NOTICE: There will be scheduled website maintenance between August 26-27, 2017, which may briefly interrupt access to CAQH.org.
NOTICE: There will be scheduled website maintenance between August 26-27, 2017, which may briefly interrupt access to CAQH.org.
The CAQH Index independent Advisory Council represents all facets of the healthcare industry. The Council guides the CAQH Index efforts to create a national reference for raising awareness and monitoring progress by the healthcare industry in its ongoing transition from manual to electronic administrative transactions.
|Advisory Council Member||Organization|
|John Bialowicz||Blue Cross Blue Shield of Michigan|
|Katy Blomeke||Anthem, Inc.|
|Kennon R. Copeland||NORC at the University of Chicago|
|Tab Harris||Florida Blue|
|Diana Lisi||UnitedHealth Group|
|Thomas L. Meyers||America's Health Insurance Plans|
|Stanley Nachimson||Nachimson Advisors, LLC|
|Andrew L. Naugle||Milliman, Inc.|
|Richard Nelli||Streamline Health|
|Erik C. Swanson||Premier, Inc.|
|Robert M. Tennant||Medical Group Management Association|
John Bialowicz manages the EDI operations and all-payer clearinghouse at Blue Cross Blue Shield of Michigan, and has 27 years of experience working with providers, vendors, trading partners, and payers to reduce cost and increase volumes of electronic transactions. Bialowicz began his career at BCBSM marketing Practice Management Systems to professional and facility providers, providing him and excellent perspective to provider’s workflows and their day-to-day challenges.
Bialowicz has participated in a number of industry organizations, WEDI (Workgroup for Electronic Data Interchange), including sub workgroup for e-attachments, NDEDIC (National Dental EDI Council), HITSP (Healthcare Information Technology Standards Panel) and is currently working with MIHIN (Michigan Health Information Network) to expand statewide clinical transactions. He earned a Bachelor’s in Business Administration from the University of Michigan.
Katy Blomeke is vice president, insights and analytics, in the service operations unit of the Anthem Commercial and Specialty Business Division, where she is responsible for service operations quality, compliance, and data reporting.
Prior to this role, she was an Anthem (formerly WellPoint) staff vice president, with leadership, governance, and management responsibility for its Enterprise Risk Management (ERM) function. In this position, she identified, evaluated, mitigated, and monitored enterprise risks. Her Anthem tenure also includes serving as the Chief of Staff to the Chief Financial Officer.
Prior to joining Anthem, Blomeke was a senior manager in the PwC Assurance Practice, where she led the investment, derivative, and international business unit teams for one of the largest public multi-national life insurers based in the United States. Her responsibilities included oversight of investment and derivative portfolios. Before that, she was the lead senior manager responsible for Japanese operations of this PwC client. She also worked in the PwC Accounting Consulting Services Group and the Financial Services Insurance Group.
Blomeke holds a Bachelor’s of Science in Accounting from Loyola Marymount University, Los Angeles. She is a licensed Certified Public Accountant in California, New York, and New Jersey.
Ken Copeland is Senior Vice President and Director of Statistics and Methodology for NORC at the University of Chicago. Dr. Copeland has more than 35 years of experience in sample design, weighting methods, and error measurement methods for large-scale household, establishment, and healthcare surveys. He has published articles in Survey Methodology, Journal of Official Statistics, Statistics in Medicine, Drug Benefit Trends, Journal of Pharmaceutical Marketing and Management, New Medicine, and Scrip Magazine, and has presented papers to the American Statistical Association on topics such as nonresponse adjustment, survey weighting techniques, establishment survey design, questionnaire design, and automated survey management systems.
Before joining NORC, Dr. Copeland was a Senior Director, Statistical Services at IMS Health, a Senior Mathematical Statistician at the U.S. Bureau of Labor Statistics, and a Mathematical Statistician at the U.S. Census Bureau. Dr. Copeland is a fellow of American Statistical Association and a member of the American Association for Public Opinion Research. He holds a Ph.D. in survey methodology from the University of Maryland.
Jay Eisenstock heads provider eSolutions at Aetna. He is responsible for the innovation and deployment of administrative, clinical and financial interactions between Aetna and the provider community. In previous roles at Aetna, Eisenstock led the company's efforts to achieve HIPAA compliance for electronic transactions.
Prior to joining Aetna, Eisenstock was vice president of the web development and business intelligence line of business for a technology consulting firm. He also held various leadership and technical positions with Electronic Data Systems Corporation (EDS). He is the current chair of the CAQH Committee on Operating Rules for Information Exchange (CORE) Joint Certification/Enforcement and Testing Subgroup, He serves the Workgroup for Electronic Data Interchange (WEDI) as a director, and the Electronic Health Network Accreditation Commission (EHNAC) as a commissioner. He was selected by the Certification Commission for Healthcare Information Technology (CCHIT) to participate in its Health Information Exchange Work Group. Eisenstock was honored with the Workgroup for Electronic Data Interchange (WEDI) Leadership in Technology award and was a finalist for Aetna's highest employee recognition award. He was also recognized as one of 11 top executives and thought leaders in the healthcare IT industry by eMids Technologies and Healthcare Payer News. Eisenstock earned a Master's degree in business administration from the University of Massachusetts.
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.
Paul Keyes is a Product Manager for Cigna National Provider eServices. He has been responsible for Cigna's provider connectivity strategy since 1992. Keyes has worked at Cigna for 31 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.
Diana Lisi is the Director of EDI Integration Services for Optum. 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.
