Rise

Gail Blacklock Chief Compliance Officer 

Elite Health Plan, Inc. 

Gail’s experience includes 25 plus years working in health care as a compliance officer and consultant in the Medcare arena. As an experienced Compliance Officer for health plans her approach to compliance involves dedication of the entire organization and helping companies develop compliance and operational strategies. This top-down organizational approach ensures support and accountability from each staff member and assists the Compliance Department with implementation and management of the Plan’s Program.  Gail’s responsibilities include implementing federal and state regulations, licensing/applications, risk assessments, work plans, compliance programs, monitoring, auditing & oversight programs for health plans and delegated entities; lead and resolution on FWA incidents; training on FWA, HIPAA, and compliance, and operations and IT Systems implementation. 

Deb Curry Risk Adjustment Programs Director

Medical Mutual

Deb joined Paramount Healthcare in May 2013, which was bought by Medical Mutual of Ohio in 2024, and oversees the Risk Adjustment, Coordination of Benefits, and Subrogation departments.

Prior to her position with Paramount she had 21 years’ experience working with the State of Ohio workers’ compensation program, both for the government and a contracted managed care organizations. She came to Paramount with extensive knowledge in medical coding, provider billing and education, Medicare payment methodologies, quality assurance, and regulatory compliance.

Deb attended The University of Toledo for both her undergraduate and graduate degrees and currently holds a Masters of Business Administration with major in Healthcare Systems Management. She is an active member of the American Health Information Management Association (AHIMA) and is a Registered Health Information Administrator (RHIA), Certified Documentation Integrity Practitioner (CDIP), and Certified Coding Specialist, physician based (CCS-P). Deb is also an active member of the America Academy of Professional Coders (AAPC) and is a Certified Risk Adjustment Coder (CRC). Additionally, Deb is a member of RISE and holds certificates as a Risk Adjustment Practitioner (RAP) and Advanced HCC Auditor (AHCCA).

Deb is a Board Member of the University of Toledo Health Information Administration Advisory Board and Health Information Technology Advisory Committee at Owens Community College.

Jennifer Del Villar Vice President of Operations 

Elite Health Plan, Inc. 

Jennifer Del Villar has over 30 years experience working in the health care industry. A good portion of that time has focused on serving in operations and as a Medicare Compliance Officer for both start-up and established Medicare Advantage Prescription Drug. Jennifer’s current role includes leadership over numerous operational processes, systems, and teams to ensure they are compliant, effective, and strategic. Jennifer’s motos she follows daily are that “compliance is everyone’s responsibility” and “everything we do touches a member.”

Jennifer holds a Certification in Healthcare Compliance (CHC) through the Health Care Compliance Association and a Professional Academy for Healthcare Management (PHAM) certification from AHIP.

Tina Dueringer CEO/Principal Advisor

Dueringer Advisors, Inc

Tina Dueringer, BSN, RN, CCM, PCC, is the CEO and Principal Advisor at Dueringer Advisors Inc., a distinguished consulting firm dedicated to supporting health plans, vendors, and leaders in the health insurance and provider sectors. With a robust background spanning Medicare Advantage, Medicaid, Duals, ACA, and commercial markets, Tina brings extensive expertise in care management, utilization management, clinical quality, Model of Care development, Stars ratings, HEDIS measures, and accreditation standards such as NCQA and URAC. 

Tina's career is marked by strategic insights into health plan operations, including strategic planning, joint ventures, partnerships, delegated relationships, and the advancement of value-based care models. She is deeply committed to advancing Health Equity, Population Health, and integrated care initiatives across the industry. 

Previously, Tina served as Vice President of Clinical Quality and Stars at Rebellis Group, specializing in Medicare Advantage and government consulting. Her leadership journey includes pivotal roles at Cityblock, Blue Cross Blue Shield of Arizona, and the Wisconsin Department of Health Services, Medicaid Policy Division. 

Tina earned her Bachelor of Science in Nursing and holds a post-graduate certification in Population Care Coordination from Duke University. She is also a Board-Certified Case Manager (CCM), underscoring her dedication to enhancing healthcare delivery and outcomes through comprehensive care coordination strategies. 

Mark Dwinnells Sr. Director, Privacy Officer & Medicaid Compliance Officer

Commonwealth Care Alliance

Mark Dwinnells, CHC, has over a decade of experience in the operation of Part C, Part D, Medicaid, Medicare, HIPAA, state privacy, and other health plan regulations. He is the Privacy and Medicaid Compliance Officer with Commonwealth Care Alliance, Inc., with 9 years’ experience directly with CCA's dual eligible plans. Mark in the Health Plan Compliance role has overseen CCA with its ventures beyond Medicare-Medicaid duals into MAPD and back out again, recently expanding on the reach and depth of the Privacy program. His experience includes building out compliance governance functions, spanning buildout of committees, policies, reporting, communications, monitoring, and responses to investigations. This includes consulting and guidance to business units, validation of corrections or implementations, and regular or targeted interactions with regulators. 

