Advisory Committee Member Recruitment The Washington Health

Transcription

Advisory Committee Member Recruitment
The Washington Health Benefit Exchange is currently recruiting for a member to serve on its Advisory
Committee. The nominee should be a consumer or have experience representing consumers and their
interests should be in accessing affordable health care.
The Advisory Committee provides expertise, experience and professional perspectives on an array of
issues with regard to health care and health insurance to the Exchange Board. More information is
available on our website: http://wahbexchange.org/committees/advisory-committee/
Interested parties can submit nominations, including a biographical sketch, to Exchange staff via the
Exchange email address: [email protected]. Please use Advisory Committee Nominee as your
subject line. The deadline for submitting nominations is Monday, November 18, 2013 at 5 PM.
Nominees
Birgit Ages
Diana Arens
Tanda Bastin
Mayling Chin
Theresa Connor
Mariella Cummings
Sydney Diamond
Bill Dowling
William Eisaman
Johanna Freedman
Malcom Langford
Nancy Lawton
Eric Lo
Sallie Niellie
Julie Severson
Sylvia Villalovos Aguilar
Audrey Wu
Charter
Advisory Committee of the Washington Health Benefit Exchange
Establishment
The Advisory Committee is established as permitted under Article III, Section 3.1 of the
Washington Health Benefit Exchange (WAHBE) Board By-Laws.
Membership
The Advisory Committee was appointed by the WAHBE Board on May 16, 2012 and will
consist of the following members:
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Sharon Beaudoin, WithinReach
Ted Blotsky, Employee Benefit Services-Associated Employers Trust
Glen Bogner, Molina Healthcare
Emily Brice, Northwest Health Law Advocates
Kitti Cramer, Premera Blue Cross
Mike Fournier, Fournier Healthcare Services
Patty Hayes, Public Health – Seattle & King County
Stacey Hendrickson, A&H Stores, Inc.
Melinda Hews, Group Health Cooperative
Stacy Kessel, Community Health Plan of Washington
Dhyan Lal, Providence Health & Services
Mary McWilliams, Puget Sound Health Alliance
Hiroshi Nakano, South Sound Neurosurgery
Jim Pinkerton, Regence BlueShield
Harvey Smith, Pacific Medical Centers
Larry Thompson, Whatcom Alliance for Healthcare Access
Joshua Welter, Mainstreet Alliance
Washington Association of Health Underwriters (WAHU) Representative (Dave
Maddock)
American Indian Health Commission (AIHC) Representative (Leslie Wosnig)
Purpose
The Advisory Committee is a standing committee that serves at the pleasure of the WAHBE
Board. The Advisory Committee provides expertise, experience and professional
perspectives on an array of issues. Topics considered by the group are generated by the
Board and requested to be considered by the Advisory Committee. The Advisory
Committee can also provide the Board with topics related to the work plan of the Board for
their consideration. The Board will then provide guidance on which topics they would like
the Advisory Committee to consider. The Advisory Committee deliberates issues and
provides comments to the Board and Board Committees. The Board understands that there
may be varying recommendations that are provided to the Board, but to the extent possible,
Washington Health Benefit Exchange – Advisory Committee
August 27, 2013 – Approved by Exchange Board
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the Advisory Committee attempts to reach common ground among its members. The Board
may request regular reports from the Advisory Committee.
Responsibilities
Advisory Committee members are responsible for:
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Attending regularly scheduled meetings either in-person or via teleconference
Reviewing issues and policy topics as delegated by the WAHBE Board
Providing reports and recommendations to the WAHBE Board and Committees
Structure
The Advisory Committee will meet at such times as is determined to be necessary or
appropriate to prepare for reporting to the Board Committees. Meetings are generally held
monthly, and the meetings are open to the public and held at a location that allows for public
observation.
Exchange staff develops agendas and facilitates discussions. Advisory Committee meeting
agendas as well as meeting minutes will be posted on the Exchange website.
Advisory member terms are one year, beginning July 1 through June 30. Terms are
renewable. If a member of the Advisory Committee leaves the Committee, Board members
submit nominations to replace the type of organization that had been represented. Changes
to the Advisory Committee must be approved by the Board.
Washington Health Benefit Exchange – Advisory Committee
August 27, 2013 – Approved by Exchange Board
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Birgit Ages Hansen, Erica
Subject:
Attachments:
FW: Advisory Committee Recruitment
Insurance Resume.doc
From: Birgit Ages [mailto:[email protected]] Sent: Monday, November 11, 2013 8:25 AM To: WAHBE Info Subject: Re: Advisory Committee Recruitment Hi;
I would be interested in serving. I have over 20 years experience in healthcare the Insurance industry up to the reinsurance level.
I have excellent communication and problem solving skills.
"If it could be done Birgit would have done it" is what my co-workers say about me.
thanks
Birgit
----- Original Message ----From: WA Health Benefit Exchange
To: [email protected]
Sent: Monday, November 11, 2013 7:30 AM
Subject: Advisory Committee Recruitment
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Advisory Commitee Recruitment
The Washington Health Benefit Exchange is currently recruiting for a member to serve on its
Advisory Committee. The nominee should be a consumer or have experience representing
consumers with interest in access to affordable health care.
The Advisory Committee provides expertise, experience and professional perspectives on an
array of issues with regard to health care and health insurance to the Exchange Board. More
information is available on our website: http://wahbexchange.org/committeeactivities/advisory-committee
Interested parties can submit nominations, including a biographical sketch, to Exchange staff via
the Exchange email address: [email protected]. Please use Advisory Committee
Nominee as your subject line. The deadline for submitting nominations is Monday, November 18,
2013 at 5 PM.
Thank you,
1
The Washington Health Benefit Exchange Communications Team
Edit your subscription | Unsubscribe
810 Jefferson St. SE
Olympia, WA 98501
[email protected]
wahbexchange.org
2
Birgit Teuwen Ages
e-mail [email protected]
http://birgitages.com
(206) 368-9720 or (206) 947-8393
(cell)
PROFILE
Senior Medical Claims Examiner with experience from third party administration, re-insurance and
government programs to fully insured plans. Medical Terminology, contract interpretation,
APPLICATIONS
FrontPage, Access, Excel, Visio, Power Point, MS Project, various proprietary IBM Insurance
programs, some basic HTML.
MEDICAL CLAIMS
Insurance Overload Seattle, WA Senior Claims Processor,
1995-1996
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King County Medical (Basic Health), Blue Cross of Washington, and PacificCare
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Processed medical claims for several Washington healthcare programs.
Group Health Seattle, WA Administrative Assistant
1992-1995
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Assisted Project Director with conversion of new Patient Accounting System.
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Supported 25-member project team by coordinating programmer and trainer schedules,
preparing training materials, tracking clinic devices, invoicing and providing
miscellaneous assistance.
Multi Hospital Shared Services
1978-1982
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Administered self funded medical plans of major Hospitals in the Southern California area.
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We were a staff of four claims examiners processing everything from A-Z . I was also involved
in interviewing and training new employees.
We started out doing manual claims and went computerized after about 2 years. We handled our
own phones and customer inquiries.
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Home Life Arcadia, CA
1982-1984
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I processed everything from medical to dental to disability claims.
I handled cases such as Mini Mart, Inyo County and Bloom Advertising agency.
Usually assigned to the most difficult customers/cases and able to turn unhappy customers into
happy ones.
US BENEFITS/Harbor Insurance Medical re-insurance benefits.
1984-1986
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I worked claims greater than $10,000.- /year with 12/12, 12/15 and 12/open contracts.
incurred/paid in 12/ etc...
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coordinated and requested information from Human Resources personnel and providers as well
as insurance carriers.
determine if claims would qualify for the reinsurance coverage and its terms.
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Escobar Administrators Los Angeles, CA Reinsurance Co-ordinator
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1986-1988
Submitted re-insurance claims to various re-insurance carriers for third-party administrator.
Evaluated claims to ensure they qualified for re-insurance benefits.
Implemented tracking system to reduce turn around time and follow up where needed.
Reduced turn around time 70 %, by training examiners in completion of packages to get proper
reimbursement by re-insurance carriers. Turn around time improved due to complete
information provided in a timely manner.
Blue Cross of Southern California
1974-1978
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I received my training at, from hospital to professional claims on Union contracts like
Carpenters Health and Welfare, Cement Masons and others.
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I went from customer service and phones to Research and Adjustments in 6 months.
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I processed everything from basic hospital benefits, to professional claims, to prescription
drugs, COB and Medicare. At the time we had both basic and major medical benefits. Always
handled the most difficult cases.
Diana Arens Hansen, Erica
Subject:
FW: Advisory Committee Nominee
From: Diana Arens [mailto:[email protected]] Sent: Tuesday, November 12, 2013 12:19 AM To: WAHBE Info Subject: Advisory Committee Nominee Washington Health Benefit Exchange staff,
I am writing to nominate myself to serve on the Advisory Committee of the Washington Health Benefit
Exchange. I am a health insurance consumer, and I have informally helped others to sign up through the
exchange.
