CAQH Index Advisory Council

The CAQH Index Advisory Council represents organizations across the healthcare industry, including medical and dental plans and providers, vendors/clearinghouses, government ad research experts. The role of the Council is to: 

  • Advise CAQH on research measures;
  • Represent unique industry perspectives to enhance findings and future reports; and 
  • Promote industry participation in the CAQH Index. 

CAQH Index Advisory Council Roster


Advisory Council Member Organization
Amy Neves Aetna
Chuck Vandenberg Anthem
Daniel Rosen Athenahealth
Deanna Stohl Blue Cross Blue Shield of Michigan
Diana Lisi UnitedHealthcare
Elizabeth Templeton Florida Blue 
Heath Hanwick Epic
Heather McComas American Medical Association
Jay Eisenstock JE Consulting
Krishna Aravamudhan American Dental Association 
Lorraine Tunis Doo Centers for Medicare & Medicaid Services
Paul Keyes Cigna
Robert M. Tennant  Workgroup for Electronic Data Interchange
Sarah Tilleman American Dental Association
Sonya R. May UnitedHealthcare
Stanley Nachimson Nachimson Advisors, LLC
Suzanne Lestina University of Chicago Medical Center
Tab Harris Florida Blue
Terrence Cunningham American Hospital Association
Thomas L. Meyers America's Health Insurance Plans
William Hawes Centene
   

 

Pharmacy Advisory Council Member Organization
Pooja Babbrah Point of Care Partners
Morgan Bojorquez Humana
Heather McComas American Medical Association
Liz Moore CoverMyMeds
Jon Paladino Prime Therapeutics
Kamal Tayal DrFirst


 

CAQH Index Advisory Council Biographies


 

Krishna Aravamudhan
American Dental Association

Dr. Krishna Aravamudhan has been employed by the American Dental Association (ADA) for 17 years and, since 2014, in the position of director for the Council on Dental Benefit Programs, directing and overseeing all of the program activities of the Center for Dental Benefits, Coding and Quality. It is in this position that she oversees the ADA’s Credentialing Service powered by ProView, the work of the Dental Quality Alliance, the CDT Code and third party payment programs.

In the past she has also served as the Associate Director of the ADA’s Center for Evidence Based Dentistry where she led the development of clinical guidelines and managed the EBD Website and critical summaries. Dr. Aravamudhan graduated from the Bangalore University, India with her dental degree and followed it with a Master of Science from the University of Alabama at Birmingham School of Dentistry.

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Terrence Cunningham
American Hospital Association

Terrence Cunningham is the Director for Administrative Simplification Policy with the American Hospital Association. In this role, Terrence engages in regulatory and legislative initiatives associated with the HIPAA Administrative Simplification provisions, as well as other activities designed to reduce administrative complexities and billing issues for hospitals. Additionally, Terrence’s responsibilities include developing and maintaining the UB-04 Data Specifications Manual (UB-04 Data Set) and serving as the Chairman to the National Uniform Billing Committee (NUBC). 

Prior to joining the AHA, Terrence served as a Senior Policy Analyst with the American Medical Association. In this role, Terrence’s work focused on regulatory and policy developments affecting physician revenue processes.

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Lorraine Tunis Doo
Centers for Medicare & Medicaid Services

Lorraine Tunis Doo is the Senior Policy Advisor for the Division of National Standards at the Centers for Medicare & Medicaid Services (CMS).  She provides policy guidance on regulatory issues pertaining to the provisions of the Health Insurance Portability Act of 1996 (HIPAA) and the Patient Protection and Affordable Care Act of 2010 (ACA) – specifically the adopted transaction standards, code sets, identifiers and operating rules exchanged between providers and health plans to conduct business operations. Lorraine also leads an intra-agency collaboration on interoperability at CMS.  She is the lead staff for the Standards Subcommittee of the National Committee for Vital and Health Statistics, the Federal Advisory Committee (FACA) to the Secretary.  In the past, Lorraine launched the agency’s foray into Personal Health Records and the BlueButton for Medicare, which has grown up to become the MyhealthEData initiative, leveraging the benefits of the HL7 FHIR standard.  She is co-chair of the HL7 Personal Health Record System Functional Model work group and continues to be active in many industry work groups.  Lorraine served in a variety of training and industry liaison roles for the first 18 months of the Affordable Care Act implementation at CMS. 

Prior to joining CMS in 2003, Lorraine was the director of a 100,000 member statewide Medicaid managed care organization run by a private insurance company in Maryland. Lorraine holds a Master in Social Work Administration and a Master in Gerontology, both from the University of Michigan, and a Master of Public Health from the Johns Hopkins School of Public Health.      

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Jay Eisenstock
JE Consulting

Jay Eisenstock is a seasoned consultant, speaker, contract negotiator and management professional with more than 30 years of recognized experience in healthcare and technology. Jay combines a solid foundation of business expertise with a strong technology background and is focused on achieving superior bottom-line results for his clients.

