drive. This facilitates sorting and selecting data for customized mailings, phoning, or faxing to appropriate individuals based on type of company, location, job category, or other criteria as defined by the user. For further information, please consult the HealthQuest Publications information sheet at the back of the Directory MCOL All Rights Reserved

4 Blue Cross & Blue Shield of Kansas 1133 Topeka Blvd Phone: Topeka, KS Fax: Web Site: Parent: Blue Cross & Blue Shield Affiliate Type of Company: Health Plan Job Function Name Title Chairman of the Board Steve Sloan Chair of the Board President/CEO Andrew C. Corbin President and CEO Chief Medical Officer Michael Atwood, MD VP, Medical Affairs and Chief Medical Officer Chief Information Officer Julie Hinrichsen Vice President, Information Services; CIO Admin. and Analytical Marlou Wegener Manager, Com. Relations; COO, BCBS Kansas Foundation Admin. and Analytical Bob Young, SPHR VP, Administrative Services and Human Development Finance Ron Simmons Vice President, Finance Government Relations Fredrick D. Palenske SVP, Provider and Government Affairs Vice President, Administrative Services and Human Human Resources Bob Young, SPHR Development Legal & Compliance Matthew D. All Senior Vice President and General Counsel Marketing Treena Mason Vice President, External Sales and Marketing Clinical Trina Riley Nurse Coordinator for PCMH and Quality Improvement Operations Shelley Pittman Vice President, Operations and Internal Sales Provider Relations Fredrick D. Palenske SVP, Provider and Government Affairs Public Relations Marlou Wegener Manager, Com. Relations; COO, BCBS Kansas Foundation Quality Management Trina Riley Nurse Coordinator for PCMH and Quality Improvement Sales Treena Mason Vice President, External Sales and Marketing Sales Shelley Pittman Vice President, Operations and Internal Sales Blue Cross & Blue Shield of Louisiana P.O. Box Phone: Baton Rouge, LA Fax: Web Site: Parent: Blue Cross & Blue Shield Affiliate Type of Company: Health Plan Job Function Name Title Chairman of the Board Thad Minaldi Chairman of the Board President/CEO Mike Reitz President and CEO Chief Operating Officer Peggy Scott Executive Vice President and COO Chief Medical Officer David Carmouche, MD EVP & Chief Medical Officer Chief Information Officer Ob Soonthornsima SVP and Chief Information Officer Other Senior Executive Dan Borné Vice Chairman Actuarial Brian Small SVP, Chief Actuary Admin. and Analytical Courtney Ardoin VP, Business Development & Strategy Admin. and Analytical Charles Gilbert VP, Administrative Services MCOL, All Rights Reserved.

5 Blue Cross & Blue Shield of Louisiana continued Job Function Name Title Admin. and Analytical Laura Landry VP, Customer Engagement and Planning Admin. and Analytical Darrell Langlois Vice President, Compliance, Privacy and Fraud Admin. and Analytical Christy Reeves Executive Director, BCBS of Louisiana Foundation Admin. and Analytical Rodney Rone VP, Planning, Projects and Financial Systems Admin. and Analytical Frank Song Director of Advanced Analytics Business Development Courtney Ardoin VP, Business Development & Strategy Business Development Tej P. Shah SVP, Business Development Claims Jacqueline Addison VP, Benefits Administration Claims Karen Lagrone VP, Benefits Administration - Claims Claims Allison Young SVP, Benefits Administration Finance Rodney Rone VP, Planning, Projects and Financial Systems Finance Mary Saporito VP, Internal Audit Finance Adam Short VP and Controller, Finance Human Resources Todd Schexnayder SVP, Human Resources Legal & Compliance Robin Bueche VP, Legal Affairs Legal & Compliance Michele Calandro SVP and General Counsel Legal & Compliance Sheldon Faulk Specialist Attorney Legal & Compliance Darrell Langlois Vice President, Compliance, Privacy and Fraud Marketing Brian Keller SVP and Chief Marketing Officer Member Services Laura Landry VP, Customer Engagement and Planning Operations Wendy Bateman VP, Consumerism Operations Sam Griffin VP, EROC Project Operations Gina Laird VP, Business Engineering Operations Dan Paquin SVP, Government Programs Pharmacy Milam Ford VP, Pharmacy Services Provider Relations Dawn Cantrell VP, Network Administration Provider Relations Steve Cunningham VP, Provider Reimbursement Public Relations John Maginnis VP, Corporate Communications; Company Spokesman Public Relations Robin M. Mayhall Corporate Communications Senior Writer Quality Management Sabrina Heltz SVP, Healthcare System Quality Medical Director Deirdre Barfield, MD Medical Director Medical Director Kenny Cole VP of Care Delivery and Associate CMO Medical Director Stephen B. Walker, MD Medical Director Sales Gregory Cross Vice President, Sales Utilization Management Cindy Hallam VP, Care Management Services Information Systems Kathy Dufour VP, Application Services Information Systems Michael Jeanfreau Enterprise Architect Information Systems Charles Landreneau VP, Enterprise Infrastructure MCOL All Rights Reserved