I am Diana Arens. I have worked for Community Resources for 23 years, providing direct support services to
adults with autism and other developmental disabilities in the Olympia area. I am a graduate student in the
Master of Public Administration program at The Evergreen State College. My MPA (in progress) is in Public
Policy and Nonprofit Management. I recently completed studies in Statistics and Graduate Writing.
As a health insurance consumer, I lost my own employer-sponsored health insurance about five years ago, and
have been purchasing health insurance on the open market since that time. I am in the process of finalizing my
application (verifying income) and selecting insurance through the Washington Health Benefit Exchange.
I have helped others all the way through their applications. I just helped my partner to sign up this evening. I
helped my brother, who has a TBI, to check out his insurance options. I have also helped various people with
developmental disabilities through my work. (In my work I have helped people access health services utilizing
Medicare, Medicaid, ProviderOne, Cigna, Humana, Windsor Rx, Social Security Part D plans, and I still
remember med coupons.) There have been a few hiccups in the Washington Health Benefit Exchange sign-ups,
which called for persistence and patience. However, the plan and coverage we are going to get through the
exchange, compared to what we had, is phenomenal.
On a very personal note, I was ill last year (I’m better now), and my out-of-pocket medical costs for the year
topped $10,000. I am very personally invested in the success of the Washington Health Benefit Exchange, and
in the public benefits of the Affordable Care Act. This is why I wish to serve on the Advisory Committee. I
want to see the process work well for everyone in Washington State. Thank you for your consideration of my
application.
Sincerely,
Diana Arens, Olympia, Washington
Cell: (360) 250-0939
----- Original Message ----From: WA Health Benefit Exchange
To: [email protected]
Sent: Monday, November 11, 2013 7:30 AM
Subject: Advisory Committee Recruitment
1
Tanda Bastin
Valley Hospital and Medical Center
Hansen, Erica
Subject:
Attachments:
FW: Advisory Committee Recruitment
Tanda110713.docx
Importance:
High
Thank you Ms. Trickle for the information. I have attached my resume for your review. I appreciate your valuable time. Have a great day  Tanda Bastin
Eligibility Screening Services/ Certified IPA- WA Health Benefit Exchange
Valley Hospital & Medical Center
12606 E Mission Ave
Spokane Valley, WA 99216
P- 509-473-5012
F- 509-473-5013
Disclaimer: This e‐mail, including attachments, is intended for the exclusive use of the person or entity to which it is addressed and may contain confidential health information that is privileged and legally protected from disclosure by federal law (HIPAA). If the reader of this e‐mail is not the intended recipient, you are hereby notified that disseminating, distributing, copying, or otherwise using the information in this e‐mail is strictly prohibited. If you have received this e‐mail in error, please advise the sender by reply e‐mail and delete this e‐mail immediately. From: WAHBE Info [mailto:[email protected]]
Sent: Monday, November 18, 2013 2:46 PM
To: Bastin, Tanda Jan
Subject: RE: Advisory Committee Recruitment
Thank you for your interest in the Advisory Committee. My apologies for the late reply. Committee members have the option of participating in person, at our Olympia office, or by webinar/teleconference. Nominees do not need to come from particular regions. The current position to be filled should be a consumer or have experience representing consumers and their interests should be in accessing affordable health care. If you are interested in submitting a nomination, please feel free to email the materials directly. Please let me know if you have any other questions. Kate Trickle Senior Program Specialist, Policy Washington Health Benefit Exchange 810 Jefferson Street SE | 360.688.7776 [email protected]|wahbexchange.org Please note: beginning April 25, 2013, my telephone number changed to (360) 688‐7776. 1
From: Bastin, Tanda Jan [mailto:[email protected]] Sent: Monday, November 11, 2013 7:39 AM To: WAHBE Info Subject: Advisory Committee Recruitment In which demographical area will the candidate need to be located? Respectfully, Tanda Bastin Eligibility Screening Services/ Certified IPA- WA Health Benefit Exchange Valley Hospital & Medical Center 12606 E Mission Ave Spokane Valley, WA 99216 P- 509-473-5012 F- 509-473-5013 Disclaimer: This e‐mail, including attachments, is intended for the exclusive use of the person or entity to which it is addressed and may contain confidential health information that is privileged and legally protected from disclosure by federal law (HIPAA). If the reader of this e‐mail is not the intended recipient, you are hereby notified that disseminating, distributing, copying, or otherwise using the information in this e‐mail is strictly prohibited. If you have received this e‐mail in error, please advise the sender by reply e‐mail and delete this e‐mail immediately. Disclaimer: This electronic message may contain information that is Proprietary, Confidential, or legally
privileged or protected. It is intended only for the use of the individual(s) and entity named in the message. If
you are not an intended recipient of this message, please notify the sender immediately and delete the material
from your computer. Do not deliver, distribute or copy this message and do not disclose its contents or take any
action in reliance on the information it contains.
NOTICE: This message (including any attachments) may contain information that is privileged, confidential,
proprietary and/or otherwise protected from disclosure to anyone other than its intended recipient(s). Any
dissemination, copying, retention or use of this message or its contents (including any attachments) by persons
other than the intended recipient(s) is strictly prohibited. If you have received this message in error, please
immediately notify the sender by reply e-mail or telephone and permanently delete all copies of this message
and any attachments. Thank you for your cooperation.
Disclaimer: This electronic message may contain information that is Proprietary, Confidential, or legally
privileged or protected. It is intended only for the use of the individual(s) and entity named in the message. If
you are not an intended recipient of this message, please notify the sender immediately and delete the material
2
Tanda Bastin
1220NMarcusSpokaneValley,Wa992016(509)599‐6108[email protected]
Objective
ToprovideexceptionalandotherTeamMemberdutieswhiledemonstratingexcellentorganization,
communication,andprojectmanagementskillsprovenby17yearsofsuccessfulpatientcare,customer
relations,andsuccessfulsmallbusinessco‐ownership.
Education
SpokaneCommunityCollege‐1991
MedicalOfficeAssistantCertificate
Skills

17yearsofmedicalofficeandhospitalexperience,providingexcellentcustomerservicetomedical
professionalsandpatientswhilecomplyingwithHIPPAregulations.
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17yearsofexperienceusingmedicalterminology,frontofficeadministration,andbackofficeclinical
assistantwhilebeingdetailorientedandaccurate.
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Ahighenergy,enthusiasticanddependableindividualwhoexcelsinchallengingenvironmentsand
hasbeenrecognizedforhighethicalstandardsinallworkperformed

Excelsinchallengingandfastpacedenvironmentswhileaccomplishingtasksquicklyandefficiently.

ProficientinMicrosoftWord,Excell,andOutlook.Extensiveexperienceinmultiplesystems;DMSHot
Key,Centricity,MediTech,AllScriptsandArtiva,aswellasdataentry,tenkey,andanabilitytotype45
WPM.
ProfessionalExperience
EligibilityScreeningServices;Jan2013‐Current
PatientRepresentative:Screenuninsuredorunderinsuredpatientstodetermineiftheyqualifyforany
local,stateorfederalprogramstohelppaytheirmedicalbills.Upondeterminingiftheyqualify,Iassistthem
withsubmittinganapplicationtotheagencytheyqualifywith.Ifollowtheapplicationthroughto
approval/denialandsubmittothebillingdepartmentforbilling.Ialsoassistpatientsinfilingcharity
paperwork.Mymainresponsibilitiesaretorecovermoneyforthehospitalandfindhealthcoverageforthe
patients.IamalsoaCertifiedIn‐PersonAssister,allowingtometoenrollpatientsintheAffordableCareAct
asmandatedbylaw.
SonoranHeartCardiovascularSpecialists;2007‐2012
Scheduler/MedicalAssistant/Tech:Fourphysicianpracticespecializingincardiovascular,primaryand
podiatry.Ischeduledappointments,procedures,andtestsforpatientsbyorderofthephysicianaswellas
gettingcorrectauthorizationsandreferralsforthepatientsbasedontheirhealthinsurancerequirements.I
wastheimmediateassistanttothephysiciansandfunctionedasthephlebotomist,medicalassistantand
cardiovasculartechrunningEKG’sonpatients.Iperformedfrontandbackofficetasksdaily.
*ExcellentReferencesAttached*
Mayling Chin Yakima County Hansen, Erica
Subject:
From: Mayling Chin [mailto:[email protected]] Sent: Thursday, November 14, 2013 11:34 AM To: WAHBE Info Subject: FW: Advisory Committee Nominee To whom it may concern,
I am responding to your request for nominations for a Consumer Volunteer to serve on the Washington Health
Benefits Exchange Advisory Committee commencing in 2014.
Since April 1998, I have been the Benefits and Compensation Administrator for Yakima County, a local
government agency. Yakima County employs over 1100 employees in 35 departments who perform work in
various industries such as road / building construction and management, planning and law and justice
administration services for the County’s residents.
