national managed care leadership directory 2019national managed care leadership directory 2019 ......

KEY CONTACTS IN TODAY’S LEADING MANAGED CARE ORGANIZATIONS

National Managed Care

The

LeadershipDirectory

2019

National Managed Care Leadership Directory 2019

2 ©2019 MCOL All Rights Reserved

The National Managed Care Leadership Directory 2019

HealthQuest PublishersSM

From MCOL Positioning you for a new kind of healthcare

1101 Standiford Avenue Suite C-3

Modesto, CA 95350 Phone: 209.577.4888 • Fax: 209.577.3557

www,healthquestpublishers.com

ISBN # 978-0-9998760-2-0 © Copyright 2019, 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.

http://www.mcol.com/



How To Use This Directory

The National Managed Care Leadership Directory is designed to help you quickly identify key executives and staff with managed care organizations. The Directory is organized alphabetically by state (for the company’s office location) and then alphabetically by company. You may also use the indexes provided in the back of the Directory, including: the Alphabetical Index to find companies by their name, 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

1,126 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 organizations and their respective key staff. 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 selected Quality Improvement Organizations, Care Management Organizations, TPAs and Insurance Exchanges. Provider Networks include IPAs, PHOs, CINs and ACOs with commercial managed care arrangements. Please note the Parent Company field includes indication of independent Blue Cross Blue Shield affiliates.

Executive Listing

There are 8,313 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 entity. 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.

Download and On-Line Database Availability

The information contained herein is also available via MCOL’s Download Center, or via an on-line subscription. An adobe acrobat version of this Directory, plus the Directory database in multiple file formats are provided in the Download Center. 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. In addition, the database files include employee direct phone and email contact information when available. For further information, please consult the HealthQuest Publications information sheet at the back of the Directory.



The National Managed Care Leadership Directory

Company Listings

Arranged by State of Office Location in Alphabetical Order Indexes begin on page 533


42 ©2019 MCOL, All Rights Reserved.

State Location: California CenCal Health

4050 Calle Real Phone: 805-685-9525 Santa Barbara, CA 93110 Fax/eMail: 805-685-8292 Type of Company: Health Plan Web Site: www.cencalhealth.org

Job Function Name Title President/CEO Bob Freeman CEO

Chief Operating Officer Paul Jaconette COO

Chief Medical Officer Takashi Wada Chief Medical Officer

Chief Finance Officer David Ambrose CFO

Chief Information Officer Barrie Parker CIO

Admin and Analytical Karyn Fish Dir, HR

Admin and Analytical Michael Harris Dir, Administrative & Gov Serv

Admin and Analytical Ron Mideiros Assoc IT Director, Data Analytics

Claims Allen Freymuth Claims Director

Claims Lulu Von Alvensleben Associate Claims Director

Clinical Florence Chan Dir of Health Services

Clinical Barbara Kramer Assoc Director, Health Services

Finance Amy Sim Interim Director of Finance

Government Relations Michael Harris Dir, Administrative & Gov Serv

Human Resources Karyn Fish Dir, HR

Information Systems Ron Mideiros Assoc IT Director, Data Analytics

Information Systems Jai Raisinghani Assoc Director, Enterprise Apps

Legal & Compliance Richard Golfin, III Compliance Officer

Legal & Compliance Caitlin Larsen Dir, Legal Affairs

Marketing Krista Vega Marketing and Comm Manager

Member Services Rob Botdorf Associate Dir of Member Services

Member Services Donna Slimak Dir of Member Services

Pharmacy Jeff Januska, PharmD Director of Pharmacy

Provider Relations Sherri Bennett Provider Services Director/Relations

Provider Relations Sherri Tarpchinoff Bennett Associate Director Provider Services

Public Rel and Comm Sherri Bennett Provider Services Director/Relations

Public Rel and Comm Krista Vega Marketing and Comm Manager

Public Rel and Comm Nicolette Worley-Marselian Director of CPR

Quality Management Carlos Hernandez Dir, Quality & Decision Support

http://www.cencalhealth.org/



Indexes

Company Name Index………………………… All companies in alphabetical order

Pages 534 - 557

Company Type Index ………………………….. All companies by Type, in alphabetical order within each Type

