Andrew Allison currently serves as Director of Business Development and Innovation at Aetna, where he helps lead value-based contracting efforts with Medicare providers across the country and evaluates technology and Managed Services Organization capabilities that can enable Aetna’s provider network to move along the value-based care continuum. He is responsible for identifying target markets, developing the appropriate partnership strategy with the right provider partners, driving deal execution, and developing the go-to-market strategy for Medicare provider partnerships.

Andrew most recently served as Director of Business Development for Iora Health, a risk-bearing primary care group with global capitation Medicare contracts with national and regional health plans in markets across the country. In this role, he developed the company’s growth strategy, led payer negotiations, and secured Medicare contracts with multiple national health plans. He is proud to have contributed to Iora’s most successful year in new partnership business development on record.

Andrew has experience growing healthcare companies along life cycle stages from ideation to Fortune 50. Notable companies he’s helped develop include hospital patient experience company Docent Health, behavioral health integration company Quartet Health, and employer wellness and benefit management company Castlight Health, among others.

Andrew earned his MBA from the Dartmouth’s Tuck School of Business and his bachelor’s in finance at the University of Maryland, College Park.

Jim Brown, Vice President, IDFS Actuarial and Analytics, leads an organization responsible for enterprise-wide financial evaluation and monitoring of value based provider dynamics. Jim directs a team of actuarial and analytic leaders with both payer and provider responsibilities to drive enterprise results, including leading development of episode of care analytics and provider facing actionable reporting for AHN. He joined Highmark in July of 2016.

Highmark Health employs more than 35,000 people nationwide and serves 50 million Americans in all 50 states. It is the third largest integrated health care delivery and financing network in the nation. Highmark Health is the parent company of Highmark Inc., Allegheny Health Network, and HM Health Solutions. Highmark Inc. and its subsidiaries and affiliates provide health insurance to 5.2 million members in Pennsylvania, West Virginia and Delaware. Allegheny Health Network is the integrated health system that includes eight hospitals and a community-based network of physicians. HM Health Solutions focuses on meeting the information technology platform needs of the Highmark Health enterprise as well as other unaffiliated health insurance plans across the county.

Mr. Brown has over 15 years of experience on both the payer and provider side of the health delivery system. Prior to joining Highmark, Jim was the Chief Actuary of Evolent Health, a population-health management firm, where he was responsible for all actuarial and financial functions for 10+ provider systems involved in various forms of risk-based management of patient performance. In that role, Jim lead both clinical analytics and financial reconciliations to ensure the best patient outcomes and largest provider returns in value-based reimbursement arrangements. Jim spent 10+ years with Coventry Health Care and Aetna, leading actuarial functions across multiple functional areas, regions, and lines of business including Commercial, Medicare, and Medicaid.

Mr. Brown earned his Bachelor of Science in Mathematics from Duquesne University in 2001 and is an associate of the Society of Actuaries.

Mr. Brown is married with two young daughters. In his free time, he enjoys spending time with his family, and is an avid exerciser and traveler.

Dr. Edgeworth is a board-certified neurologist and neuro-oncologist. Following his medical training, Dr. Edgeworth joined the faculty at Vanderbilt University Medical Center and remained there until 2008, when he left to join TriStar StoneCrest Medical Center, serving as Director of the Stroke Program and Chairman of the Department of Medicine. While at StoneCrest, he helped launch the HCA TriStar tele-neurology program that has grown to cover over 40 hospitals in 3 states with underserved neurological needs.

Dr. Edgeworth left his practice at StoneCrest to join Cigna-HealthSpring as Senior Medical Director in 2014. His primary focuses in this role are on value-based physician engagement, population health and chronic disease program development. Dr. Edgeworth has helped launch, manage and grow several programs at Cigna-HealthSpring, including programs focused on palliative care, COPD, heart failure and behavioral health.

Outside of Cigna-HealthSpring, Dr. Edgeworth enjoys golf and spending time with his family and friends. He has volunteered his time as a neurologist with Siloam Family Health Center in Nashville, TN and has helped lead three medical mission trips to Ethiopia. Dr. Edgeworth is also a co-founder of The Black Abbey Brewing Company in Nashville, TN. He is married to a talented singer-songwriter, and they have two sons, ages 14 and 11.

Ms. Gallagher is a Medicare, Medicaid and Exchange subject matter expert with 25+ years’ experience in Government Sponsored healthcare. She has C-Suite level expertise in Managed Medicaid and Managed Medicare, skilled in managing all aspects of Health Plan Operations to include: P&L;, policy, general management, network development, RFP response, policy, implementation, regulatory and compliance, while maximizing efficiency and effectiveness.

She is currently leading ATTAC Consulting Group’s (ACG) Provider Network Management and Payer Innovation / Population Health service offerings. Founded in 2003, ACG has been recognized as a premier national consulting and auditing firm serving insurers, managed care and provider organizations. ACG’s network development team is one of the nation’s largest, bringing clients broad coverage along with, strong experience in assessing and developing high performance provider networks. ACG specializes in provider network development and management, regulatory compliance, program development, business process engineering and auditing, along with medical and pharmacy management.