Jay has a demonstrated track record of managing strategic partnerships and delivering large-scale, mission-critical projects on time and within budget. Throughout his career, Jay has leveraged a team-based management style and interpersonal communication skills to guide all levels of internal and external customers. Jay has negotiated strategic contracts in excess of $120M annually and played a crucial role in performing due diligence measures in the evaluation of corporate acquisitions.

Jay received his MBA from the University of Massachusetts and his Bachelor of Science degree from Rochester Institute of Technology. He is active in the industry serving as Board Chair for the Workgroup for Electronic Data Interchange (WEDI), a Commissioner for the Electronic Healthcare Network Accreditation Commission (EHNAC) and on several committees with the Council for Affordable Quality Healthcare (CAQH).

Among Jay’s previous accomplishments, he was recognized by Healthcare Payer News as one of 11 top executives and thought leaders in the healthcare IT industry, a finalist for Aetna’s highest employee recognition award, and won the WEDI Leadership in Technology award. He was also the 2017 recipient of the prestigious WEDI Andrew J. Melczer Leadership award.

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Heath Hanwick
Epic

Heath Hanwick is a Product Manager for Referrals and Prior Authorization at Epic where he is responsible for product direction and design. Heath has worked with multiple research and development teams and a community of over 400 customers to prioritize development suggestions, gather feedback, and validate development projects within the organization.

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Tab Harris
Florida Blue

Tab Harris is the Director of Provider Connectivity Solutions and EDI Operations at Florida Blue and is accountable for all provider e-capabilities including HIPAA and HL7 transactions in addition to portal based capabilities. Florida Blue has been recognized as an industry leader and model for gateway management and mandate implementations.

Harris has 24 years of commercial and Medicare health payer experience at Florida Blue and its associated organization, First Coast Service Options and has worked the last 16 years in the electronic data interchange space. Harris is a frequent attendee and is occasionally asked to present at organized and standards workgroup meetings. He attends and is a voting member at HIMSS, WEDI, X12 and other Opal sponsored events.

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William Hawes Jr
Centene

William Hawes Jr, is a Senior Director of Reporting and Analytics at Centene, formerly Sr. Director of EDI-Operations at WellCare - a Centene Company.

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Paul Keyes
Cigna

Paul Keyes is a Product Manager for Cigna Provider Digital Solutions. He has been responsible for Cigna's provider connectivity strategy since 1992. Keyes has worked at Cigna for 36 years with management roles in Operations, Compliance, EDI and EDI Vendor strategy and management.

Keyes has extensive industry workgroup experience, including the NEIC Payer Advisory Board Member 1991–1995, WEDI Board Member 1995-1999, Phase III CAQH CORE operating rule development, and serving as the Cigna lead for CAQH EFT enrollment and the CAQH Index.

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Suzanne Lestina, FHFMA, CPC
American Hospital Association

Suzanne advises AHA leadership on the best strategic future course for administrative transactions, given the move toward value and other changes in the broader health and technology landscape, with a view toward efficiency and burden reduction. In her role at AHA, Suzanne serves as chair of the National Uniform Billing Committee (NUBC), a multi-stakeholder group whose purpose is to review and approve a billing data set capable of supporting the HIPAA administrative transaction standard for billing (the UB-04 Data Set).

Prior to her role at AHA, Suzanne was actively involved in healthcare transformation and innovation, where she engaged health system leaders with forward-thinking concepts, strategies and trends in revenue cycle management and patient financial experience as the VP of Revenue Cycle Innovation for Avadyne Health. In addition, Suzanne was HFMA’s Director of Revenue Cycle where she advised health systems on revenue cycle performance improvement and was the MAP product line expert. Suzanne has held revenue cycle leadership roles in the Chicago area as well as revenue cycle management consulting on a national level. She has a bachelor’s degree in organizational management from Concordia College and is a past president of the 1st Illinois Chapter of HFMA.

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Diana Lisi
UnitedHealthcare

Diana Lisi is the Director of EDI Integration Services for UnitedHealthcare. Diana has worked in the Healthcare Industry nearly 20 years. The majority of her career has been spent specializing in electronic healthcare transactions. Diana is an active participant in a number of industry consortiums focused on increased utilization of administrative transactions and Provider Self Service. Native to Connecticut, Diana holds a Finance Degree from Fairfield University.

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Sonya R. May
UnitedHealthcare

Sonya is an EDI Compliance Analyst/EDI Industry Engagement Coordinator/Attachment Product Owner at UnitedHealthcare. 

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Heather McComas
American Medical Association

Heather McComas is the Director of Administrative Simplification Initiatives at the American Medical Association.

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Thomas L. Meyers
America's Health Insurance Plans 

Thomas L. Meyers is a Vice President with America's Health Insurance Plans (AHIP). AHIP is a national trade association representing member companies that provide health benefits to more than 200 million Americans. His industry experience provides insight and direction from a perspective developed as an executive in the group benefits business with a proven track record of successfully implementing business strategies focused on market expansion and bottom-line growth. Process alignment, product development, product management, marketing, operations, and strategic and tactical planning have been key areas of focus.