Pages 558 - 568

Parent Company Index ………………………… Companies with Parent Organizations/ Affiliates listed, in alphabetical order by Parent Company in order of states served within Parent

Pages 569 - 583

Job Function Index……………………………… Companies with applicable Job Functions, in alphabetical order within each Job Function

Pages 584 - 639

Changes Index……………………………… Organizations newly listed in the 2019 Directory and previously listed 2018 organizations no longer included in the 2019 Directory

Pages 640 - 644

Change Index National Managed Care Leadership Directory 2019


Newly Listed Organizations in the 2019 Directory: Company State Page Adventist Health Plan California 28 Aetna Better Health of Kansas Kansas 203 Aetna Better Health Premier Plan Illinois 169 Aetna Maine Maine 222 Allina Health | Aetna Minnesota 271 America’s 1st Choice South Carolina 438 American Health Advantage of Oklahoma Oklahoma 388 American Health Advantage of Tennessee Tennessee 450 America's Health Plan California 32 Amerigroup Community Care of New Mexico New Mexico 323 AmeriHealth Caritas VIP Care Plus Michigan 251 ArchCare Advantage New York 329 AtlantiCare LIFE Connection New Jersey 312 BayCare Health Plans Florida 131 C and O Employees' Hospital Association Virginia 493 CarePartners of Connecticut Connecticut 112 CareSource Georgia Georgia 155 CareSource Indiana Indiana 189 CenterLight Healthcare New York 331 Central Florida Behavioral Heath Network Florida 133 Cgs Admnistrators, LLC Tennessee 453 ChiroCare Minnesota 273 Cigna-Healthspring Houston Texas 463 Cigna-Healthspring Nashville Tennessee 454 Cigna-Healthspring of Texas Texas 464 Cigna-HealthSpring Pennsylvania Pennsylvania 409 Clear Spring Health of Illinois Illinois 174 Community Care Health California 48 Community PACE at Home, Inc Michigan 254 Complete Health with PACE Arkansas 22 Consolidated Association Of Railroad Employees Texas 466 CountyCare Illinois 175 DeCare Dental Minnesota 273 Delaware Life Insurance Company Massachusetts 240 Devoted Health Plan of Florida Massachusetts 241 Doctors HealthCare Plans, Inc. Florida 134 First Medical Health Plan Puerto Rico 429 GeoBlue Pennsylvania 414 Great Plains Medicare Advantage - North Dakota North Dakota 371 Great Plains Medicare Advantage - South Dakota South Dakota 448 Group & Pension Administrators: GPA Texas 470 Group One Thousand One Indiana 191 Guidewell Florida 139 Harvard Pilgrim Health Care New Hampshire 309 Health Choice Utah Utah 485



Newly Listed Organizations continued Company State Page Health Colorado Colorado 104 Health Partners Network Inc West Virginia 516 Health Pointe of New York New York 338 HealthNet Community Solutions California 61 HealthPartners UnityPoint Health Iowa 199 Hennepin Health Minnesota 277 Heritage Provider Network California 63 Humana Arkansas Arkansas 23 Humana California California 64 Humana Green Bay Wisconsin 523 Humana Intermountain Region Washington 507 Humana Pennsylvania Pennsylvania 417 Humana Utah Utah 485 Imperial Health Plan of California California 65 InnovAge Pennsylvania LIFE Pennsylvania 418 InnovAge Virginia PACE - Blue Ridge Virginia 494 InnovAge Virginia PACE - Richmond and Peninsula Virginia 494 Innovation Health Virginia 495 Integra Managed Care New York 342 Integrated Health Partners of Southern California California 66 Kaiser Permanente Washington Health Research Inst Washington 508 Kansas Health Advantage Kansas 205 Lasso Healthcare Pennsylvania 419 Liberty Advantage North Carolina 365 Lighthouse Healthplan Florida 143 Longevity Health Plan Illinois Illinois 181 Longevity Health Plan New York New York 343 Magellan Complete Care Virginia 495 Magellan Complete Care of Arizona Arizona 15 Magellan Health Arizona 15 Mercy LIFE Massachusetts 245 Mercy LIFE - St. Agnes Continuing Care Center Pennsylvania 421 Missouri Medicare Select Missouri 294 MMM of Florida Florida 145 Molina Healthcare of Mississippi, Inc. Mississippi 288 Molina Healthcare of Puerto Rico, Inc. Puerto Rico 431 Mutual of Omaha Medicare Advantage Nebraska 301 Nascentia Health Plus New York 349 Navitus MedicareRx Wisconsin 526 New York Hotel Trades Council and Hotel Assoc New York 349 NextLevel Health Partners Illinois 183 NHC Advantage Tennessee 456 Northeast Health Partners Colorado 107 Oscar Health Plan of California California 81 PACE Central Michigan Michigan 263