Prior to joining ACG, Ms. Gallagher held State Plan President positions for various fortune 100 companies, and held executive Leadership roles responsible for regional and/or statewide health plan performance.

Mohit Ghose is a health care executive and healthcare policy expert with 20 years of experience working with business leaders to anticipate, respond to, and influence the changing health care landscape. He has managed a wide range of contracting, planning and implementation, advocacy and policy programs designed to improve results, and position a company for success and impact in an ever-evolving marketplace.

Most recently, Mohit was on the senior leadership team of Molina Healthcare of California as vice president of government contracts, policy & strategic initiatives.

Under his direction, the government contracts team served as the plan’s primary point of contact with regulatory agencies while also driving contract implementation within the plan. Mohit also led the policy team covering legislative, public policy and regulatory challenges and opportunities. The strategic initiatives department initiated by Mohit now manages company planning and implementation of new initiatives and projects impacting all business units, including Molina’s annual operating plan.

Prior to Molina, Mohit was vice president of public affairs for Aetna, Inc. and led Aetna’s internal and external efforts for policy advocacy and communications through health care reform and its implementation. Earlier, Mohit started his career in health care policy and advocacy in Washington, DC at America’s Health Insurance Plans (AHIP). As senior vice president of public affairs, Mohit managed all aspects of media and crisis communications and served as national spokesman on all industry issues over several legislative and policy campaigns, including the landmark Medicare Prescription Drug bill.

Under John’s leadership, Gorman Health Group has become the leading professional services and solutions firm for government-sponsored health care, providing thought leadership and expert strategic, operational, and technology-based solutions to drive better outcomes for plans, providers and beneficiaries

As part of the leadership team of The Root Cause Coalition, Mr. Gromley plays a critical role in the continued development and implementation of the Coalition’s strategic plan, recruitment of Coalition members, and is responsible for the day-to-day management of the non-profit.

Mr. Gromley utilizes the depth of knowledge he has amassed as a seasoned health policy, government relations, and coalition development consultant to guide the coalition toward the use of operationally sound strategies for engaging healthcare organizations in successful community collaboration. Mr. Gromley is licensed to practice law in Pennsylvania and received his law degree from the Drexel University Thomas R. Kline School of Law in Philadelphia.

John Lovelace is President of UPMC for You, a managed care organization that serves Medical Assistance and Medicare Advantage Special Needs Plan recipients in 40 counties in Pennsylvania.

Mr. Lovelace provides leadership, direction, and administration for the services provided by UPMC for You, which offers coverage to eligible Medical Assistance recipients through its contracts with the Pennsylvania Department of Public Welfare as well as coverage options for Medicare beneficiaries who are also enrolled in the Pennsylvania Medical Assistance program.

He is also President of Government Programs and Individual Advantage for the UPMC Insurance Services Division. In this role, he oversees Medicare products, Medicaid, and the Children's Health Insurance Program (CHIP) of UPMC Health Plan, known as UPMC for Kids. He also oversees a group of Medicare Advantage special needs plans for people who are dually eligible for Medicare and Medicaid, and for individuals who are eligible for long-term care services. He oversees UPMC Individual Advantage, a guaranteed renewable individual product. He is also responsible for compliance, finance and operations for individual products on and off the Healthcare Exchange.

In addition, he is Chief Program Officer at Community Care Behavioral Health Organization, a behavioral health managed care organization that is part of the UPMC Insurance Services Division. Community Care provides behavioral health coverage for more than 900,000 Medicaid beneficiaries in 36 Pennsylvania counties, as well as care coordination services in New York State.

In addition to his service on local, regional and national organization boards of directors, he serves as Board Chair for the Association of Community Affiliated Plans (ACAP), a trade association comprised of 60 provider-affiliated regional health plans enrolling Medicaid and other low-income beneficiaries.

Mr. Lovelace holds graduate degrees in Rehabilitation Counseling from the State University of New York at Buffalo, as well as in Information Services from the University of Pittsburgh.

As Executive Director of Operations Integrity for Aetna, Audrey leads efforts to ensure organizational success and operational compliance. Responsible for mobilizing business resources to identify, mitigate, and remediate challenges leading to compliance and business risk, she has supported the execution of strategic goals. Prior to this role, Audrey served as the Medicare Compliance Officer of the Amerigroup Corporation, and held Product Management and Compliance roles at Healthfirst and Centerlight Health Systems before that. She has continued to bring her health insurance expertise and leadership skills to guarantee the success of the projects she joins.

Casey McKeon joined HealthSpring as the Vice President of Administration for the Texas Market in June 2011 and has served as the Market Manager of the Mid Atlantic and Pennsylvania market before becoming the National Lead for Cigna-HealthSpring Health Services and Revenue Management in October of 2015. Casey is responsible for risk adjustment, coding, Stars, operating effectiveness and health services strategy across Cigna-HealthSpring. Prior to joining HealthSpring, Casey was the Vice President of Operations for the Houston based Radiology Benefits Manager (RBM) HealthHelp. Casey is also a former Director of Medicare at Humana, Inc. where he worked for 8 years. Roles with Humana included the management of Humana’s Puerto Rico Medicare Operations of 13,000 members and 8,000 contracted providers as well as directing operations for Humana’s International Business Development (IBD) team which was tasked with planning international expansion with a core focus on providing consulting services to the National Healthcare Service (NHS) of England. Mr. McKeon is a graduate of the University of Notre Dame.