Bill Marvin is the President, CEO and Co-Founder of InstaMed, the leading Healthcare Payments Network. InstaMed is the only single, integrated network connecting providers, payers and patients for the entire healthcare payments process and has processed over $80 billion in healthcare payments to date.
Before founding InstaMed, Bill was an executive in Accenture’s Health and Life Sciences practice. He worked with senior executives at clients such as UnitedHealth Group, U.S. Department of Treasury, WellPoint Health Networks and other large Blues plans where he developed strategies and led projects in the areas of transaction processing, web-portals, provider adoption and medical management.
Bill was also the founder and CEO of CareWide, which developed Microsoft-based software for managing provider offices and was acquired by Amicore, a joint venture of Microsoft and Pfizer, and now is a part of AllScripts. Bill graduated from the University of Pennsylvania with a BA in Economics.
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.
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.
Andrew L. Naugle is a Principal in the Seattle office of Milliman, where his research focuses on analysis of administrative expenses for health plans. He maintains an extensive dataset of health plan operations benchmarks, which are used to evaluate the staffing, efficiency, productivity, and cost levels of health plans, insurance companies, and third-party administrators. He also has considerable experience with operational design and re-design for payers. His work was featured in the Institute of Medicine's Roundtable on Evidence-Based Medicine publication, "The Healthcare Imperative: Lowering Costs and Improving Outcomes."
Naugle is a professional member of the Academy for Healthcare Management. He holds a Master's degree in business administration with cum laude distinction from the University of Notre Dame.
Richard Nelli is the SVP & Chief Technology Officer for Streamline Health.
A strategic consultant for Health IT; Richard was previously SVP & Chief Technology Officer for Streamline Health. Prior to joining Streamline Health, Nelli served as chief technology officer for CareMedic Systems, where he led product management and information technology. Previously he was vice president of product management at Quovadx, where he guided the company's healthcare interoperability solutions strategy, and before that he spent 10 years leading QuadraMed product development efforts. He has served in various product development and product management roles throughout his career, leading initiatives involving patient access, electronic data interchange, claims and remittance management, ePrescribing, health information exchange and medical banking. He holds a Bachelor of business administration degree in management information systems with a minor in telecommunications engineering from the University of Mississippi.
Jane Sarasohn-Kahn is a health economist and management consultant who has worked with healthcare stakeholders for more than 20 years. She focuses at the nexus of healthcare and technology, deploying scenario, strategic and business planning; forecasting; and health policy analysis. She also writes the Health Populi blog.
Sarasohn-Kahn has assisted stakeholders in every segment of the healthcare industry throughout her career, including technology and medical device companies; educational institutions; pharmaceutical manufacturers and distributors; healthcare providers; payers and health plans; consumer products companies; non-profits; and financial services firms. She founded THINK-Health, a strategic health consultancy, after spending 10 years as a healthcare consultant with firms in the U.S. and Europe. She is a frequent collaborator with the California HealthCare Foundation (CHCF) and writes a column for iHealthBeat, an online publication of CHCF. She often speaks and writes on healthcare consumers, health economics, information technology and scenario planning in healthcare. She earned a Master's degree in economics and MHSA in Health Planning from the University of Michigan.
Erik Swanson is responsible for corporate strategy and development at Premier, Inc., including management of the overall strategic planning process, oversight for enterprise strategic projects and support for external development of partnerships, investments and acquisitions. He works closely with the management team in an advisory capacity on multiple business issues including mergers and acquisitions, investment priorities, product development, operational improvement, and innovation.
Prior to joining Premier, Swanson held a similar position at WellPoint as its vice president of corporate strategy development. Before that, he was a partner in the strategy practice of Accenture, where he advised health plan clients on key business issues. He holds a Master's degree in business administration from Emory University.
Robert Tennant is the Senior Policy Advisor with the Washington, DC-based Government Affairs Department of the Medical Group Management Association (MGMA). Tennant focuses on federal legislative and regulatory health information technology issues for MGMA including HIPAA, ICD-10, electronic health records, electronic prescribing, administrative simplification and other electronic health information technology issues. He serves on numerous industry initiatives, including as Vice Chair of the Board of Directors of Workgroup for Electronic Data Interchange (WEDI) and is a past Chair of the WEDI Strategic National Implementation Process (SNIP).
In addition, Tennant was co-chair of a multi-stakeholder ICD-10 coalition and serves on the HIMSS ICD-10 Workgroup, the Physicians EHR Coalition, Bipartisan Policy Center on Health IT, Markle Foundation Consumer Engagement Workgroup, CAQH CORE initiative, National Uniform Claim Committee. He previously served several workgroups for the Certification Commission for Healthcare Information Technology. He was the recipient of the WEDI leadership in Technology and Distinguished Service awards. Tennant earned his Master's degree in political science from the University of Western Ontario.
Robin Thomashauer is the Executive Director of CAQH. Thomashauer has overall responsibility for CAQH strategy, operations and membership. She brings more than 30 years of experience in managed care operations and hospital administration, including responsibility for a broad range of operating and staff functions. She is a Diplomate in The American College of Healthcare Executives and serves on the Adventist HealthCare Board of Trustees.
Prior to joining CAQH, Thomashauer was a director in the health care practice at PricewaterhouseCoopers (PwC), with a primary focus on payer organizations. She also held senior management positions with Kaiser Permanente, as well as in several teaching hospitals. Thomashauer holds an M.H.S.A. in Hospital Administration from The George Washington University, and a B.A. in Social Sciences from Colgate University.
Raynard Washington is a Senior Manager at CAQH where he serves as the lead researcher for the CAQH Index reports.