6 Indexes State Index All companies by state, in alphabetical order within each state Company Type Index.. All companies by Type, in alphabetical order within each Type Parent Company Index Companies with Parent Organizations/ Affiliates listed, in alphabetical order by Parent Company in order of states served within Parent Job Function Index Companies with applicable Job Functions, in alphabetical order within each Job Function Pages Pages Pages Pages MCOL All Rights Reserved

7 State Index National Managed Care Leadership Directory 2015 Company City Page Alaska Aetna Health Plans of Alaska Anchorage 15 Qualis Health Alaska Anchorage 358 Alabama Behavioral Health Systems, Inc. Birmingham 58 Blue Cross & Blue Shield of Alabama Birmingham 66 First Community Health Plan Huntsville 181 VIVA Health, Inc Birmingham 419 Arizona Aetna Health Plans of Arizona Phoenix 15 Aetna Medicaid Phoenix 22 AmeriChoice MSO Phoenix 34 Arizona Care Network, LLC Phoenix 48 ASPA-Connected Community Phoenix 50 Blue Cross & Blue Shield of Arizona Phoenix 66 Bridgeway Health Solutions Tempe 89 Care 1st Health Plan Arizona, Inc. Phoenix 99 Cigna HealthCare of Arizona, Inc Phoenix 116 Cigna Medical Group Phoenix 122 Health Choice Arizona Phoenix 207 HealthNet of Arizona Tempe 219 Humana Health Plan of Arizona Phoenix 238 John C. Lincoln ACO Phoenix 252 Magellan Rx Management, LLC Scottsdale 271 Maricopa Integrated Health System Phoenix 274 Matrix Medical Network Scottsdale 276 Mercy Care Plan Phoenix 283 Meritus Tempe 285 Phoenix Health Plan Phoenix 335 Scan Health Plan Arizona Phoenix 367 SilverScript Insurance Company Phoenix 375 The Mahoney Group - The Mahoney Group Private Exchange Mesa 386 The University of Arizona Health Plans Tucson 387 TriWest Healthcare Alliance Phoenix 391 UnitedHealthcare of Arizona Phoenix 399 Arkansas Arkansas Accountable Care Fayetteville 48 Arkansas Foundation For Medical Care Little Rock MCOL All Rights Reserved

