Susan Cimbalo is one of the foremost industry experts in risk adjusted predictive modeling and payment systems. Susan has 18 years of experience working with enrollments and payments in Medicare Managed Care, and healthcare operations. She is been a leader in Medicare compliance and revenue recovery projects since 1998 for some of the most successful health plans in the United States, including HIP Health Plans of New York (now Emblem Health). She managed a Medicare Choices demonstration program for the University of Virginia Medical Center and a claims system conversion for George Washington University Health Plan. Susan is often sought out for her opinions, commentary and expertise in the Risk Adjustment field, making numerous speaking engagements and often referenced in national publications.
Prior to working in Medicare, Susan was the pension and benefits manager for Harvard Management Company. Susan has her MBA from Boston University specializing in Public Management and a bachelor's degree, magna cum laude, in Accounting and Finance from the University of Alabama.
Marc Wise has over 15 years experience in building business service organizations. Before joining Health Risk Partners, he served as Chief Operating Officer for FedMed, Inc. a provider of network whitespace outsourcing based in Rockville, MD. He spent the eight years prior to FedMed as a Senior Vice President for NCO Group, Inc., a global business process outsource solutions company.
Prior to 1995, Mr. Wise worked for DiMark Inc., a preeminent health care and insurance direct marketing company, where he provided direct marketing consulting services. Marc holds a Bachelor of Business Administration from Delaware Valley College.
Brian Boyce holds multiple certifications which include Clinical Bioethics from Georgetown University; Total Quality Management from the US Air Force; Medical Survival from the USAF School of Aerospace Medicine, and a Medical Service Specialist from the US Air Force. He was also trained in Six-Sigma through the Juran Institute as well as Model-Netics, a comprehensive management training and development program. He is a veteran of the US Air Force where he began his healthcare career in Aeromedical Evacuation (flight nursing). In this capacity he was trained to be the healthcare provider when there was no physician present. This training included minor surgery, primary care, emergency treatment, biological and chemical warfare response and even delivering babies. He has over 16 years of clinical nursing experience and trained corpsmen in clinical procedures when in the military. He has several awards and accolades from his military career and is a veteran of Desert Storm.
Brian has over 10 years of experience in Healthcare Operations and Physician Practice Management and is very knowledgeable in JCAHO, HIPAA, CLIA, & OSHA. He has provided physician practice audits, start ups and divestitures nationally. He is an approved PMCC coding instructor and teaches new coding students at Practice Integrity. Additionally, Brian has been trained by AHIMA as an ICD-10 instructor. Brian has spoken at many national events, to include Medicare conferences and has authored many articles for healthcare management, quality of care issues and coding education. He has a strong interest in ethics, patient safety, and clinical issues. He is a member of the Medical Group Management Association and the American Academy of Professional Coders and is the 2011 term President for his local AAPC chapter. Brian volunteers on his State Central Committee as well as local state caucuses and advocates for healthcare issues and other interests.
Holly Killian is Director of Operations for HRP. She has extensive hands-on experience in operations, revenue enhancement and management. Before joining the HRP team, Holly worked at HealthPort, a healthcare information technology company, for twelve years. During the last eight years, Holly served as Operations Director where she was instrumental in the start-up of Inova Health Systems, HealthPort's largest ROI partner site, and managed profit and loss control both external and internal.
Holly received her degree from DeVry Institute of Technology.
Brandy Hylton is a Director of Client and Data Services for HRP. Brandy has extensive experience in the healthcare industry including physician practice management. For 6 years Brandy worked as a senior analyst in the Actuarial Department of a national health plan that serviced over two million Medicare and Medicaid beneficiaries where she was instrumental in the preparation of bids for Medicare Parts C and D.
Brandy received her bachelor's degree in Finance from the University of South Florida.
Lydia Huber has 18 years of experience in health care administration. Prior to joining HRP, Lydia was instrumental in starting both a Medicare and Medicaid managed care product for HealthNet of Kansas City, and was responsible for all aspects of these product lines. She spent some time as Vice President of Marketing, Planning and Development for a regional hospital before returning to managed care consulting for various health care organizations including hospitals and Medicare, Medicaid and commercial health plans. Lydia has her Masters in Health Administration from Cornell University and a bachelor's degree in Industrial Engineering from Kansas State University.
Pamela Price is a Senior Healthcare Consultant for HRP. Pam has over 20 years of experience within the Healthcare industry. Prior to joining HRP, Pam was the Vice President of Finance for a Florida HMO, where she led the Risk Adjustment efforts and ran various data validation and medical record review projects. Prior to that, Pam spent three years as the Chief Financial Officer of a Physician Group practice that also provided laboratory services and offered a Medicare Supplemental Cost plan. Pam also spent twelve years in the Pharmaceutical industry, working for Bristol-Myers Squibb. During that time, Pam worked in the following capacities: mergers and acquisitions, joint ventures, internal audit, strategic planning and budgeting, Rx-to-OTC switches, new product development, and brand management. Pam has her Master's degree in Finance, International Business and Management from New York University's Leonard N. Stern School of Business and a Bachelor's degree in Business Economics from University of California at Santa Barbara. Pam is a Certified Public Accountant.
Jamie Wells is Health Risk Partners' Chief Operating Officer. Jamie has extensive healthcare and disease management expertise, with specific areas of focus in performance improvement, quality, data management, metrics management, application development, reporting, and business intelligence. Prior to joining HRP, Jamie held Vice President positions with one of the nation's largest health plans, as well as with a Fortune 500 national and international IT services company. With over 30 years of business management and information technology experience, he has streamlined operations and delivered solutions to government and commercial clients across the U.S. and abroad.
Jamie holds a bachelor's degree in Business Administration from Kennedy-Western University.
Larry Moncol has over 10 years of Healthcare information technology experience, with specific expertise in application development and information management for software products supporting Care and Medical Management. Prior to joining HRP, Larry was the Director of Application Development with one of the nation's largest health plans, a Fortune 50 company. In that role he directed the development of the enterprise Care Management Application Suite, as well as the enterprise Customer Service and Call Center Applications.
Before that, Larry was a software development consultant for several Fortune 500 companies. Larry holds a bachelor's degree in Political Science from James Madison University.
Maria Calcaterra has over twenty years of domestic and international experience managing operations, compliance and quality assurance under commercial time constraints and rigid standards imposed by multiple US and European regulatory agencies. Originally trained as a microbiologist with a degree from Georgia Tech and multiple certifications in electron microscopy, her executive career has focused on the production management of highly sensitive client information regulated and certified by agencies to include not only CMS but also the FDA, EPA, NIOSH, NIST and the French L'Institut National de l'Environnement Industriel et des Risques (INERIS).
In addition to healthcare, her management and consulting experience includes the financial services and environmental industries in operations across the U.S. as well as Paris and Lyon, France.
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