Michelle Fogg Manager, Operational Compliance

Jefferson Health Plans

Tammy Gilliland Supervisor of Outcomes Medical Management

Government Employee Health Association, Inc.

Tammy Gilliland, RN, BSN, CCM, CPC, is a seasoned supervisor on the Outcomes and Reporting team at G.E.H.A Insurance, with over 20 years of experience in the health insurance industry both UM and fraud, waste and abuse and nearly two decades as a registered nurse. Tammy brings a unique blend of clinical expertise, claims knowledge, and investigative skills to the role.  Throughout her career, Tammy has demonstrated an ability to leverage critical thinking developed through nursing practice to enhance health insurance processes.  Tammy possesses strong investigative skills to effectively address complex issues.   She has played a key role in improving the Utilization Management Appeals process at G.E.H.A, transforming it into a comprehensive, end-to-end review system that ensures thorough resolution of each case while apply lessons learned to decrease unnecessary appeals.  

Tracy Jones Senior Compliance Coordinator

Summacare

Amanda Lambert Owner & CEO 

Lambert Consulting 

Angela Lloyd Associate Compliance Officer

Jefferson Health Plans

Angela Lloyd is the Associate Compliance Officer at Jefferson Partners Plans of Philadelphia (JHP). She oversees all functions under Compliance which encompasses the audit program, day-to-day incidents/inquiries, the risk program, regulatory interpretation, and regulatory reporting for all lines of business (Medicare, Medicaid, CHIP). In addition, her oversight includes operations and processes, analyzing data, and reviewing Policies and Procedures.  Fostering collaborative relationships with the leadership of operational units, and partners with vendors to ensure compliance with state and federal regulatory statutes. 

Angela has worked for JHP for 17 years and possess over twenty years of product, compliance and operations experience in CHIP, Medicaid and Medicare programs. Her creative and result focused program has proven successful in driving compliance throughout the organization. Her expertise in the execution of regulatory contractual requirements with the understanding of policy in various channels has improved the companies understanding and awareness of the products offered under the Centers of Medicare and Medicaid Services, the Department of Human Services and the Office of CHIP especially the Special Needs product. Angela truly strives for excellence in everything she does keeping the JHP communities and membership in mind. Angela received a bachelor’s degree in business law, a master in  public health from Drexel University and certified in HealthCare Compliance. 

Kaye Markham Manager of Outcomes Medical Management

Government Employee Health Association, Inc.

Kaye Markham is a dedicated and results-driven healthcare professional with a Bachelor of Science in Nursing (BSN) and extensive experience in managing operations within the healthcare insurance sector. Kaye currently serves as a Manager at GEHA (Government Employees Health Association), where she has oversight of the clinical appeals process, reviewing and resolving complex clinical cases. With a strong foundation in nursing and healthcare operations, Kaye combines clinical expertise and managerial skills to ensure that each appeal is handled with meticulous attention to detail, efficiency, and adherence to regulatory standards. 

A proven leader, Kaye fosters a collaborative work environment, guiding and mentoring a team of skilled professionals to consistently achieve and surpass departmental objectives. Known for her strategic thinking and problem-solving abilities, Kaye is committed to delivering exceptional service and advocating for the best outcomes for GEHA members. Her leadership is marked by a focus on continuous improvement, fostering a culture of excellence within the appeals department, and ensuring that the team is equipped to handle the most complex and challenging clinical scenarios. 

Cathy McClain Gordon Managing Partner & CEO 

4E Health Care Ventures, LLC 

Cathy provides strategic leadership as the Managing Partner & CEO at 4E Healthcare Ventures, a multifaceted healthcare management consulting firm that fosters strategic & operational excellence.  With 30+ years in the healthcare industry, assessing and transforming health care operations is her specialty. 

Cathy is a dynamic resource person, equipping clients with the necessary skills to achieve operational goals and compliance. Whether it is guiding a firm through the launch of a new service offering, compliance mitigation, ops improvement or delegation oversight and monitoring, she is well positioned to set clients apart. She maintains extensive knowledge of core health plan and medical group functional areas, specifically: utilization management, quality improvement, ​​provider data management, claims, appeals & grievances, fraud, waste & abuse, and credentialing​. ​  

​​Prior to ​founding 4​E​ Healthcare Ventures, LLC, Cathy served in healthcare leadership roles including Vice President Health Services, Vice President, Commercial & Medicaid Services, Senior Director of Operations & Strategic Projects. 