Before joining AHIP, Tom held a variety of executive and management level positions at Travelers Insurance Company and Mutual of Omaha. He currently serves on the Workgroup for Electronic Data Interchange (WEDI) Board of Directors. Tom earned a Bachelor's degree in finance from Siena College.

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Stanley Nachimson
Nachimson Advisors, LLC 

Stanley Nachimson is Principal of Nachimson Advisors, LLC, a health IT consulting firm dedicated to finding innovative uses for health information technology and to encouraging its adoption. Nachimson is focused on assisting healthcare providers and plans with ICD-10 implementation.

Nachimson is retired from the U.S. Department of Health and Human Services, where he served for more than 30 years in a variety of statistical, management, and health technology positions. While there, he developed HIPAA policy, regulations, and implementation planning and monitoring, beginning the CMS work on Personal Health Records, and serving as the CMS liaison with several industry organizations, including the Workgroup for Electronic Data Interchange (WEDI) and the Healthcare Information Technology Standards Panel (HITSP). He currently is the director of the North Carolina Healthcare Information and Communications Alliance, Inc. (NCHICA)-WEDI Timeline Initiative and serves QualEDIx Corporation as a member of its Board of Advisors. He earned a Master's degree in applied statistics from The George Washington University.

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Amy Neves
Aetna

Amy Neves is Director of EDI Transaction and Regulatory Support at Aetna. Neves promotes effective EDI industry standards by expressing Aetna's viewpoints to influence decisions and representing Aetna as an industry leader in their adherence to and compliance with these standards. In her role, Neves collaborates with a wide array of business stakeholders, technical and testing counterparts to deliver 25-50 technical projects and service requests each year, focuses on impact and value add of regulatory requirements and recognizes the impact of new work on current and planned solutions.

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Daniel Rosen
athenahealth

Daniel Rosen is the Director of Client Performance Analysis for Care Delivery and Value Based Care at athenahealth. In this position, he develops and delivers client performance analytics to medical provider groups, helping them take action to improve their business and clinical performance.  Prior to athenahealth, Dan received his MBA from the University of Michigan Ross School of Business. Rosen has a Bachelor of Arts degree in Political Science from Washington University in St. Louis.

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Elizabeth Templeton
Florida Blue

Elizabeth Templeton is an EDI Consultant of Provider Connectivity Solutions at Florida Blue.

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Robert M. Tennant
Workgroup for Electronic Data Interchange

Robert Tennant is Director of Health Information Technology Policy for the Medical Group Management Association (MGMA). In his role at the association, Mr. Tennant focuses on federal legislative and regulatory health information technology issues including MACRA, HIPAA Privacy and Security, administrative simplification, EHR policy, and other HIT topics. Mr. Tennant currently participates with numerous industry organizations including his position on the executive committee of the Board of Directors of the Workgroup for Electronic Data Interchange (WEDI); and co-chair of the WEDI Virtual Clipboard Initiative, Secure Messaging Workgroup, and ePayments Taskforce. In addition, he serves as co-chair of the National HIPAA Summit, is a member of the CMS DRLS workgroup, Board of Commissioners for the Electronic Healthcare Network Accreditation Commission (EHNAC), the United Healthcare Administrative Simplification Workgroup, the National Uniform Claim Committee, the Physicians EHR Coalition, and others. Mr. Tennant was named as one of HealthData Management magazine’s “Top 30 Health IT Experts to watch in 2019.”

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Sarah Tilleman, MNM
American Dental Association

Sarah Tilleman is a Senior Manager of Credentialing and Third Party Payer Advocacy for the American Dental Association. She was previously the Dental Director of the Family Dental Clinic in Fort Collins, CO and served as the Dental Benefits Program Manager for the State of Colorado’s Medicaid dental program.

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Pooja Babbrah
Point of Care Partners

Pooja Babbrah is Point-of-Care Partners’ Practice Lead for Pharmacy Benefit Manager (PBM) and Pharmacy Services and is Vice-Chair of the NCPDP 2021-2022 Board of Trustees.  As a Senior Healthcare Information Technology Consultant, Pooja specializes in product management, strategic planning and go-to-market strategies and execution. Babbrah has more than 20 years’ experience in various health care services and health care IT companies and has vast knowledge of PBMs, health plans, patients, physicians, ePrescribing and EMR vendors and hospitals/health systems.

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Jon Paladino
Prime Therapeutics

Jon Paladino is a Senior Industry Affairs Analyst at Prime Therapeutics where he focuses on improving pharmacy industry standards and interoperability in healthcare insurance operations.

 

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Kamal Tayal
DrFirst

Kamal Tayal is the Vice President of Provider Solution Products at DrFirst. Tayal leads product development and innovation to serve physicians, patients at point of encounter to drive better patient outcomes by working collaboratively with Pharmacy Benefit Managers (PBM), Health Plans, and Life Science companies.

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Type
Audience
Organization Type
CAQH Program