Improving audit readiness and plan performance with respect to Appeals and Grievances is a sure-fire way to boost member satisfaction ratings. Analyzing the common conditions in Part C ODAG and Part D CDAG and understanding the appropriate corrective actions and remediation and validation outcomes is vital for success in the MA market.

This event brings together leading experts from MA plans and solutions-providers to help you:
  • Build and operationalize an effective monitoring program
  • Apply real-time compliance systems to Appeals and Grievances processes
  • Sustain continuous ODAG and CDAG readiness
  • Combine Operational and Compliance best practices in your Universe to optimize a accuracy and effectiveness
  • Develop an effective Compliance mindset
  • Understand Audit Lessons from your peer plans
  • Identify and focus in on key Member Dissatisfaction drivers in how Grievances are handled organizationally
  • Prevent Payment Disputes from becoming Grievances

Plus: Gain a comprehensive understanding of the latest CMS Guidelines and ODAG & CDAG Protocols and the key issues you need to zero in on to ensure compliance, audit readiness and member satisfaction.


2022 Speakers
IU Health, Inc.

Tammy Chadd, CHC, CHPC

Compliance Program Manager
BlueCross BlueShield of North Carolina

Nicole Henderson, MBA, CSM

Director, Stakeholder Escalations
MMM Holdings LLC

Michael Soto Maldonado, MHCM

A&G Manager, Medicare Advantage & Medicaid
SummaCare

Deborah Marine, JD, CHC

Chief Compliance Officer,Health Plan Operations
UPMC Health Plan

Rebecca Richards

Senior Manager, Medicare/SNP Complaints and Grievances
CHRISTUS Health Plan

Krishelle Watts, MHA

Manager of Regulatory Compliance
Cody Consulting Group

Hannah LaMere, MA

Sr. Director, Consulting
Cody Consulting Group

Michelle Larson, CHC

Sr. Consultant, Compliance Solutions
Health Plan of San Mateo

Karla Rosado-Torres

Medicare Product Manager
Virtusa

Alok Mandal

Vice President - Technology
Inovaare

Gabe Viola

Senior Vice President, Customer Relations and Implementations
Inovaare

Craig Giangregorio

Senior Vice President, Healthcare Solutions
SummaCare

Tracy Jones

Senior Compliance Coordinator
2022 PARTNERS
Platinum Sponsor
  • Strategic Solutions Network (SSN), based in Boca Raton, FL, is the parent company of the Medicare Risk Adjustment & Revenue Management Management, Plus Quality and Star Ratings and a series of related conferences.
Gold Sponsor
  • Strategic Solutions Network (SSN), based in Boca Raton, FL, is the parent company of the Medicare Risk Adjustment & Revenue Management Management, Plus Quality and Star Ratings and a series of related conferences.
  • Strategic Solutions Network (SSN), based in Boca Raton, FL, is the parent company of the Medicare Risk Adjustment & Revenue Management Management, Plus Quality and Star Ratings and a series of related conferences.
Bronze Sponsor
  • Strategic Solutions Network (SSN), based in Boca Raton, FL, is the parent company of the Medicare Risk Adjustment & Revenue Management Management, Plus Quality and Star Ratings and a series of related conferences.

Who Should Attend:

From Medicare Plans, VPs, Directors and Managers of:

● Appeals and Grievances ● Claims ● Compliance ● Complaints and Appeals ● Operational Compliance ● Revenue & Clinical Operations
● Regulatory Oversight & Compliance


Also of Interest to:

● Clinical Innovations and Performance ● Clinical Operations ● Quality of Care ● Utilization Management ● Medicare Audit ● Pre-Certification
● Customer Care ● Member Experience ● Star Ratings


And from Solution Provider Companies:

● Business Development ● Payer Product Innovations ● Government Health Care Program Development ● Revenue Recovery Solutions
● Audit Compliance Solutions ● Processing and Workflow Solutions