As Benefits Administrator, my duties include assisting a committee composed of elected employees in reviewing,
selecting and administering cost effective health and ancillary benefit plans for a majority of employees and
retirees that obtain health coverage through the County. This requires comprehensive knowledge of the
healthcare reform and its effect on County employees and citizens in Washington State.
My knowledge of health care reform and health benefits extends beyond my employment. In addition to my
professional duties, I am an active SHIBA counselor (1998) and currently serve on the RVSP of Yakima County
Board of Directors (2011). My volunteer work as a SHIBA counselor and Board member have broadened my
knowledge of the benefits provided by original Medicare, Medigap, MedAdvantage plans and Medicaid, of which
I share with others in need of making an informed decision about acquiring health care coverage for themselves,
family and / or friends. I have also obtained certification as a Community Partner with Enhanced Access to
assist others in enrolling into the Marketplace.
I feel my background is ideal and would be an asset to the Committee. Thank you for your consideration. If you
have questions or are in need of references, please contact me.
Sincerely,
Mayling Chin, SPHR
Administrative Supervisor - Benefits and Compensation
Yakima County
Human Resources
128 N 2nd Street Room B27
Yakima, WA 98901
Tel: 509-574-2217
Fax: 509-574-2211
Email: [email protected]
1
Theresa Connor Compassion & Choices Hansen, Erica
Subject:
Attachments:
THERESA M CONNOR, JD 2013.pdf
From: Theresa M. Connor, JD [mailto:[email protected]] Sent: Monday, November 18, 2013 1:34 PM To: [email protected]. Cc: Theresa M. Connor, JD Subject: Advisory Committee Nominee Dear Sir or Madam,
Please accept my nomination for the Washington Health Benefit Exchange Advisory Committee. My attached
resume describes my professional experience, health-related public service, and my personal commitment to
ensuring Washingtonians have access to affordable and quality health care.
Thank you for your consideration.
Sincerely,
Theresa M. Connor, JD
1916 Franklin St SE
Olympia, WA 98501
(360) 561-2907
[email protected]
1
THERESA M. CONNOR, JD 1916 Franklin Street, S.E. • Olympia, Washington 98501 (360) 561-‐2907 • [email protected] PROFESSIONAL PROFILE Licensed attorney with community service and public policy experience related to health and social issues at the federal, state and local levels. HEALTH CARE RELATED COMMUNITY SERVICE Over two decades of public service as a board member and volunteer with state and local organizations working to improve public health and increase support for families and caregivers. •
Member, Leadership Conference on Civil & Human Rights (LCCHR) Health Care Task Force, 2012-‐2013; •
Member, Center for Excellence in Assisted Living (CEAL) Advisory Council, 2012-‐2013; •
Member, Assisted Living Consumer Alliance, 2011-‐2013; •
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Appointed Consumer Representative to the National Association of Insurance Commissioners (NAIC), 1997-‐1998; Member of the Washington State Health Services Commission’s Working Group on Adolescent Health Services, 1993-‐1995; Member, Washington State Health Care Authority’s Primary Care Access Study Advisory Committee, 1994; Founding Member/Secretary Treasurer, Washington State Women’s Health Care Coalition, 1994-‐1998; Co-‐author, Mandated Insurance Coverage of Prescription Contraceptives, Report for the Department of Health by the Washington State Council on Family Planning, 1998; Co-‐author, Minors Access to Confidential Health Services, Report of the Health Services Commission Issue Investigation Group on Adolescent Health Services, 1995; State Board Member, Children’s Alliance, 1991-‐1992; Member, Washington Federation of State Employees (WFSE), Local 443, 1987-‐1992. Chair of Local 443’s Women’s Committee, 1990. HEALTH CARE & SOCIAL SERVICES POLICY EXPERIENCE Legal, legislative, and regulatory experience related to: •
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Medicare, Medicaid, and state-‐funded health programs; Health insurance cost, quality, and access, including the Affordable Care Act, state health reform implementation, accountable care organizations, health insurance exchanges, network adequacy, essential community providers, Medicaid expansion efforts, and State Health Care Innovation Plans; Federal statutes and regulations related to electronic health records and protection/disclosure of protected health information; Licensing and certification of health care providers and facilities; Informed consent and access to confidential services for reproductive health, STIs, HIV/AIDs, mental health, and chemical dependency treatment; State and federal programs to improve the quality of care for older adults. PROFESSIONAL EXPERIENCE BLAIR BUTTERWORTH HEALTH POLICY FELLOW June 2013 – Present The Office of Congressman Jim McDermott Washington, DC Ranking member, House Ways & Means Subcommittee on Health Policy work has included: (a) monitoring state implementation of the federal Patient Protection and Affordable Care Act and documenting the impact of market consolidation on health care costs and access to care; (b) engaging with stakeholders involved in state, federal and global health programs; (c) monitoring global health efforts related to HIV/AIDs, tuberculosis, malaria, polio, non-‐communicable diseases, maternal/child health, sanitation and drinking water; and (d) serving as staff liaison to the Congressional Kidney Caucus and Congressional HIV/AIDS Caucus. DIRECTOR OF GOVERNMENT AFFAIRS March 2011 – Present Compassion & Choices Washington, DC Directed federal and state government affairs to improve care and protect patient rights at the end of life. PRINCIPAL January 2008 – February 2011 North Star Strategies, LLC Olympia, Washington Provided policy guidance and executive support for nonprofit organizations and advocacy coalitions. DIRECTOR OF PUBLIC POLICY November 1992 – December 2007 Planned Parenthood Public Policy Network of Washington Olympia, Washington Directed public policy efforts and stakeholder engagement for five non-‐profit community health care providers serving Washington, Oregon, and Idaho. GOVERNOR’S EXECUTIVE POLICY EXTERN April 2006-‐June 2006 Executive Policy Office Olympia, Washington Conducted research for the Governor's Executive Policy Office. SUMMER ASSOCIATE June 2005 – September 2005 Bennett Bigelow & Leedom, PS Seattle, Washington Conducted legal research and drafted legal memoranda on health care issues. LEGISLATIVE STAFF MEMBER December 1986 – October 1992 Washington Legislature Olympia, Washington Senior Legislative Assistant, 1990-‐1992; Senior Information Officer & Assistant Communications Coordinator, 1989; Public Information Officer II, 1986-‐1988. EDUCATION UNIVERSITY OF WASHINGTON SCHOOL OF LAW, Seattle, Washington Juris Doctor, June 2006 THE EVERGREEN STATE COLLEGE, Olympia, Washington Bachelor of Arts, Liberal Arts, emphasis on communications/political science, December 1982 Mariella Cummings Physicians of Southwest Washington Hansen, Erica
Subject:
Attachments:
Mariella Cummings November 2013 bio.docx
From: Mariella Cummings [mailto:[email protected]] Sent: Tuesday, November 12, 2013 12:54 PM To: WAHBE Info Subject: Advisory Committee Nominee I would like to offer my services as a volunteer to serve on the Advisory Committee. In the past I was the consumer advocate appointed by the OIC Commissioner to the WSHIP Board, a position that ended when the legislature reorganized the state high risk pool. I was honored to serve in that capacity. Please see the attached biographical sketch. I strongly support the Washington Health Benefit Exchange and would be pleased to participate as a volunteer on the Advisory Committee or in any other way that I can assist in your efforts. Mariella Cummings
Chief Executive Officer | Physicians of Southwest Washington
[email protected] | 360-528-2202 (direct) | 360-943-4337 (alt) | 360-701-1029 (cell) 1-877-943-4337 (toll free) | 360-754-4324 (fax) 319 Seventh Avenue SE, Suite 201 | Olympia, WA 98501 | www.pswipa.com This electronic message transmission, including any attachments, contains information from Physicians of Southwest Washington, which may be confidential or
privileged. The information is intended to be for the use of the individual or entity named above. If you are not the intended recipient, be aware that any
disclosure, copying, distribution or use of the contents of this information is prohibited. If you have received this electronic transmission in error, please
notify the sender immediately by a "reply to sender only" message and destroy all electronic and hard copies of the communication, including
attachments. 1
Mariella Cummings For the past thirteen years Mariella Cummings has served as the CEO of Physicians of Southwest Washington (PSW), an independent physician association serving Thurston and Lewis Counties. She concurrently serves as Board Vice Chair of Soundpath Health, a Medicare Advanatage insurance company which PSW co‐founded in 2007 and in which health insurance company PSW continues as a minority shareholder. Cummings is also President of Results Incorporated, a management consulting company founded by her late husband Max Cummings who succumbed to complications of AIDS in 1993. Since his death advocating for HIV/AIDS prevention and care services has been a major focus of Cummings’ volunteer activities. Cummings served on the WA State high risk insurance pool board appointed by the OIC Commissioner filling the designated consumer advocate position from 1994‐1997, and chaired the WSHIP grievance committee. She was appointed by the Thurston Board of Health to its Thurston Thrives Advisory Council and also serves as a member of its Access to Health Care Services Action Team. Cummings relocated to Olympia in 1987 when she was named the CEO at Capital Medical Center, a position she held for four years and through which position she formed lasting professional relaltionships with the medical community. Previously Cummings also served as the Director of Infectious Disease and Reproductive Health for the Washington Department of Health, responsible for HIV/AIDS, STD, TB, and Family Planning Programs. For 23 years through August of 2012 she served as a community board member and Panel Chair for Western Institutional Review Board. Cummings currently serves on the Boards of the Thurston County Chamber of Commerce and United Way of Thurston County. Cummings is Washington native who graduated from the University of Washington School of Nursing and has a Master of Science degree from the University of Arizona. She resides in Olympia with her daughter Rebecca who is an elementary school teacher. Cummings also has two sons and five grandchildren who live in Michigan and California. Sydney Diamond Sound Telecom Hansen, Erica