Cathy holds a Master of Health Administration & B.A. in Psychology. She is an alum​ni of​ America’s Health Insurance Plan (AHIP) Leadership Development Program. As a decorated veteran, she is committed to service and currently serves her community as an appointed Commissioner on the Economic Development Committee.  

Ally McNally Quality Assurance Supervisor

CareOregon

I’ve worked with CareOregon as a QA Supervisor now for three years. Prior to that, I was a grievance coordinator on the team I’m currently supervising for four years. I’ve worked in healthcare now for over ten years and really enjoy the work that we do. I feel that we make a genuine difference to our members and community. We help to ensure that we provide quality care and service and that our members feel heard by us as their healthcare company.  

I’m a native Portlandian and currently live here with my husband, miniature daschund and many stray cats. I enjoy hiking, reading, crosswords, travel and motorcycle riding with my husband. 

Andrew Meggison Senior Director, Regulatory Affairs and Benefits Compliance

Health Plans Inc.

Andrew H. A. Meggison is a dedicated and accomplished regulatory and government affairs professional who has worked in the Self-Insured, Fully Insured, and State Government markets for over 10 years.

Currently serving as the Senior Director of Regulatory Affairs and Benefits Compliance at Health Plans Inc. (HPI) in Massachusetts, Andrew brings a wealth of experience and expertise in analysis and interpretation of federal and state rules applicable to clients’ plans, oversees and monitors HPI and subsidiaries’ licensing program in nearly all 50 States, and acts as HPI’s liaison regarding regulatory-related programs and initiatives. 

Andrew holds a Master’s Degree in Political Science from Northeastern University, a Bachelor’s Degree in Government Relations from Clark University, and lives in Boston Massachusetts.

Katrina Nottke FDR Compliance Analyst

Commonwealth Care Alliance

Katrina Nottke, MBA, has over three years of experience in the health plan space, specifically focused on FDR and Material Subcontractor compliance with Medicare and Medicaid regulations. She is the FDR Analyst with Commonwealth Care Alliance, Inc. Katrina also has experience with many product lines of business including, Medicare, Medicaid, Dual-Eligible, Commercial, and the Health Exchange. Katrina’s experience in the FDR Analyst role includes overseeing federal and state requirements with vendors who are FDRs and/or Material Subcontractors working with CCA performing healthcare or administrative services on behalf of CCA.  In addition, Katrina has been working to re-engineer the FDR Compliance Program at CCA to continue to ensure full compliance with all regulations and contract requirements as well as to streamline and strengthen the Program at CCA. 

Lisa Rabbitt Sr. Vice President, Corporate Compliance & Ethics and Risk Operations

Commonwealth Care Alliance

As Senior Vice President of Corporate Compliance & Ethics and Risk Operations at Commonwealth Care Alliance, Lisa Rabbitt brings over two decades of expert leadership in the healthcare industry. Her proven track record includes developing and enhancing comprehensive compliance, ethics, and risk management programs, with a focus on building high-performing teams and driving strategic initiatives. Lisa holds a Bachelor's degree in Business Administration from Clarion University of Pennsylvania, and consistently delivers measurable results through her deep understanding of regulatory adherence and risk mitigation. 

Dana Renicker Senior Medicare Education Specialist

SummaCare

Cherié K. Shortridge Sr. Advisor/Principal

CKS Consulting

Cherié boasts over two decades of experience in Medicare Advantage, complemented by insights into Medicaid and Commercial sectors. Throughout her career, she has developed deep expertise in Stars, Health Plan Operations, Process Improvement, Enrollment, Reconciliation, Premium Billing, Appeals & Grievances, Compliance, and Audit. Her journey includes both direct health plan experience and consulting engagements with various plans nationwide. Cherié has successfully steered organizations through strategic transitions such as acquisitions, sanction remediation, and system implementations, all while ensuring that plan members receive timely and appropriate care in the right setting. 

Beth Socoski  Vice President of Compliance 

Longevity Health Plan 

Daron Webb Quality Assurance Manager

CareOregon

As the Quality Assurance Manager over Appeals and Grievances at CareOregon, Inc., I bring over 11 years of expertise in utilization management, with a specialized focus on appeals for the past 7 years and grievances for the last 5 years. My role includes supervising a team of nurses and a behavioral health specialist who handle our clinical work, as well as overseeing 2 supervisors who manage their own teams for appeals and grievances. I ensure the highest standards of quality and compliance in handling member appeals and grievances, striving to enhance member satisfaction and outcomes. With a commitment to continuous improvement, I enjoy identifying process improvements and implementing best practices. My extensive experience in the healthcare industry has equipped me with an understanding of regulatory requirements and a passion for advocating on behalf of members. At CareOregon, I am dedicated to fostering a culture of excellence and integrity, ensuring that every member's voice is heard and their concerns are addressed with the utmost care and professionalism.