Senior Director of Benefit Coding, Subscriber Services
Division (SSD), Health Care Service Corporation (HCSC)
||Gena Misouria is the Senior Director of
Benefit Coding in the Subscriber Services Division (SSD) at
Health Care Service Corporation (HCSC), the nation’s largest
customer-owned health insurer operating Blue Cross and Blue
Shield Plans in Illinois, New Mexico, Oklahoma and Texas.
Mrs. Misouria joined HCSC in 1997 and has served in a
leadership role for various SSD teams including customer
service, claims, financial suspense and technical support.
Prior to joining HCSC, Mrs. Misouria served in the US Air
Force in the Public Health arena. She was stationed at
Tinker Air Force Base in Oklahoma City, Oklahoma and Dyess
Air Force Base in Abilene, Texas.
A native of Chapin, South Carolina, she graduated from
Chapin High School in Chapin, South Carolina. She earned her
bachelor's degree in Liberal Arts and her Masters of
Organizational Development from Abilene Christian University
in Abilene, Texas.
Mrs. Misouria resides in Murphy, Texas, with her husband,
Jeff, an Account Manager in the Major National Accounts
department at HCSC, and their three children, Malaysia (15),
Davon (13) and Lailah (3).
Jerry D. Kneller
Senior Director of Production Reliability and Operational Excellence,
Information Technology Division, Health Care Service
||Jerry D. Kneller is the Senior Director of
Production Reliability and Operational Excellence in the
Information Technology Division at Health Care Service
Corporation (HCSC), the nation’s largest customer-owned
health insurer operating Blue Cross and Blue Shield Plans in
Illinois, New Mexico, Oklahoma and Texas.
Mr. Kneller joined HCSC in 2004 and has served in a
leadership role for various IT Governance and related
process improvement activities for the company. Areas of
focus include Regulatory Initiatives (i.e., Health Insurance
Portability and Accountability Act, National Association of
Insurance Commissioners Model Audit Rule), Process
Excellence, Policy Management, Risk Management and Audit
Prior to joining HCSC, Mr. Kneller served in various staff
positions and leadership roles at Sears, Roebuck, and Co.,
in Hoffman Estates, Illinois.
A native of Chicago, Illinois, he graduated from Lions
Township High School in LaGrange, Illinois. He earned his
bachelor's degree in Finance and Management Information
Systems from Illinois State University in Normal, Illinois,
and he earned his Masters of Business Administration from
the University of Chicago in Chicago, Illinois.
Mr. Kneller resides in Chicago, Illinois, with his wife,
Shannon, an Information Technology analyst in the Investment
Banking Division of UBS AG.
Director, Health Industries Advisory,
||George Mansour, is a Director in the Health
Industries Advisory at PricewaterhouseCoopers.
Previously he served as Corporate Vice President,
Products and Pricing at Blue Cross and Blue Shield of
Illinois for three years, and prior that was a Managing
Principal at ORION for thirteen years.
He has an MBA in Finance, Strategy, Economics from The
University of Chicago - Booth School of Business, and
received his undergraduate degree at Case Western Reserve
Katie Kuesters Huyck
Consultant, Health Industries Advisory,
||Katie Kuesters Huyck is a
Consultant, Health Industries Advisory, at
David MacLeod, Ph.D., FHIMSS, CISSP
Vice President Services
The TriZetto Group
||David MacLeod, Ph.D., FHIMSS, CISSP is Vice President Services for The TriZetto Group, with responsibility for Research & Development. Dr. MacLeod has almost 30 years of healthcare information technology systems design & development experience, with an emphasis on the transformation of healthcare delivery and financing.
Previously, Dr. MacLeod was the Director of Systems Delivery, Sourcing and Operations and Chief Information Security Officer for The Regence Group; and Chief Information Security Officer at Medicare NW, a contracted CMS Data Center & Fiscal Intermediary. His prior experience also includes directing Healthcare IT organizations with integrated Delivery Systems and Life & Health entities.
Dr. MacLeod was appointed by Secretaries Thompson and Ridge to advise U.S. HHS and DHS on the protection, first responders and reconstitution of the healthcare and public health sectors of the national infrastructure. He is a Fellow of the Healthcare Information Systems Society and a Certified Information Systems Security Professional.
Joseph Nichols MD
ViPS, a General Dynamics IT Company
||Dr. Joe Nichols, a board certified
orthopedic surgeon, is the Medical Director at ViPS, a
General Dynamics IT Company. He is responsible for the value
measurement products including Healthcare Effectiveness Data
and Information Set (HEDIS®) reporting and provider
profiling applications, as well as oversight for healthcare
Dr. Nichols’ healthcare information technology experience
spans provider, payer and vendor. He has held positions in
executive management, system design, logical database
architecture, consulting and healthcare value measurement.