Subject:
From: Sydney Diamond [mailto:sdiamond@sound‐tele.com] Sent: Monday, November 11, 2013 9:49 AM To: WAHBE Info Subject: Advisory Committee Nominee Hello. I would like to nominate myself. As the CFO of a 26 year old Seattle Company employing 70 people, this market has been largely ignored by the ACA. Washington State has done a remarkable job thus far in its own roll out to comply with the new law, and I see many ways we can perhaps make this service even more valuable to consumers and the small to medium sized business market. My career spans 25 years at the CFO level, and benefits has always been under my umbrella. Going through enrollments and insurance premium increases has become more and more challenging this past several years and I feel I can add that perspective the Exchange is looking for. I live in the Seattle metropolitan area and have resided here for the past 20+ years. I am an avid support of Children’s Hospital and First Place. When people ask me what my job description is I say that basically I have two responsibilities: Protect the Assets of the Company (people, cash, property – in that order), and serve our employees. We have studied and continue to study the Affordable Care Act ( I have the 2000 page bill saved on my computer and yes I actually read it, research it, etc.) As a smaller employer, we have studied the ACA and continue to stay current on topics affecting it, as it affects our employees, and as it affects our fellow businesses in Washington State. Please let me know what materials I can submit for your consideration. Thanks much! Sydney Sydney Morgan Diamond, CFO-Controller
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1
William Dowling University of Washington Hansen, Erica
From:
Sent:
To:
Subject:
WAHBE Info
Monday, September 23, 2013 7:50 AM
Hansen, Erica
FW: Nomination of William Dowling for WAHBE Advisory Committee
From: Douglas Conrad [mailto:[email protected]] Sent: Saturday, September 21, 2013 6:15 AM To: WAHBE Info Subject: Nomination of William Dowling for WAHBE Advisory Committee Dear Selection Committee: I’d like to nominate William Dowling, Professor (and former Chair) of the University of Washington Department of Services, for a position on the Advisory Committee of the Washington Health Benefits Exchange. Bill has served in a variety of senior leadership positions in health care and academe, and his counsel would be extremely valuable for the Exchange. In addition to the brief précis below, I refer the Committee to the link to Bill’s faculty profile on the Department of Health Services website: http://depts.washington.edu/hserv/faculty/Dowling_William Précis: Professor Dowling served as Chair of the Department of Health Services from 1994-2008. He was first
appointed to the faculty in 1974, serving as Director of the MHA Program until 1981. From 1981 to 1994,
Dowling was employed as Vice President for Planning and Development in the corporate headquarters of the
Providence Health System where he was responsible for system strategic planning, linking system and
institutional planning, and government affairs. He returned to the University in 1994. Dowling's main interests
are in the development and execution of strategy in health care organizations and in understanding factors that
affect organizational performance.
Research Interests:
The relationships between the changing environment of health care, the strategic and structural responses of
health care organizations, their management, and their performance; management practice in health care
organizations; physicians in management and leadership roles; the medical home model of primary care; rural
health care
If the Committee were amenable, I’d propose that we recommend Bill in addition to Mark Stensager, whom I also strongly support. Sincerely, Doug Conrad (WAHBE Board & Selection Committee member) 1
Douglas A. Conrad, PhD Professor of Health Services Box 357660, H660C Magnuson Health Sciences Center 1959 NE Pacific Street Seattle, Wa 98195‐7660 Phone: (206) 616‐2923 2
Dowling_William - Department of Health Services. Graduate Degree (PhD, MPH, MS, M... Page 1 of 3
The Department of Health Services is the home for an extraordinarily
talented and productive group of faculty and students. Their interests
are far-ranging, but all share the aim of discovering ways to improve the
effectiveness and equity of society's efforts to improve the health of the
population.
Dept. of Health Services
Program Affiliations
•
Master of Health Administration Program
• Community-Oriented Public Health Practice
• Health Policy Faculty Affinity Group
• MPH Program in Health Services
William L. Dowling
Professor
Professor Dowling served as Chair of the Department of Health Services from 1994-2008.
He was first appointed to the faculty in 1974, serving as Director of the MHA Program until
1981. From 1981 to 1994, Dowling was employed as Vice President for Planning and
Development in the corporate headquarters of the Providence Health System where he
was responsible for system strategic planning, linking system and institutional planning,
and government affairs. He returned to the University in 1994. Dowling's main interests
are in the development and execution of strategy in health care organizations and in
understanding factors that affect organizational performance.
Research Interests:
The relationships between the changing environment of health care, the strategic and
structural responses of health care organizations, their management, and their
performance; management practice in health care organizations; physicians in
management and leadership roles; the medical home model of primary care; rural health
care
SciVal Experts Profile
Contact Information
email:
[email protected]
office:
H-690, Health Sciences Building
address:
School of Public Health
University of Washington
Seattle, WA 98195
campus box: 357660
voice: 206-616-2929
fax:
206-543-3964
Education
PhD University of Michigan, 1971 (Medical Care Organization)
MA University of Michigan, 1970 (Economics)
MBA University of Chicago, 1961 (Business (Hospital Administration))
BA Duke University, 1959 (Business Administration)
Teaching
(Department of Health Services Courses)
http://depts.washington.edu/hserv/faculty/Dowling_William
9/24/2013
• HSERV 591
COPHP PBL Core Curriculum - Year 2
• HSMGMT 510
Organizational Behavior and Human Resource Management
• HSMGMT 562
(Certificate in Medical Management)
Strategic Management of Health Care Organizations
• HSMGMT 562
Strategic Management of Health Care Organizations
Recent Publications
see more collected citations
Dowling WL. The "community-oriented" IHCO: how viable? Front Health Serv Manage.
1996 Summer;12(4):57-62. PMID: 10156174
PubMed
Wong B, Dowling WL. Organizing and sizing an integrated delivery system: building a
common strategic vision for hospitals and physicians. Health Syst Lead. 1994 Apr;1
(2):31-6. PMID: 10140244
PubMed
Durbin S, Haglund C, Dowling W. Integrating strategic planning and quality management
in a multi-institutional system. Qual Manag Health Care. 1993 Summer;1(4):2434. PMID: 10131008
PubMed
Dowling WL. The insurance industry's role in reforming delivery. Front Health Serv
Manage. 1992 Fall;9(1):36-40. PMID: 10120465
PubMed
Conrad DA, Dowling WL. Vertical integration in health services: theory and managerial
implications. Health Care Manage Rev. 1990 Fall;15(4):9-22. PMID: 2266012
PubMed
view books/publications in WorldCat
Dissertation, Thesis & Capstone Committees (recent HSERV
graduates)
2011
Chair, capstone for Britt Carlson
A case study of selected primary care practices participating in the Washington
Patient-Centered Medical Home Collaborative
2011
Chair, thesis committee for Nelly Kinsella
Healthcare reform and King County community health centers: An analysis of
organizational strategic planning
External Funding (sampling of recent awards from UW SAGE data)
Grand Rounds; Moments in Leadership: Case Studies in Public Health Policy and
Practice
Pfizer, Inc.
PI: Dowling
Dates:
1/1/2009 - 12/31/2010
9/24/2013
Projects
Clinical Integration
PI. Literature review on approaches to integrating patient care services, formal clinical
integration models, factors that facilitate and impede clinical integration, and "best
practices". Center for Health Management Research.
Links
Member, Board of Directors; Chair, Accreditation Council
• Commission on Accreditation of Healthcare Management Education
http://www.cahmeweb.org/
Member, Advisory Council, Basic Health Plan
• Washington State Health Care Authority
http://hca.wa.gov/
Member, Steering Committee, King County Health Action Plan
• Public Health - Seattle & King County
http://www.kingcounty.gov/healthservices/health.aspx
Faculty Associate; Member, Higher Education and Research Committee; Member,
Programs, Products and Services Committee
• American College of Healthcare Executives
http://www.ache.org/
Featured
• It's Not All Coffee and Computers as Health Care Innovation Thrives in Washington
State (Workforce, 09/24/2012)
Health Services | School of Public Health | Contact Us
© 2011 Department of Health Services, Box 357660, Seattle, WA 98195-7660
(206) 616-2935
• fax (206) 543-3964
• e-mail: [email protected]
Equal Opportunity and Disability Accommodation
SPH Emergency Information
9/24/2013
William Eisaman Hansen, Erica
From:
Sent:
To:
Subject:
Attachments:
WAHBE Info
Monday, November 18, 2013 2:47 PM
Hansen, Erica; Trickle, Kate
FW: Advisory Committee
Bill CV @.docx; Best Cover letter.doc
Kate Trickle Senior Program Specialist, Policy Washington Health Benefit Exchange 810 Jefferson Street SE | 360.688.7776 [email protected]|wahbexchange.org Please note: beginning April 25, 2013, my telephone number changed to (360) 688‐7776. From: William Eisaman [mailto:[email protected]] Sent: Monday, November 11, 2013 7:37 AM To: WAHBE Info Subject: Advisory Committee I submit my background for your opening
William (Bill) Eisaman
Duty, Honor, Country. Those three hallowed words reverently
dictate what you ought to be, what you can be, what you will be.
