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Karen Hale (Senior Adviser, Technology)

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An executive with a broad public and private healthcare knowledge base and committed to the transformation and improvement of the delivery of healthcare and outcomes through the use of emerging technologies. Recognized as a leader in strategic and business development sales and initiatives with Managed Care Organizations (MCOs), health systems, hospitals, providers, and healthcare technology entities. Healthcare advisory services including Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) direction and vision, vendors, payers, private sector clients, and industry organizations. Also, an active participant and instrumental key member in multiple industry collaborative organizations and committees for the betterment of technology solutions in the delivery of healthcare.

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Kris Vilamaa (Senior Adviser, Behavioral Health)

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Kris has over eighteen years of behavioral health, health information technology and health policy experience.  Kris has lead major state system transformations including planning for Medicaid Transformation, development of new behavioral health treatment standards, service definitions and leading large information technology system implementations. He has worked with community mental health providers, behavioral health county boards, federally qualified health centers, managed care organizations, state and county health departments, safety net hospitals and large health systems to enact meaningful initiatives.  Prior to joining HCP, he was Director of Behavioral Health for Germane Solutions and the first Chief Information Officer for the Alabama Department of Mental Health.

Expertise

  • Worked with providers and behavioral health county boards to develop transition strategies and support during a large managed behavioral health carve-in effort in Ohio.
  • Assisted behavioral health providers with EHR optimization strategies.
  • Developed an insurance strategy for a large county health department in Texas.
  • Developed and executed the IT vision and strategy for the Alabama Department of Mental Health, which was named one of the Elite 100 IT organizations in the country by Information Week under his leadership.
  • Led development of a strategic plan for implementation of an integrated care pilot project for a Local Managing Entity/Managed Care Organization in North Carolina.
  • Led the implementation of a case management and claims processing information system for the Alabama Department of Mental Health – Substance Abuse Services Division that generated an additional $3 million in revenue for the state in the first year by appropriately sending claims for Medicaid-eligible services.
  • Wrote a successful $1.6 million HRSA grant for a Health Center Controlled Network managed by the primary care association in Ohio.
  • Led Strategic Planning for multiple county boards, community health centers and community behavioral health centers in Ohio, Connecticut, Hawaii and South Carolina.
  • Developed the State Health Improvement Plan for the State of Wyoming Department of Health and the Community Health Needs Assessment for Dallas County, Texas.
  • Secured and served as the project director for a $9 million federal grant to the State of Alabama for implementing a statewide initiative for the prevention of substance abuse.
  • Serves as a grant reviewer for the Substance Abuse and Mental Health Services Administration and the Institute for Healthcare Improvement.

 

Education

 

  • Purdue University, West Lafayette, IN
  • Bachelor of Arts, Political Science (Emphasis in Public Policy and Public Administration)

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Cindy Becker (Senior Adviser, State Policy and Community Engagement)

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Cindy Becker is a health professional with more than 25 years of progressive leadership experience in Medicaid funding and delivery systems.  She has a demonstrated record of achieving results with a strong focus on collaboration, communications, and customer service.

Becker has significant experience in health systems in both the public and private sectors.  She is well versed in health transformation – as a founding member of Oregon’s largest Coordinated Care Organization (CCO) now serving more than 230,000 members and a senior executive at the second largest CCO serving 125,000 members.  She has also held executive positions with state and local governments, serving as deputy director of the state’s health and human services agency and director of health for one of the large metropolitan counties.

A few examples of her work include:

  • Redesigned services to increase access, integration, and diversity
  • Expanded partnerships to streamline delivery systems
  • Removed organizational silos, aligning systems, structure and people
  • Strengthened relationships among various stakeholders
  • Instituted performance metrics and process improvements across multiple programs
  • Coordinated state and local legislative agendas

Becker is adept at bringing groups together to plan and accomplish strategic priorities.  Her passion is getting systems, policies, and resources aligned to achieve positive outcomes for individuals, families, and communities. Her experience in the private and government sectors, combined with her consulting work, uniquely positions her as a go-to person with the skills, abilities, and insights to provide exceptional services to clients.

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Tom Kaye (Senior Adviser, Pharmaceutical Solutions)

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RPh., DPH., MBA, FASH

Tom has provided innovative and dynamic leadership in pharmacy management for over 25 years using broad work experiences in State affiliated Medicaid, Medicare MA/PD/SNP programs. Other highlights from his experience include:

  • Graduate of the schools of pharmacy and master program in business at Southwestern Oklahoma state university and Oklahoma City school of business
  • Maintains licensees in pharmacy for the states of Oklahoma, Kansas, Kentucky and Arkansas
  • Serves as strategic pharmacy consultant for several national and regional managed care plans with efforts to improve operations, efficiencies and patient outcomes by the deployment of technology, benefit structure, payer relations and data analytics.
  • Past assignments have been with national and regions payer plans, MCO’s and healthcare providers in various models including directorship of pharmacy departments.
  • Strategic consults of manufacturers
  • Regulatory compliance – State- Federal (Medicaid – Medicare)
  • Technology review/ assessment and emerging markets
  • 340b
  • Pharmacy pricing, costing and rebating
  • PBM (pharmacy benefit manager) details
  • Specialty pharmacy deployment
  • Pharmacy and health care benefits design
  • Provider incentives for improvement in plans quality achievements

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Mary Doherty (Senior Adviser, Health Plan Solutions: LTSS Focus)

RN, MSN, DNP

With more than 25 years experience as a clinician and operations expert in the healthcare space, Mary brings critical insights for clients working on health home and MLTSS programs. She has a strong industry knowledge of health insurance, managed care, Medicare, and Medicaid.  She helps clients develop strategies to increase quality, improve operational efficiencies and optimize revenue opportunities.  

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Pamela Tyranski (Senior Adviser, Health Plan Solutions)

Pam has over 30 years of experience in executive leadership roles in healthcare operations, program development and support in the public and private sectors. Her accomplishments include restructuring and establishing clinical and non-clinical programs, writing and evaluating proposals, strategic planning, compliance and program integrity. For clients and former employers, she has developed strategic partnerships in various arenas. Specializing in clinical and government compliance, individual case and situational analysis, her expertise has contributed to the operational success of many government, for-profit, and not-for-profit entities nationwide.

Pam currently serves on the Delaware Board of Nursing as a Board member, formerly as President and chairs the Limited Lay Administration of Medications Committee (formerly AWSAM). She served on the National Council of State Boards of Nursing (NCSBN) Committee on Long Term Care, and as the Delaware Delegate and on the Delegate Assembly Resolutions Committee. Pam donates her knowledge and time to various community and charitable agencies, and served as a healthcare advisor to Delaware Legislators.

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Clay Farris (Practice Lead, Client Solutions)

Clay has advised CMS administrators, state Medicaid Directors, health plan CEOs, technology COOs and a wide range of other clients in the healthcare industry.  His unique blend of management consulting, project management, policy making and analytics help deliver on-time, actionable results for a wide array of business challenges. His Weekly Medicaid Roundup is read and loved by more than 10,000 professionals in the Medicaid industry.

His experience includes policy making at both the federal (CMS) and state levels (State of Georgia), management consulting for large organizational change initiatives, big data solution sales and implementation and cutting-edge analytics.

He currently leads key project components related to consultation design, Medicaid subject matter expertise and project management. He has a masters in Health Policy from the Johns Hopkins Bloomberg of School of Public Health and is also a Certified Internal Auditor.

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