He has participated in efforts supporting cross enterprise
data-related quality and efficiency initiatives. He was a
contributing author to a university text on electronic
health records, specifically the data dictionary development
Dr. Nichols has presented on healthcare data, standards
and quality on behalf of organizations such as Centers for
Medicare & Medicaid Services (CMS), Healthcare Information
and Management Systems Society (HIMSS), and the American
Academy of Orthopedic Surgeons.
Pendulum HealthCare Development Corporation
||William J. DeMarco MA CMC is the President
& Chief Executive Officer of DeMarco & Associates, Inc., a
national, independent healthcare consulting firm
specializing in healthcare delivery system redesign and
transformation. The firm specializes in research and
strategy development, organization development of successful
provider owned enterprises and marketing management
including product design and promotion.
Mr DeMarco is recognized as a leader in the research, design
and implementation of community based healthplans. Since his
involvement in several startup health plans in Minnesota in
the early 1970s Bill and his team of management consultants
clinical specialists and reimbursement analysts have
assisted employers and physicians in developing better
relationships with insurers up to and including developing
local solutions to deliver and finance care.
Using Health Services Research from its affiliate Pendulum
HealthCare Development Corporation www.pendulumhealth.com,
DeMarco and Associates assists both provider and employer
clients in addressing prospective payment approaches in
order to build Pay for Performance models to develop direct
employer/provider contracting entities, benchmarking
collaboratives under the new value purchasing legislation as
well as single specialty centers of excellence. Mr. DeMarco
is a well-known author having written or contributed to over
a dozen books on managed care topics. He holds a master’s
degree in organizational development from DePaul University.
He a past faculty member of Loyola Law School’s graduate
program and was recently awarded the Follomer Bronze award
from the Healthcare Financial Management Association for his
outstanding service and contributions to HFMA chapters and
Rong Yi, PhD
||Rong Yi, PhD is a senior consultant at
Milliman’s Boston office. She joined the firm in September
2009. Dr. Yi has extensive experience in risk adjustment and
predictive modeling for healthcare, workers compensation,
and other fields. She has worked with government agencies,
health plans, managed care organizations, provider
organizations, employers, workers compensation insurers, and
researchers in the U.S. and other parts of the world. She is
a frequent speaker at professional and academic conferences.
Dr. Yi’s expertise includes Medicare and Medicaid risk
adjustment, risk adjusted underwriting, risk selection and
migration, provider pay-for-performance and contracting,
predictive modeling for risk stratification and program
evaluation, data-driven cost and utilization management,
system reforms, and health reforms, etc. She pioneered in
the areas of predictive modeling for workers compensation
medical management, risk adjusted episodes for provider
profiling, risk adjustment models for group underwriting,
and predictive models for the Patient-Centered Medical Home.
She also led the adoption of diagnosis-based risk adjustment
in the recent German health reforms, and is assisting
foreign government organizations in their research and
strategy for their future health reforms.
Prior to joining Milliman, Dr. Yi led research and
consulting at DxCG (now Verisk Health), and was responsible
for its major releases of the risk adjustment and predictive
models that are now widely used in the healthcare industry,
as well as numerous custom models and tools developed for
specific client applications.
Jaan Sidorov, MD, MHSA,
Sidorov Health Solutions
M.D. is a general internal medicine physician with over 20
years experience in primary care, disease management and
population based care coordination. Dr. Sidorov is a Medical
Director in the Medical Informatics Center of Excellence at
EDS, an HP Company. Dr. Sidorov has numerous peer-reviewed
publications, two of which were named as “Best Article” by
DMAA and one of which on the electronic medical record was
listed as “most read” by the prestigious health policy
journal Health Affairs. He had been quoted in the Wall
Street Journal and National Public Radio’s All Things
Considered as well as the Disease Management Advisor. He is
the author of the widely read “Disease Management Care
Blog,” available at
http://diseasemanagementcareblog.blogspot.com / and is a
much sought after speaker who has presented research
findings nationally and internationally in the areas of
health services research, disease management and managed
He received his medical degree from the Pennsylvania State
University College of Medicine, and did his internship and
residency at the Dartmouth Hitchcock Medical Center in
Hanover, New Hampshire. He has also served as a Chief
Resident, at Reading Hospital, Reading, Pennsylvania. He
received additional training in health services research
through the Faculty Development Fellowship of the University
of North Carolina at Chapel Hill and in managed care through
the American Association of Health Plans certified managed
care executive program. He also has a Masters Degree in
Health Services Administration from Marywood University in
Scranton Pennsylvania. He is a past Treasurer and member of
the executive committee of the Board of Directors of the
Disease Management Association of America (DMAA). Dr.
Sidorov is board certified in internal medicine and is a
Fellow of the American College of Physicians. He is a
Medical Director in the EDS Medical Informatics Center of
Excellence and is President of PMSLIC, the largest physician
malpractice insurance company in Pennsylvania. He also holds
a 4th Degree Black Belt Master Rank in Chimukwan style Tae