The CAQH Index Advisory Council represents organizations across the healthcare industry, including medical and dental plans and providers, vendors/clearinghouses, government and 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 |
| Edward Smith | athenahealth |
| Elizabeth Templeton | Florida Blue |
| Heath Hanwick | Epic |
| Heather McComas | American Medical Association |
| Jay Eisenstock | JE Consulting |
| Lorraine Tunis Doo | Centers for Medicare & Medicaid Services |
| Paul Keyes | Cigna |
| Robert M. Tennant | Workgroup for Electronic Data Interchange |
| Sarah Tilleman | American Dental Association |
| Kristin Burdge | 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 |
| Jon Paladino | Prime Therapeutics |
| Kamal Tayal | DrFirst |
CAQH Index Advisory Council Biographies
Terrence Cunningham
American Hospital Association
Terrence Cunningham is the Director of Administrative Simplification Policy at the American Hospital Association. In his role, Terrence leads a team reducing administrative burdens negatively impacting the provision of efficient care to hospital patients, serve as Chairman of the National Uniform Billing Committee, the group responsible for the creation and maintenance of standard forms and codes used in medical claims billing by institutional providers, advocates for the adoption of efficient claims processing systems by hospitals, health insurers, and vendors; and represent hospital interests to data integrity and claims processing development stakeholders.
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.
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.
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.
Morgan Bojorquez is the Assistant Vice President of Pharmacy Clinical Integration for Humana. Morgan has focused on Six Sigma initiatives and process improvements to provide support to the clinical area and has implemented several new systems while managing Humana's formularies.
Tab Harris is the Senior Director of the Provider Connectivity Solutions and EDI Operations organization at Florida Blue. He and his team are accountable for all provider e-capabilities including HIPAA and HL7 electronic transactions and messages in addition to driving the Interoperability strategy and execution. In his role as the senior director, Tab provides direction and establish strategy for EDI, HIT operations and product management teams, oversight of EDI compliance (Operating Rules, Admin Simplification, SNIP Level Editing HIPAA next) including federal, state and blue cross association regulatory mandates.
William Hawes Jr, is a Senior Director of Reporting and Analytics at Centene, formerly Sr. Director of EDI-Operations at WellCare - a Centene Company.
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.
Suzanne Lestina
American Hospital Association
Suzanne Lestina is the Executive Director, Access and Revenue Integrity at University of Chicago Medical Center.
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.
Kristin Burdge
UnitedHealthcare
Kristin Burdge is the Associate Director of Electronic Data Interchange (EDI) at UnitedHealthcare.
Heather McComas
American Medical Association
Heather McComas is the Director of Administrative Simplification Initiatives at the American Medical Association.
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.
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.
Amy Neves is the Director of EDI Transaction and Regulatory Support at Aetna. Amy promotes effective EDI industry standards by expressing Aetna's viewpoints to influence decisions and represents Aetna as an industry leader. In her role, Amy collaborates with a wide array of business stakeholders, technical and testing counterparts to deliver 25-50 technical projects and service requests each year, focusing on impact and value add of regulatory requirements and recognizing the impact of new work on current and planned solutions.
Edward Smith is the Executive Director of Customer Success Analytics at athenahealth. In this role, Edward leads the provider network-enabled software services for medical groups and health systems nationwide.
Elizabeth Templeton
Florida Blue
Elizabeth Templeton is an EDI Consultant of Provider Connectivity Solutions at Florida Blue.
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.”
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.
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.
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.
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.
Chuck Vandenberg is the Senior Business Information Analyst at Anthem.
Kristin Burdge
UnitedHealthcare
Kristin Burdge is the Associate Director of Electronic Data Interchange (EDI) at UnitedHealthcare.
Mahesh Siddanati is the Staff Vice President of Business Digitization (Clinical Initiatives). Mahesh is focused on healthcare outcomes with broad domain expertise, passionate about making a difference with Technology and Innovation, and collaborating with stakeholders across the organization and industry.