Douglas
MacArthur
1
William Eisaman, CPAM, MBA, FHFMA, FACHA
1725 242ndStt SE # 213
Bothell, Washington 98021
425-488-4708 H
425-877-3434 C
To Whom It May Concern:
Please find attached my curriculum vitae for your current opening. As a professional I bring 20+
years experience in hospital management to the table. My experience ranges from high volume,
high energy Corporate Environment to Non- Profit Businesses.
Among the many skills I possess I have prepared monthly statements for the Board of Directors,
for agency Senior Management and for outside Accounting Firm; I know and have worked MIP
accounting software and updated it as the newest updates were published for updating to system;
I have been in charge of payables in excess of 225-230 thousand a week and have done payroll
for 8-10 Sr. Management and 47 general employees; I always reviewed monthly billings for
accuracy and detail and then sent them out and performed Check and balance on all deposits and
monitored cash flow daily.
I made sure cash flow was what budget called for and also kept track of CD’s and investments as
well as seeing if we are getting best interest for all, I was instrumental, in Coordinating Support
Services.
My reputation is high with Maintenance and IS and I keep Quality Assurance as primary goal. I
perform periodic reviews of Maintenance Department and IS to be sure Policy and Procedures
are kept up to date and practiced as well as purchasing and or materials management.
Peer relations are maintained in an atmosphere of mutual respect and collaboration. In a
supervisory role I have a knack of dealing with my employees in all areas of the facility to
facilitate the aforementioned. I pride my self in relations with Board Members, Sr. Management
and all Staff Members in general.
Also am familiar with all Federal and States rules and regulations pertaining to the financial well
being of a facility and or practice. I work with at CMS pertaining to above. Work to create better
Patient Friendly Statements, Revenue Cycle, and HIPAA policy and procedures and following it
to the letter of the law.
Sincerely
William O. Eisaman CPAM/FHFMA
Email: [email protected]
Duty, Honor, Country. Those three hallowed words reverently dictate what you
ought to be, what you can be, what you will be.
Douglas MacArthur
William Eisaman, CPAM, CPAT,MBA, FHFMA, FACMA
1725 242nd St Se # 213
Bothell, Washington 98021
425-425-877-3434 C 425-488-4708 H
E-Mail: [email protected]
CAREER QUALIFICATIONS – CONFIDENTIAL RESUME

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
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

Healthcare Professional with more than 15years experience as Revenue Cycle Manager, Patient
Accounts Manager, Controller and CFO.
Hands-on manager able to work ably with staff to increase productivity and maintain high staff
morale. Excellent Project Manager and team player. Extensive experience with human resources
& expert in Patient/Client relations.
Extensive and varied financial experiences. Excels at contract negotiations, revenue cycle
design/re-design, AR, Billing, Collections, IS, Charge Master Updates & usage, cost reports &
appeals. Intensive HIPAA & Corporate compliance knowledge. Excellent relations with
Medicare/Medicaid and all intermediaries. 
Expert at lowering AR days, reducing expenses & setting and meeting budgets.
Lean Six Sigma Graduate Green Belt
Certified Healthcare Professional CHP
Certified Revenue Cycle Professional 
BroadknowledgeofcomputersystemsincludingSiemens,Envision,IDX,
CPSI,Dairyland,SMS,MedOffice,&Med‐Systems.Seniortrainer,inMedi
Tech,HBOC/McKesson.ExperienceinParagon,HorizonBusiness
Folders,PathwaysFinance,PathwaysScheduling.ActedasProgram
Managerinthreeinstallations.

Experienced Practice Manager: Administered and led hospital-owned and managed physician
practices. Practices ranged from 4-110 physicians. Broad knowledge of computer systems
including Siemens, Envision, IDX, CPSI, Project Manager for 6 installations and Sr. Trainer for
CPSI. Dairy land, SMS, Med Office, & Med systems. Senior trainer in Medi tech/HBOC
McKesson (Senior Trainer), Eclipses Next Gen, IDX, Gems’, Centricity, Misys Tiger and Vision.
Objectives
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

To lower AR and losses within six months and work closely with the Accounting Agency to
ensure financials and cost reports were done accurately and on a timely basis
Implement stricter Pre-Certification, Cash Deposits, and Collections of Co-Pays and
deductibles.
Set up Revenue Cycle Redesign, Patient Access and Critical access
Update charge master and redo OP surgery charge ticket Implemented more stringent policies,
on ABN verification MRI, Nuclear Medicine, CT tests Set up new Policies and Procedures for
Admissions, Business Office and Cashiering as well as making them HIPAA Compliant.

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Work through certification and new provider numbers and billing format for all Critical Access
Hospitals Critiqued RCU and Geri-Psych beds for critical access status.
Establish new patient-friendly statements and using out-sourcing to mail them. Saved $42,500
from previous vendor 
Form strong alliances with County Commissioners, Board of Directors, and Community leaders 
Have worked and am working on HIPPA 5010 implementation and maintenance 835/837
programs as well. 835 electronic submission 837 Anis edits and for use of Contract Management
and Denial Management. Have attended 5 seminars on ICD 10 and implementation of it and also
have gone through RAC audit and Medicare/Medicaid audits with Meditech. Primarily on
Meditech 4.5 5.0 went to seminar on 6.0 was in charge of Critical Access Facilities budget.
Electronic Clearing houses used or experienced in SSI, E-Premise, E-healthcare. NAIS Learned
and taught all four to billers and Patient Accounting departments. Plus WEBMD clearinghouse.
PROFESSIONAL EXPERIENCE
BLH Enterprises, New York, NY 2000-2011
VP Revenue Cycle Director/ Based in New York City, NY
E-mail:[email protected]
Work in a variety of facilities providing strategic Critical Access Conversions and Revenue Cycle
Redesign. Maintain a reputation for reducing AR, expenses and payables, increasing staff efficiencies,
assuring timely reports filing and producing accurate balance sheets for the following providers: Just a
few of the facilities I was at during my tenure.
Global Health Management (Now BLH Enterprises)
1990-2000
Beverly Hills, California
Vice President, Operations/CFO/Rev-Cycle Director/COO
I was employed 18 years at varying levels for this for-profit firm. The company merged with
BLH LLC in January of 2000. I was a full-time, salaried employee during this period.
Accomplishments with Global Health


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
Employed to manage a series of hospitals and physician practices throughout US.
Entered the hospitals and clinics and worked to bring facilities AR and Billing Collections in line.
Corporate Policy and Procedures and profit and loss equations made significant strides for the
Hospital and Community. Building up the reputation, financial well being of the facility in the
Community as well as with the fiscal Administrator. Worked on budget issues, HR issues,
Medical Records and Information Systems. Through the facilities/
During these assignments, served as a trouble-shooter, interim manager and company liaison, as
well as intermediary with Medicare and Medicaid providers. Also negotiated Contract with
outside HMO-PPO-Contract Providers both Hospital/Physicians.
EDUCATION
M.B.A, MHA Emphasis in Healthcare, Otto Berlin University, Otto Berlin,
B.A. Accounting, University of Wittenberg, Nottingham, England
B.S., Computer Science, University of Wittenberg, Nottingham, England
Certified Healthcare Financial Professional® (CHF Certified Revenue Cycle Representative Program (CRCR)
William Eisaman
Duty Honor, Country. Those three hallowed words reverently dictate what you ought to be,
what you can be, what you will be. Douglas MacArthur Johanna Freedman Johanna Freedman
9906 181st Ave NE
Redmond, WA, 98052
November 14, 2013
Washington Health Benefit Exchange
810 Jefferson St. SE
Olympia WA 98501
[email protected]
wahbexchange.org
I would like to serve on the Washington Health Benefit Exchange Advisory Committee because I
believe strongly in the value of ensuring the universal availability of health care in Washington
State and I could contribute to the Board's fulfillment of that mission. As a developmental
psychologist by training (PhD, Yale University, 2000) and a Washington Health Benefit
Exchange consumer, I am uniquely qualified to help the Board increase enrollment and meet the
health care needs of the citizens of Washington State.
The Washington State health care rollout has had a successful start, one that could serve as a
model for the nation, but as elsewhere, older adults have made up the greatest percentage of
enrollees. To achieve continued success, young adults will need to enroll in greater numbers.