8 Company Type Index National Managed Care Leadership Directory 2015 Administrative Organizations A&I Benefit Plan Administrators, Inc. 6 Accordant Health Services 7 ACE/ESIS 9 Active Health Management 10 Advantek Benefit Administrators 11 Advanzeon Solutions 11 Agate Healthcare 24 AIM Specialty Health 25 Allegiance Benefit Plan Management, Inc. 27 American Health Holding, Inc. 31 AmeriChoice MSO 34 AmeriHealth Administrators, Inc. 37 Arkansas Foundation For Medical Care 49 Arthur J. Gallagher & Co. - Gallagher Marketplace 49 Asuris Northwest Health 51 BB&T Insurance Services 56 Beacon Health Strategies 57 Benefit & Risk Management Services 58 Benefit Express 58 Benefit Management Administrators 59 Benemax 59 Bloom Health 61 BrocorXchange 90 California Foundation for Medical Care 92 Capitol Administrators 97 Cardinal Health Alliance 97 CareAllies 100 CBIZ Benefits & Insurance Services, Inc 106 CHOICE Administrators 113 CIMRO Quality Healthcare Solutions 123 Coastal TPA 125 Conner Strong & Buckelew - Private Benefit Exchange 138 CorVel Corporation 143 Cypress Benefit Administrators 150 Delmarva Foundation For Medical Care 154 Delta Health Systems 159 Digital Benefit Advisors 162 Eide Bailly Employee Benefits 165 Emblem Health Administrators 167 Employee Benefit Management Services, Inc. 169 First Niagara Benefits Consulting - Niagara Benefits 183 Foundation for Medical Care of Tulare and Kings 186 Health Integrated Inc 209 Healthcare For You Now 214 HealthFirst TPA 217 HealthSCOPE Benefits Inc. 224 Healthways Inc 226 HeatlhEdge Administrators 228 Humboldt Del Norte Foundation for Medical Care 242 Insurance Management Administrators 248 IPRO 250 Itasca County Health and Human Services - IMCare 251 Kansas Foundation for Medical Care, Inc. 262 KePRO 263 MagnaCare 271 Massachusetts Peer Review Organization, Inc. 276 MedCost, LLC 279 Medical Benefits Administration 280 Meritain Health 285 MJ Insurance - MJ Private Exchange 292 Mountain Benefits Management Company 301 MRCT - SmartBenefits Marketplace 301 National Benefit Fund 306 New World Administrators, Inc. 311 Noble Health Alliance 312 North America Administrators 313 Northwest Administrators, Inc. 314 Nova Healthcare Administrators 315 NovaSys Health 315 NovoLogix 315 Nurtur Health 316 NYCHSRO/MedReview, Inc. 316 Optum Bank 321 OptumHealth 322 Permedion 333 Premier Healthcare Exchange 344 Professional Benefit Administrators, Inc. 353 Providence Administrative Services, Inc. 354 Pulse Systems 355 Qliance Medical Management 355 Qualidigm 357 Qualis Health 357 Qualis Health Alaska 358 Qualis Health Idaho 359 Secure Health Plans of GA, LLC 369 Self Insured Plans 371 Shasta Administrative Services 375 Stratis Health 379 Stratose 380 SynerMed 383 Telligen 384 The Mahoney Group - The Mahoney Group Private Exc 386 The Vitality Group 388 TPA Systems Inc. 390 TriWest Healthcare Alliance 391 True Coverage 391 UMR 395 UMWA Health and Retirement Funds 395 United Administrative Services 396 United Benefit Advisors - Benefits Passport 397 USI Insurance Services, LLC - USI Bright Choices 415 WEA Trust MCOL All Rights Reserved

9 Parent Company Index National Managed Care Leadership Directory 2015 Parent Company Organization Name State Page Abrazo Health Care Phoenix Health Plan AZ 335 Aetna Aetna Health Plans of Alaska AK 15 Aetna Aetna Health Plans of Arizona AZ 15 Aetna Aetna Medicaid AZ 22 Aetna Aetna Health Plans of California CA 16 Aetna First Health CA 182 Aetna Aetna Corporate CT 12 Aetna Aetna Pharmacy Management CT 23 Aetna Delaware Physicians Care DE 153 Aetna Aetna Health Plans of Florida FL 16 Aetna Coventry Health Care of Florida FL 144 Aetna Aetna Health Plans of Georgia GA 16 Aetna Coventry Health Care of Georgia, Inc GA 144 Aetna Coventry Health Care of Iowa IA 145 Aetna Aetna North Central Region IL 23 Aetna Coventry Health Care of Illinois IL 144 Aetna Coventry Health Care of Kansas KS 145 Aetna Preferred Health Systems KS 342 Aetna Aetna Health Plans of Kansas City/Missouri KS 17 Aetna Coventry Health Care of Louisiana, Inc. LA 145 Aetna Aetna Health Plans of Maryland MD 17 Aetna Group Dental Service MD 195 Aetna Aetna Health Plans of Maine ME 17 Aetna Aetna Health Plans of Michigan MI 18 Aetna Cofinity MI 125 Aetna Coventry Cares of Michigan MI 143 Aetna Aetna Health Plans of Missouri MO 18 Aetna Coventry Health Care of Missouri MO 145 Aetna HealthCare USA of Missouri MO 216 Aetna Aetna Health Plans of the Carolinas Inc NC 21 Aetna Coventry Health Care of the Carolinas, Inc. NC 146 Aetna Coventry Health Care of Nebraska, Inc NE 146 Aetna Aetna Health Plans of New Jersey NJ 18 Aetna Active Health Management NY 10 Aetna Aetna Health Plans of New York NY 19 Aetna Meritain Health NY 285 Aetna Aetna Health Plans of Ohio OH 19 Aetna Aetna Health Plans of Oklahoma OK 19 Aetna Aetna Health Plans of Pennsylvania PA 20 Aetna Aetna Health Plans of Pennsylvania - Western PA PA 20 Aetna Aetna Mid Atlantic Region PA 23 Aetna Coventry HealthAmerica Penn.. - Pittsburgh PA 147 Aetna Aetna Health Plans of Tennessee TN 20 Aetna Aetna Health Plans of Texas TX 21 Aetna Aetna Health Plans of Texas- Houston/Beaumont TX 21 Aetna MHNet Behavioral Health TX 288 Aetna Altius Health Plan UT 30 Aetna Coventry Health Care of Virginia VA MCOL All Rights Reserved