Newly Listed Organizations continued Company State Page

PACE of the Ozarks Arkansas 24 Palmetto GBA South Carolina 442 Positive Healthcare - PHC Florida Florida 147 Preferred Care Partners Florida 147 PruittHealth Premier North Carolina North Carolina 368 PSM - Plan de Salud Menonita Puerto Rico 432 Senior Care Partners P.A.C.E. Michigan 266 Senior LIFE Greensburg, Inc. Pennsylvania 423 Senior LIFE Johnstown, Inc. Pennsylvania 423 Senior LIFE Lehigh Valley, Inc. Pennsylvania 424 Senior LIFE Washington / Uniontown / Greene Pennsylvania 424 Senior LIFE York, Inc. Pennsylvania 424 Sidney Hillman Health Centre Illinois 184 Solis Health Plans Florida 149 Solstice Benefits, Inc. Florida 149 Stockton PACE California 92 Sunsrise Advantage Plan Virginia 499 The Health Plan - Health Plan of the Upper Ohio Val West Virginia 517 Trinity Health PACE Michigan 269 Tufts Health Plan Rhode Island 437 Union Pacific Railroad Employees Health Systems Utah 488 United Healthcare Community Plan - San Diego California 95 United Mine Workers of America Health & Ret District of Columbia 127 UnitedHealthcare Community Plan Ohio Ohio 386 UnitedHealthcare Conmmunity Plan Oklahoma Oklahoma 391 UnitedHealthcare of Alabama Alabama 8 UnitedHealthcare Oxford Connecticut 121 Univera Healthcare New York 354 University of Maryland Health Advantage Maryland 234 Valor Health Plan Ohio 387 Versant Health Maryland 235 Via Christi HOPE Kansas 207 Village Care New York 355 Vitality Health Plan of California California 98 Vivida Health Florida 152 Wabash Memorial Hospital Association Illinois 187 Wellcare of Texas Texas 483 WellDyneRx Colorado 110 West Virginia Family Health Pennsylvania 428 Western Sky Community Care New Mexico 325



Previously Listed Organizations Deleted in 2019

Company State Accesscare North Carolina Aetna Health Plans of Michigan Michigan Aetna Health Plans of Pennsylvania Pennsylvania Aetna Pharmacy Management Connecticut Alliant Health Plans Texas Amerigroup Kansas, Inc. Kansas Amerigroup of Florida Florida Anthem Blue Cross California Better Health Florida Blue Cross & Blue Shield of MI Metro Service Center Michigan Blue Cross & Blue Shield of MN RiverPark I Office Minnesota Blue Ridge PACE Virginia Blue Shield of California - Los Angeles California CareAllies Pennsylvania CareFirst Blue Cross & Blue Shield - Baltimore Maryland CareFirst Blue Cross& Blue Shield- DC Dist of Col. CareLink Complete Health Arkansas Celtic Insurance Company Illinois ChiroCare Minnesota CIGNA HealthCare of New York, Inc New York Cigna HealthCare of Texas Texas Cigna Healthspring - Tennessee Tennessee Cleveland Health Network Ohio Comprehensive Senior Care Corporation PACE Michigan Coventry Health Care of Illinois Illinois Douglas County IPA Oregon Eastern Connecticut Physician Hospital Organization Connecticut Easy Choice Health Plan of New York New York GuildNet New York Gundersen Lutheran Health Plan, Inc Wisconsin Harvard Pilgrim Health Care -Quincy Office Massachusetts HealthCare USA of Missouri Missouri HealthNet - Corporate California HealthPartners Central MN Clinics Minnesota Healthy Palm Beaches Florida Highmark Blue Cross Blue Shield Delaware Delaware Hudson Health Plan, Inc. New York Humana Health Plan - Houston Texas Humana Health Plan - Jacksonville Florida Humana Health Plan Omaha Nebraska INOVA Cares for Seniors PACE Virginia Kaiser Permanente - Colorado - Aurora Colorado Kaiser Permanente - Colorado - Colorado Springs Colorado Kaiser Permanente - Corporate - Harrison Office California LifeWise Health Plan of Oregon Oregon Lovelace Health System New Mexico