As a developmental psychologist, I appreciate that young adults are in transition, and as with all
transitions, there is opportunity and risk. Far from the "young invincibles" of current media
fame, young adults have high rates of motor vehicle accidents, depression, suicide, and STDs.
This generation is particularly vulnerable, as their difficulty in obtaining well-paying, stable
work has undermined their confidence in themselves and potentially alienated them from a
society in which they cannot find a place. Affordable health care should be offered to them as a
source of support and an invitation to become a valued part of a community from which they are
in danger of feeling estranged.
As a consumer, my perspective on the Washington Health Benefit Exchange would balance that
of industry leaders, providing insight as to the experience of using the Health Exchange,
affording an opportunity for tweaks and corrections to the system that could improve the
experience for clients.
Sincerely,
Johanna Freedman Malcom Langford Retired Hansen, Erica
Subject:
Attachments:
Bio - WORD.doc; ATT00001.htm
From: Mac Langford [mailto:[email protected]] Sent: Monday, November 11, 2013 4:51 PM To: WAHBE Info Subject: Advisory Committee Nominee The Washington Health Benefit Exchange:
This is submission of an application to serve on the Exchange Advisory Committee.
I am highly interested in seeing that the Affordable Care Act is implemented so as to serve the best
interests of the broad population, especially those who in the past have found it difficult to obtain
affordable health insurance.
As a SHIBA volunteer for the past 20 years I have seen the frustration experienced by many seeking
to responsibly provide health insurance for their families, only to discover how extremely expensive
this would be. These are the ones who can now most benefit from the ACA.
Also, I understand how critical it is to the success of the program to have young, relatively healthy
people participate in the pool.
Volunteering has been an important part of my life, especially now that I have the time to devote to it.
I would be happy to serve as a member of the Advisory Committee.
A biographical sketch is copied below and is also attached as a WORD document.
Sincerely,
Malcolm (“Mac”) Langford
Malcolm S. Langford
97 Nelson Lane
Lopez Island, WA 98261
(360) 468-4015
[email protected]
Bio for the opening on the Washington Health Board Benefit Exchange Advisory Committee:
Higher education: BA Amherst College, 1960; MA Stanford University, 1962
Currently retired from a high school teaching career in Cupertino, California - history, government,
various other social studies courses, English, and English as a second language
Have lived on Lopez Island since 1993 after being a “summer person” since 1972
1
Volunteer experience:
SHIBA - since 1993
Lopez Community Center - board member (1998-2003, 2007-2009 - serving as chair, vicechair, treasurer, and secretary), currently chair of the major fundraising activity
Lopez Solid Waste Disposal District
Flat Point Community board (several years ago and 2008-present)
While teaching, served on curriculum committees and on community choir boards (sometimes
as president or treasurer)
Have traveled extensively in the US and Europe
2
Malcolm S. Langford
97 Nelson Lane
Lopez Island, WA 98261
(360) 468-4015
[email protected]
Bio for the opening on the Washington Health Board Benefit Exchange Advisory
Committee
Higher education: BA Amherst College 1960, MA Stanford University 1962
Currently retired from a high school teaching career in Cupertino, California - history,
government, various other social studies courses, English, and English as a second
language
Have lived on Lopez Island since 1993 after being a “summer person” since 1972
Volunteer experience:
SHIBA - since 1993
Lopez Community Center - board member (1998-2003, 2007-2009 - serving as
chair, vice-chair, treasurer, and secretary), currently chair of the major
fundraising activity
Lopez Solid Waste Disposal District
Flat Point Community board (several years ago and 2008-present)
While teaching, served on curriculum committees and on community choir
boards (sometimes as president or treasurer)
Have traveled extensively in the US and Europe
Nancy Lawton Neighborcare Health Nancy Lawton, BSN, MN, ARNP, FNP
(206) 817-3335
[email protected]
Experiences: President, ARNPs United of Washington State, 2012 - present
Current Washington State Representative to the American Academy of Nurse
Practitioners
Family Nurse Practitioner providing primary care to medically underinsured
patients among vulnerable populations; including homeless, immigrant
and refugee populations, and those with behavioral health needs.
Assistant Medical Director, Greenwood Medical Clinic, 2010-2012
Biographical Sketch:
After 35 years providing primary care I am excited to
participate in health policy, including the implementation of the Affordable Care Act. My
goal is to increase access to care for our patients and cultivate a balanced working
environment for the next generation of providers.
My journey as a health care advocate began in rural Kentucky in the mid 1970s, pursuing the
model of nurses delivering primary care to underserved people through the Frontier Nursing
Service. I attended nursing school at Boston State College, now part of the University of
Massachusetts. I trained during the years Senator Ted Kennedy advocated for National Health
Insurance. My graduate school education at the University of Washington was funded by the
Carter Administration that endorsed expanding the role of advanced practice nurses for
primary care services in underserved areas.
I am a primary care provider and have trained healthcare workers throughout my career, in
community health centers and at Harborview Medical Center. At Harborview’s Women’s
Clinic I saw primary care patients and began the Breast Care Center, collaborating with the
Departments of Ob/Gyn, Surgery, Radiology and Oncology, while participating in the training
of surgery residents. Earlier in my career, I worked for the International Rescue Committee
with Cambodian refugees, training health care personnel in a refugee camp; including
midwives, PAs, nurses, and physical therapists. With the World Health Organization I trained
nurses as Community Health Workers for regions with no primary health care providers.
Skills:
I have been a nurse for 36 years and an Advanced Practice Nurse for 33 years.
Nursing perspective is a unique and valuable contribution to policy making.
I have participated in the implementation of three different Electronic Health
Records systems; Mindscape and Orca at Harborview Medical Center, and NextGen at
NeighborCare Health.
Employment:
Neighborcare Health, Greenwood Medical Clinic, 2005- present,
currently locums status.
Harborview Medical Center, 1982-2004
Education:
Bachelor of Nursing Science, Boston State College, 1977
Master of Nursing Science, University of Washington, 1980
Eric Lo Delta Dental Hansen, Erica
Subject:
FW: Advisory Committee Nomination
From: Sean Pickard [mailto:[email protected]]
Sent: Monday, November 18, 2013 13:38
To: Danielson, Benjamin
Subject: Advisory Committee Nomination Dr. Danielson: I was speaking with Teresa Mosqueda and she reminded me of the open position on the Advisory Committee.
Since the Exchange is considering expanding the access to adult & family dental coverage moving forward, we think it would be important to have a dental voice on the Advisory Committee. Eric Lo is our VP for Underwriting at Delta Dental of Washington, formally Washington Dental Service. He would be an excellent asset to have in providing the Board with dental coverage expertise. Thank you for your consideration and assistance. Sean P. Pickard Government Relations Delta Dental of Washington 9706 Fourth Avenue NE, Seattle, WA 98115-2157 p. (206) 528-2304 c. (206) 818-5405 f. (206) 985-4786 [email protected] www.deltadentalwa.com ______________________________________________________________________
The information contained in this e-mail and subsequent attachments may be privileged, confidential and
protected from disclosure. This transmission is intended for the sole use of the individual and entity to whom it
is addressed. If you are not the intended recipient, any dissemination, distribution or copying is strictly
prohibited. If you think that you have received this message in error, please e-mail the sender at the above email address.
______________________________________________________________________ CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the
intended recipient(s) and may contain confidential and privileged information protected by law. Any
unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please
contact the sender by reply e-mail and destroy all copies of the original message.
<Eric Lo bio.docx>
1
NOTICE: This message (including any attachments) may contain information that is privileged, confidential,
proprietary and/or otherwise protected from disclosure to anyone other than its intended recipient(s). Any
dissemination, copying, retention or use of this message or its contents (including any attachments) by persons
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Eric Lo is vice president of Underwriting and Actuarial Services for Washington Dental Service. He directs the actuarial and underwriting functions, which include pricing of dental products, projection of revenues and claim liabilities, as well as oversight of corporate financial risk. Before joining Washington Dental Service in 2008, Mr. Lo spent 5 years in various actuarial roles with Trustmark Life Insurance Company, a mid‐sized health and life insurer based in Lake Forest, Illinois. His career began at Lucent Technologies, what is now Alcatel‐Lucent, as a wireless network engineer involved in the deployment and integration of CDMA wireless communications systems in the international market. Mr. Lo, an Associate of the Society of Actuaries and Member of the American Academy of Actuaries, holds a Bachelor of Science in Electrical Engineering from the University of Illinois at Urbana‐Champaign with a minor in Mathematics. Sallie Niellie Project Access Northwest Hansen, Erica
Subject:
Attachments:
FW: Advisory Committee Nominee.