10 Job Type Index National Managed Care Leadership Directory 2015 Job Type Index Starts on Page Chairman of the Board 470 Chief Operating Officer 457 Chief Medical Officer 459 Chief Financial Officer 462 Chief Information Officer 465 Actuarial 466 Administration and Analytical 467 Business Development 470 Case Management 472 Claims 472 Clinical 473 Dental 475 Finance 475 Government Relations 477 Human Resources 478 Information Systems 480 Legal & Compliance 482 Marketing 484 Medical Director 487 Member Services 489 Network Contracting 491 Operations 492 Optical 495 Pharmacy 495 Population Health & Disease Management 496 Provider Relations 497 Public Relations 499 Quality Management 501 Sales 502 Utilization Management MCOL All Rights Reserved

11 Job Type Index National Managed Care Leadership Directory 2015 The Job Type Index indicates companies with a listing for a standardized job type. CEOs are excluded from the index as most companies in the Directory have a CEO listed. Other Senior Executives and Other Executive/Staff are also excluded from the index, as these are non-specific job categories. Chairman of the Board p. 6,AAMC Collaborative Care Network p. 7,Access Community Health Network p. 8,Accountable Care Coalition of Greater Athens GA p. 9,ACO Providers of Central Texas (AmpliPHY ACO #3) p. 11,Advanzeon Solutions p. 12,Aetna Corporate p. 25,Alameda Alliance for Health p. 27,AllCare IPA p. 27,Alliance of Community Health Plans p. 29,Aloha Care p. 32,American National Life Insurance Company p. 33,American Specialty Health Inc. p. 40,Ameritas Group Dental and Eye Care Division p. 40,Antelope Valley ACO p. 44,Anthem, Inc. p. 46,APS Healthcare p. 48,Arizona Care Network, LLC p. 48,Arkansas Accountable Care p. 49,Arkansas Foundation For Medical Care p. 50,ASPA-Connected Community p. 50,Assurant Health p. 54,Bassett Healthcare Network p. 55,BayCare Physician Partners ACO p. 57,Beacon Health Partners p. 57,Beacon Health Strategies p. 58,Behavioral Health Systems, Inc. p. 60,Bienvivir Senior Health Services p. 61,BioScrip p. 61,Bloom Health p. 62,Blue Care Network of Michigan p. 63,Blue Cross & Blue Shield Association p. 67,Blue Cross & Blue Shield of Arkansas p. 69,Blue Cross & Blue Shield of Kansas p. 69,Blue Cross & Blue Shield of Louisiana p. 71,Blue Cross & Blue Shield of Michigan p. 72,Blue Cross & Blue Shield of Minnesota p. 74,Blue Cross & Blue Shield of Nebraska p. 76,Blue Cross & Blue Shield of North Dakota p. 78,Blue Cross & Blue Shield of Rhode Island p. 79,Blue Cross & Blue Shield of Tennessee p. 81,Blue Cross & Blue Shield of Vermont p. 82,Blue Cross Blue Shield of Massachusetts p. 83,Blue Cross of Idaho p. 84,Blue Cross of Northeastern PA p. 84,Blue Cross of Northeastern PA p. 84,Blue Shield of California p. 88,Bon Secours Good Helpcare (GoodHelp ACO) p. 90,Brown & Toland p. 91,Cal Optima p. 95,Capital Blue Cross p. 95,Capital Blue Cross p. 96,Capital District Physicians' Health Plan, Inc. p. 100,CareFirst Blue Cross & Blue Shield p. 101,CareMore Health Plan p. 102,CareOregon p. 103,CarePoint Health Plans p. 103,CareSource p. 104,Carilion Clinic p. 104,Catamaran p. 105,Catholic Medical Partners p. 106,Cedars-Sinai Accountable Care p. 107,CenCal Health p. 108,Centene Corporation p. 108,Center For Elders' Independence p. 109,CenterLight Healthcare p. 109,Central California Alliance for Health p. 112,Chinese Community ACO p. 112,ChiroCare p. 114,Cigna Corporate p. 123,Citizens Choice Healthplan p. 125,Coastal Plains Network p. 128,Commonwealth Care Alliance p. 131,Community Health Choice, Inc p. 132,Community Health Network of Connecticut p. 133,Community Health Plan of the Siskiyous p. 134,Compsych Corporation p. 141,Cooperativa de Seguros de Vida de Puerto Rico p. 141,CoOportunity Health p. 143,CorVel Corporation p. 148,CSMS-IPA p. 148,Cumberland Pediatric IPA p. 148,Cumberland Pediatric IPA p. 149,CVS Caremark p. 152,Dean Health Plan p. 154,Delmarva Foundation For Medical Care p. 154,Delta Dental of Washington p. 157,Delta Dental Plan of Michigan,Indiana, Ohio p. 157,Delta Dental Plan of Minnesota p. 158,Delta Dental Plan of New Jersey p. 161,Denver Health Medical Plan MCOL All Rights Reserved