Previously Listed Organizations continued Company State Magellan Health Connecticut Mercy ACO, LLC Missouri Mercy Life PACE Massachusetts MetLife Dental New York Molina Healthcare - Louisiana Louisiana Molina Healthcare - Virginia Virginia Molina Medicaid Solutions - Idaho Idaho Molina Medicaid Solutions - Maine Maine Molina Medicaid Solutions - West Virginia West Virginia Monarch Healthcare (OptumCare Accountable Care) California National Care Network Texas Network Health Plan Wisconsin Wisconsin New Courtland LIFE Pennsylvania New West Health Services Montana New York-Presbyterian Community Health Plan New York Nurtur Health Connecticut OptiCare Managed Vision North Carolina Palladian Muscular Skeletal Health New York Physicians Plus Insurance Corporation Wisconsin Preferred Care Partners Florida Presence Health Partners Illinois Qualis Health Alaska Alaska Quartz -Unity Health Plan Wisconsin Riverside PACE Virginia Saint Joseph PACE Michigan SecurianConnect Dental Minnesota Smilecare Florida St. Francis Care Connecticut Stratis Health Minnesota Surescripts - Minnesota Minnesota Telligen Iowa The Vitality Group Illinois UMWA Health and Retirement Funds Dist of Col UnitedHealthcare Community Plan - Delaware Delaware UnitedHealthcare of California - Northern California California UnitedHealthcare of Florida - Orlando Region Florida UnitedHealthcare of Mississippi Mississippi Universal American New York Universal American - Texas Texas Wellmont Health System Tennessee West Michigan Physicians Network Michigan



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 "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 20+ year-old publisher delivering healthcare business information resources. For more information, or to place orders on these and other HealthQuest publications, go to: www.healthquestpublishers.com or call (209) 577-4888.

HQ Online subscriptions provide searchable on-line 24/7 access to Health Care Executive Profiles, The National Managed Care Leadership Directory and more. 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.

http://www.healthquestpublishers.com/



The ideal resource for collaborating, networking, recruiting, marketing or monitoring of ACOs with 672 pages that encompasses: (1) Organizational Directory of 731 selected ACOs along with a listing of 4,213 key individuals with leadership or operational involvement and direct phone/ email contact information when available; (2) Executive Profiles providing contact and biographical information for 246 executives and thought leaders involved with Accountable Care; and (3) Indexes for convenient navigation and reference organized six different ways. Priced at $239 softcover and $198 pdf with add-on database available for additional purchase.

The Medicaid Managed Care Directory 2019 is the ideal resource for collaborating, networking, recruiting, marketing or monitoring of Medicaid managed care organizations and state agencies. Included are organizational directories of state and national Medicaid MCOs, as well as state Medicaid agencies. Key staff are listed for each organization. Also included are Executive Profiles of Medicaid managed care thought leaders and national executives, as well as indexes. The Directory is available as a 380 page softcover book for $219, or in electronic pdf format for $178, with 431 Medicaid managed care organizations and 52 state agencies listed, representing 3,287 key staff positions including direct phone and email contact information when available. A database/pdf bundle is available for $395.

Custom select your healthcare business mailing from the B2B Database. Select from 53,100+ healthcare business professionals. 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 e-mail, in Excel or Text delimited formats. Pricing is based on $95 per 1,000 records, with a minimum order of $495

national managed care leadership directory 2019national managed care leadership directory 2019 ......

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