S Neillie bio 8 2013.docx
From: Sallie Neillie [mailto:[email protected]] Sent: Monday, November 11, 2013 11:16 AM To: WAHBE Info Cc: Sallie Neillie Subject: Advisory Committee Nominee. I would like to be considered for appointment to the Advisory Committee. Attached is my short bio. As the founder of Project Access Northwest, I am the leader of an organization whose mission is to improve access to needed medical and dental services for vulnerable populations regardless of income or insurance status. We work closely with uninsured patients – many of whom may now be eligible for Medicaid and or able to purchase coverage on the Exchange. Many of these patients are not used to having insurance and may not know how to use it appropriately. We work with the patients referred to us to build health literacy on using the health care system appropriately. If chosen the sit on the Advisory Committee, the unique perspective I’d bring would be the low income who  Don’t know how to use insurance  Don’t know how to access the health care system appropriately  Who may not have the financial resources to pay the cost‐share even with the assistance of the federal subsidy  Who are still “outside.” Additionally, Project Access NW’s success is, in large part, due to our attention to making serving the low income patient population easy for the physicians who donate care to the uninsured or bill Medicaid for the Medicaid.  I bring the perspective of needing to keep the health system at the table in a way that works for them and for their business model.  We have experience at getting and keeping physicians at the table to serve the Medicaid population – with the reimbursement level the specialty practices see as unfavorable by making it easy and efficient to provide care to a balanced number of uninsured and low‐reimbursement patients.  We have experience and credibility in improving the efficiency of serving no and low‐cost reimbursement patients by case managing and care managing to assure health system time is will utilized (ie, making sure labs and images are available prior to a patient appointment to reduce the need for redundant diagnostics I appreciate your consideration. Sallie Sallie Neillie | Executive Director
Project Access Northwest | 1111 Harvard Avenue | Seattle, WA 98122
Direct: 206.496-1590 | T: 206.788.4204 ext 101
F: 206.382.3507 or 800.579.1494 | [email protected]
Please visit our website at www. projectaccessnw.org 1
This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged. If you are not the
intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited. If you have received this
message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy
all copies of this message. Thank you. 2
Sallie Neillie, MS. Executive Director, Project Access Northwest.
Sallie Neillie founded Project Access Northwest in early 2006 with the help and support of
committed group of individuals who were determined to find a way to improve access to needed
specialty services for the low-income uninsured and underinsured. Since its inception, Project
Access has served over 16,000 patients from all over King, Snohomish and Kitsap
Counties. The specialty care services they received are valued at approximately $50 million
dollars. By staying focused on the goal – appropriate and timely specialty care provided by a
broad network of participating specialty providers – Sallie and her organization continue to grow
and are an important part of the local safety net.
Prior to founding Project Access NW, Sallie worked for Group Health Cooperative for 16
years. While there, her experience included a number of positions in both the health care
delivery system and in the insurance division. She also spent four years as the Director of Health
Access for the Washington Health Foundation. In this role, she worked with numerous
communities throughout the state to improve access to health services for the uninsured and
underinsured.
In addition to being the Executive Director of Project Access NW, Sallie sits on the board of
Washington Health Access Alliance, an association focused on supporting free clinics, mobile
clinics and other efforts to address local health care access needs. She also sits on the board of
the Prescription Drug Assistance Foundation, a Washington based non-profit whose mission is to
assure that low- income Washingtonians have accesses to needed donated name brand
prescription medications.
8/2013
Julie Severson Children's Alliance Hansen, Erica
Subject:
Attachments:
FW: Advisory Committee Nomination
Severson, CV, Nov 2013.pdf
From: Christina Peters [mailto:[email protected]] Sent: Sunday, November 17, 2013 2:53 PM To: WAHBE Info Cc: Jon Gould Subject: Advisory Committee Nomination Dear Exchange Staff, I would officially like to nominate Julie Severson for the Advisory Committee. I have also attached her CV. Below is a biographical sketch. Julie Severson's entire career trajectory has oriented around healthcare policy. After receiving a M.A. focused on the history of medicine and twentieth‐century public health policy, she obtained her doctorate from the University of Washington Women's Studies program with an emphasis on clinical ethics in the obstetrical context. Her dissertation explored the rare, but patterned, phenomenon of court‐ordered Cesarean sections, and highlighted the role that clinical decision‐making frameworks, hospital policies, and local laws have on the trend to compel reluctant women (the vast majority of whom are women of color) to undergo surgical interventions when their behavior appears "noncompliant." She supplemented this degree and research with a J.D. (also from the University of Washington) heavily grounded in health law. After working for two years for UW Medicine in medical‐legal risk management, she began working at Neighborhood House (a broad‐spectrum human services organization in the Seattle and King County region) as their healthcare policy analyst. She is a current board member, and former chair, of Planned Parenthood Votes Northwest, and is a current member of Legal Voice's assisted reproductive technology workgroup. She is also a published author in the subject areas of bioethics and healthcare policy. Furthermore, Dr. Severson has remained current with the Health Benefit Exchange's board activities and policy decisions, and looks forward to the opportunity to assist the board as a member of the Advisory Committee. Thank you, Christina *Please note my email address is now [email protected]
Christina Peters
Health Policy Director
Children’s Alliance
206.324.0340 x 22 [email protected]
www.childrensalliance.org
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c u r r i c u l u m v i t a e Ju lie R . S e v e r s o n , P h .D ., J.D .
2419 East Lake Washington Boulevard
Seattle, WA 98112 206.992.9997
[email protected]
E D U C A T I O N
University of Washington, School of Law, Seattle, WA J.D., June 2012 University of Washington, Seattle, WA Ph.D., Department of Women Studies, August 2009 Dissertation: “Conflict in the Clinic: A New Reading on Court-‐Ordered Cesarean Sections” University of Colorado, Boulder, CO M.A., Department of History, May 2002 University of Washington, Seattle, WA B.A., U.S. History and American Indian Studies, December 1998
P R O F E S S I O N A L
E X P E R I E N C E
Healthcare Policy Analyst, Neighborhood House, June 2013 – current • Assess the significance and potential impact of current laws and institutional structures on the matters of healthcare and community health • Develop strategies to further the organization’s health and human services mission • Represent the organization’s political interests on the matters of healthcare and community health Risk Manager, University of Washington Health Sciences, June 2011 – current • Develop hospital policy for UW and Harborview Medical Centers and other UW Medicine entities • Assess institutional liability of adverse medical events and patient complaints • Maintain institutional compliance with state and federal laws Research Assistant, University of Washington, September 2011 – August 2012 • Researched UW Medical Center risk management cases to recommend institutional improvements to patient decision-‐making models • Publications from study forthcoming Court Extern, Washington State Court of Appeals, Division II, June 2010 – September 2010 • Wrote screening memos outlining cases that came before the court • Wrote draft opinions for judges • Researched legal issues on an as-‐needed basis Instructor, University of Washington, March 2008 – August 2009 • Introduction to Women Studies – taught course three times for the Department of Women Studies. Course consisted of a feminist analysis of the construction and enforcement of gender differences and gender inequalities in various contexts. Specifically, it considered the intersectionality of gender/sex, race, class, dis/ability, age, sexual orientation, and analyzed the subject areas of history, law and politics, health and medicine, media, as well as social and cultural contexts. In my iteration of this course, I also introduced the students to critical theoretical perspectives such as post-‐structuralism, critical legal studies, and critical race studies. Teaching Assistant, University of Washington, September 2003 – December 2010 • Pharmacy Law & Ethics – assisted course for the School of Pharmacy. Course focused on pharmaceutical industry’s compliance with federal and state law; legal and ethical dilemmas encountered in the delivery of pharmaceutical care; and methods of statutory and regulatory reform. •
•
•
Introduction to Women Studies – assisted course twice for the Department of Women Studies. Please see above. Women in Law and Literature – assisted course twice for the Departments of Women Studies and the Comparative History of Ideas. Course analyzed the representations of women in American law and literature, and paid special attention to how women’s political status and social roles have influenced legal and literary accounts of their behavior. The course examined how legal cases and issues involving women are represented in literary texts and how law can influence literary expression. Psychobiology of Women – assisted course three times for the Departments of Women Studies and Psychology. Course examined the physiological and psychological aspects of women’s lives, and introduced students to the theoretical distinction between biological understandings of sex and socio-‐cultural expectations of gender.