12 ABOUT HEALTHQUEST PUBLISHERS HealthQuest Publishers offers critical market intelligence for those doing business with the managed care and health care industries. HealthQuest directories provide leads, contact information, mailing lists, profiles and tools for those involved with marketing, recruitment, business development and others involved with health management and managed care. HealthQuest Publishers has produced key managed care directories since 1994, including the popular "Who's Who in Managed Health Care" and the "National Managed Care Leadership Directory." MCOL acquired HealthQuest Publishers in 2000, and has expanded HealthQuest offerings to include a number of additional resources. MCOL is the fifteen-year-old health care company delivering business to business health management and managed care resources. For more information, or to place orders on these and other HealthQuest publications, go to: HQ Online subscriptions provide searchable on-line 24/7 access to three continually updated databases: Health Care Executive Profiles, The National Managed Care Leadership Directory and MCOL's Health Plan Directory. With a HQ Online Subscription, you can target your information using powerful searches, and access these databases anyplace, any time on the web. An annual on-line subscription is priced at $895, but National Managed Care Leadership Directory customers can receive a significant discount. Corporate pricing is also available MCOL All Rights Reserved

13 The ideal resource for collaborating, networking, recruiting, marketing or monitoring of ACOs with over 680 pages that encompasses: (1) Organizational Directory of 540+ selected ACOs along with a listing of 1,800+ key individuals with leadership or operational involvement and direct phone/ contact information when available; (2) Executive Profiles providing contact and biographical information for over 180 executives and thought leaders involved with Accountable Care; and (3) Indexes for convenient navigation and reference organized five different ways. Priced at $219 softcover and $178 pdf with add-on database available for additional purchase. Profiles of key decision makers and thought leaders in the managed care industry, and a directory of Health Plan CEOs, with 800+ pages and 1,800+ listings. Profiles feature full contact information and extensive biographical information on key leaders highlighting their experience, education, credentials, significant achievements, professional affiliations and activities. The Directory is presented in a user-friendly format with indexes as well. The Directory is presented in a user-friendly format and provides indexes by last name, and by state and organization, and is available for $178 in book form or $139 in CD-ROM format MCOL All Rights Reserved

14 Custom Select your Health Care Business Mailing from the B2B Database. Select from 51,000+ professionals from health management and managed care. Selections include standardized organization categories and job levels, in addition to state. Selections can also be randomized to fit a specified number of requested records. Your selection is delivered via CD or , in Excel or Text delimited formats. Pricing is based on $95 per 1,000 records, with a minimum order of $495. The ideal resource for collaborating, networking, recruiting, marketing or monitoring of Health Insurance Marketplaces that encompasses for 2015: Organizational Directory of 104 selected HIXs, including public exchanges, private exchanges and exchange platform companies, with 814 executives and staff listed with these organizations Executive Profiles providing contact and bio info for 103 executives and thought leaders involved with Health Insurance Exchanges Indexes for convenient navigation and reference Order Information You can order any HealthQuest Publishers products the following ways: By phone at (209) By fax at (209) , order forms can be downloaded online Or Online at MCOL All Rights Reserved