Leila Nowroozi leads Corporate Alliances within the Government Affairs office of Aetna. Her focus is to forge partnerships with patient, provider, and community organizations in order to identify and address gaps in the healthcare system. In a time of significant turmoil within healthcare, the goal of the Alliance function is to highlight Aetna’s thought leadership and to forge relationships that help advance common goals. Areas of focus for partnerships include addressing the social determinants of health in communities across the United States, driving patient-centered care that reflects the patient’s definition of value, and promoting the use of technology to inform health and wellness choices at the individual level. Leila works closely with Aetna’s clinical teams as well as the Aetna Foundation to bring the company’s expertise and experience to Alliance relationships. Prior to joining Aetna, Leila was the Chief Marketing Officer of Avalere Health. She worked for a number of years in the pharmaceutical industry launching pharmaceutical products with J&J; and Pfizer. Leila has her MBA from Duke’s Fuqua School of Business and her MPH in Epidemiology and Biostatistics from the University of South Carolina School of Public Health.

Tanya Shah, M.B.A., M.P.H., joined The Commonwealth Fund in November 2015 as Senior Program Officer in the Delivery System Reform Program with responsibility for the high-need, high-cost population portfolio. Previously, Ms. Shah was Assistant Commissioner, Bureau of Primary Care Access and Planning with the New York City Department of Health and Mental Hygiene, where she was responsible for creating the mission and developing the strategic plan for the bureau. She oversaw all functions including policy analysis, program management and evaluation, and budgeting and resource allocation. She helped guide planning related to primary care, Affordable Care Act implementation and the New York State legislative agenda. Recent work has included policy analysis on the impact of DSRIP, health planning for the New York’s State Health Improvement Plan, and health access for immigrants. Ms. Shah also served as the principal investigator on a number of ongoing studies that focused on the primary care provider landscape in New York City, as well as emergency planning and response for primary care. Ms. Shah worked at the Boston Consulting Group from 2005 to 2012, where she advised Fortune 500 companies, coordinated a climate change strategic planning process for Mayor Bloomberg’s office, and led the “International Consortium for Health Outcomes Measurement” for Harvard University’s Institute for Strategy and Competitiveness. From 1998 to 2004, Ms. Shah was a senior consultant for Accenture in their Health Services group. She holds a B.A. in International Development Studies, an M.B.A., and an M.P.H. in Health Policy and Management from the University of California at Berkeley.

Compliance professional with over 20 years of experience within government programs including Medicare, Special Needs Plans, Dual Demonstrations, Medicaid and Marketplace. Currently serving as Medicare Compliance Officer and Director of Marketplace Regulatory Compliance at CareSource in Dayton, Ohio.

As vice president of Risk Adjustment, Elaine Taverna is responsible for leading, developing, refining and implementing risk adjustment strategies for HAP. This involves collecting and analyzing member health data in order to determine the cost of providing care, particularly for those with chronic conditions.

Elaine is an expert in government health programs with more than 20 years of clinical, operations and administrative experience, which includes time in the nonprofit sector and national consulting experience.

Prior to joining HAP, Elaine was the director of government programs for Henry Ford Health System. In this role, she led a transformational project to evaluate, design and implement a system-wide integrated risk adjustment program designed to improve health outcomes for patients and members.

Elaine holds a bachelor's degree in social work from Eastern Michigan University and a master's degree in health administration from Central Michigan University. She is a licensed social worker in the State of Michigan.

Pritpal S. Virdee, Senior Vice President and Chief Operating Officer- Senior Health Services leads the operational areas across all product lines, fostering a strong matrix partnership across key operational functions within BCBSM. Pritpal recently came from Anthem, where he held the position of Health Plan President, Medicare - Indiana, Kentucky and Missouri holding profit and loss responsibility for all Medicare products within the regions. He previously served in leadership roles at Walgreens and Express Scripts. Pritpal earned a Bachelor’s degree in Chemical Engineering from Southbank University in London, and a Diploma in Marketing from the Institute of Marketing in the United Kingdom.

Dr. Dirk Wales is the Chief Medical Officer for Cigna-HealthSpring and has been with the company since 2008. He is responsible for clinical oversight and setting the direction and strategy for clinical initiatives.

Prior to his current role, he was senior medical director for the Texas market, one of the company’s largest markets. Before joining Cigna-HealthSpring, he served in leadership roles with other managed care companies including North American Medical Management, Inc.

He graduated from Wright State University, Dayton, Ohio with an M.D. and Psy.D. He completed his residency and a chief residency at Northwestern University, Chicago, Ill. He holds a B.S. from Emory University, Atlanta, Ga.

Wales is an internist by training and practiced for several years on the West Coast. His areas of interest are dual diagnosis patients, chronic pain and emotional concerns in a physical setting.