Teaching Assistant, University of Colorado, August 1999 – December 2001 • American History to 1865 – assisted the course once for the Department of History. Course consisted of a survey of American history from first settlement until the end of the Civil War. Political, economic, and social lenses focused the course’s scope. • Western Civilization – assisted the course twice for the Department of History. Course began with the development of Western civilization from its beginnings in the ancient near East and ended with the Reformation of the 16th century. • African American History – assisted the course once for the Department of History. Analyzing major problems, issues, and trends affecting African Americans from 1600 to the present, the course’s focus encompassed political rights and power, the evolving social and cultural context, and economic forces affecting the African American population. • The Biological Components of Human Behavior – assisted course once for the Center of the American West. Interdisciplinary in its focus, this course examined the relationship between the environment and human behavior. It juxtaposed how historians explain social, political, and environmental change with theories proposed by evolutionary psychologists. Research Assistant, Center of the American West, Univ. of Colorado, October 2000 – August 2002 • Researched the history of federal water management for the Bureau of Reclamation’s History Symposium Centennial Celebration, “A Century of Water for the West, 1902 – 2002.” • Researched the history of gender and justice in Colorado for the State of Colorado Justice Department’s celebration of the Ten Year Anniversary of the Gender and Justice Taskforce
P U B L I C A T I O N S
“To Regulate More or Less: The Ethics and Laws of Sperm Donation” • In print, forthcoming book chapter in Third Party Reproduction: A Comprehensive Guide, Jim Goldfarb ed. “The Potential for Shared Decision-‐Making to Reduce Hidden Liability Costs for Healthcare Organizations” • Accepted for publication, forthcoming book chapter in Advances in Patient Safety and Medical Liability, ed. TBD. “LGBTQI Patients & the Access Gap: What North Coast Tells Us About Discrimination in Reproductive and Genetic Technologies” • Accepted for publication, forthcoming article in peer-‐reviewed journal, Medicolegal & Bioethics. “In Vitro Fertilization Ethics: A Summary” • Accepted for publication, forthcoming article in peer-‐reviewed journal, Medicolegal & Bioethics. “Shared Decision Making in Surgery to Improve Patient Safety and Reduce Liability” • Submitted for publication to peer-‐reviewed journal Health Affairs. “The Discourse of Court-‐Ordered Obstetrics: Patients, Power, and the Production of Knowledge” • To be submitted for publication, Spring 2013. State v. Farris, 158 Wash.App. 1034, Not Reported in P.3d, 2010 WL 4514189 (2010) A C A D E M I C
&
P U B L I C
P R E S E N T A T I O N S
Opening Remarks & Introduction to guest speaker, Liz Winstead, Planned Parenthood Votes Washington, PAC Event, Seattle, WA, October 2011 Opening Remarks & Introduction to guest speaker, Professor Anita Hill, J.D., Planned Parenthood Votes Washington, Annual Luncheon, Seattle, WA, June 2011 Opening Remarks & Introduction to guest speaker, Arianna Huffington, Planned Parenthood Votes Washington, PAC Event, Seattle, WA, October 2010 Presenter, American Society for Bioethics & Humanities, Annual Meeting, San Diego, CA, October 2010 • Panel – Ethical, Legal and Social Implications of State-‐level Regulation of Fertility Medicine in the United States • Paper – “Feminist Ethics, State Laws, and LGBTQI Use of Assisted Reproductive Technology” Presenter, International Network on Feminist Approaches of Bioethics, Seventh Annual Congress, Rjieka, Croatia, September 2008 • Paper – “Feminist Bioethics and Court-‐Ordered Obstetrics” Guest Lecturer, Universities of Washington & Colorado
• Pharmacy Law & Ethics (October 2010) Lecture topic: federal law and the pharmaceutical industries. •
Comparative History of Ideas Focus Group (April 2010) Lecture topic: legal history of history of law and public health. •
Introduction to Women Studies (February 2005, April 2007, February 2009) Lecture topics: the state-‐sanctioned sterilization of poor women of color during the 1950s through 1970s; eugenics and the history of federal family planning in the U.S.; introduction to feminist bioethics and post-‐structural theory •
Race, Class and Gender (May 2004) Lecture topic: African Americans, medical research, and eugenics following the Civil War •
African American History (October 1999) Lecture topic: African Americans in the 19th century U.S. West. Presenter, Physician-‐Scholars in the Social Sciences and Medical Humanities, Annual Conference, Chicago, IL, April 2007 • Panel – Bioethics and Medical Authority • Paper – “Conflict in the Clinic: Court-‐Ordered Cesarean Sections” Panel Chair, Joint Atlantic Seminar for the History of Medicine, Annual Seminar, Harvard University, Boston, MA, October 2004 • Panel – Medicine and Race “From Below”: Race and Health Policy Presenter, Western Social Science Association, Annual Conference, Las Vegas, NV, April 2003 • Panel – Reproductive Ethics and Understandings of Eugenics • Paper – “‘When People Pollute’: Eugenic Ideology, Medical Ethics and the Case for Modern Family Planning” Presenter, Rocky Mountain Interdisciplinary History Conference, Annual Conference, University of Colorado, Boulder, CO, September 2001 • Paper – “‘Hell Bent on Making the System Work’: Family Planning, Politics, and Medical Ethics in Postwar America” Roundtable Chair, Center of the American West Symposium, University of Colorado, April 2000 G R A N T S
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F E L L O W S H I P S
Public Health Service Grant, Agency for Healthcare Research & Quality, 2011-‐2012 Research Fellowship, University of Washington, Department of Women Studies, 2008 and 2009 Graduate Opportunities and Minority Achievement Program Fellowship, University of Washington, 2002 – 2003 Bean Fellowship, Department of History, University of Colorado, 2001 A D D I T I O N A L
P R O F E S S I O N A L
E X P E R I E N C E
Mediation Clinic, UW School of Law, 2011 – 2012 • Mediated cases for Economic Employment Opportunity Commission (Seattle division), King County Municipal Court, and for the community at-‐large • Participated in mediation skills training seminar (36 hours) • Underwent 60 hours of additional mediation training in clinic Articles Editor, Washington Journal of Law, Technology & Arts, 2010 – 2011 Co-‐President, Student Health Law Organization, University of Washington School of Law, 2010 – 2011 Campus Coalition Representative, Law Students for Reproductive Justice, University of Washington School of Law, 2010 – 2011 Committee Member, Provost-‐assembled Women’s Center Review Committee, University of Washington, July 2009 – October 2009 Member, Graduate Committee, Department of Women Studies, University of Washington, 2007 – 2009 Member, Visiting Committee, Department of Women Studies, University of Washington, 2006 – 2009 Representative, Department of Women Studies, Graduate and Professional Student Senate, University of Washington, 2003 – 2005 Representative, Department of History, United Government of Graduate Students, University of Colorado, 2000 – 2002 Member, Graduate Studies Committee, Department of History, University of Colorado, 1999 – 2000 Member, Executive Planning Committee, Rocky Mtn. Interdisciplinary History Conference, University of Colorado, 2000 – 2001 N O N P R O F I T & P U B L I C
S E R V I C E
E X P E R I E N C E
Board Member, Planned Parenthood Votes Northwest, 2008 – 2012 • Legislative and Political c4 organization for Washington, Idaho, and Alaska, affiliated with Planned Parenthood Federation of America • Chair of the Board, 2010 – 2012 • Chair, Tri-‐State Merger Committee, 2010 – 2011 • Inslee Gubernatorial Transition Team, 2012 -‐ 2013 Member, Assisted Reproductive Technology Policy Workgroup, Legal Voice, 2011 – 2013 Democratic Precinct Committee Officer, 1993 Precinct of the 43rd Legislative District of Washington State, Elected term, 2008 – 2010 R E F E R E N C E S
Available upon request.
Sylvia Villalovos Aguilar UnitedHealthcare Community and State Hansen, Erica
Subject:
Attachments:
Sylvia_VillalovosInsur_Sales_Mrkting10292013.doc; ATT00001.txt; ATT00002.htm
From: Villalovos Aguilar, Sylvia [mailto:[email protected]] Sent: Monday, November 18, 2013 11:32 AM To: WAHBE Info Subject: Advisory Committee Nominee Hello, Please accept this as my nomination for the Advisory Committee. I am currently the Lead Outreach Coordinator in King County for UnitedHealth Care Community Plan, Medicaid division. I have more the 15 years of healthcare experience in all aspects as well as working with underserved populations. Accomplishments
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More than 10 years of successful extensive experience in Sales, Marketing and Outreach, supporting Mid-Large, National and
Global Group Healthcare Campaigns, Products and Initiatives.
Healthcare experience also includes successful expert knowledge in Healthcare Administration/Support, Benefits and Coverage,
Member Services, Medical Claims and Billing and Provider Relations, etc.
Numerous years of hands on experience working with diverse communities including Medicaid, Medicare and CMS populations.
Thorough knowledge of all WA Health Plans including Individual, Medicare/Medicaid, and Employer health plans including HMO,
PPO and POS plans offered by Regence Blue Shield, Group Health, Aetna, United Health Care, Cigna, Pacific Care, LifeWise.
Expert knowledge in Medicaid/ Medicare including Apple Health for Kids, CHIP, Adult Blind & Disabled, etc
Current knowledge and training on the Affordable Healthcare Act with HCA/HBE policies and procedures including successful
training on WA Healthplan Finder, etc. Also currently licensed with WA State Office of Insurance Commissioner (OIC) for Health,
Life and Disability Insurance Sales Agent.
Thorough knowledge of all aspects of the WA Affordable Healthcare Act, WA Health plan Finder, WA Benefit Exchange and
Medicaid Expansion policies and guidelines. Also well Health Insurance Administration, Sales and Retention policies, benefits/
coverage, medical terminology , including successful training in WA guidelines policies and procedures in Underwriting, COBRA,
HIPAA, Coordination of Benefits and Medicare/ Medicare part D.
Best Regards, Sylvia Villalovos-Aguilar l Marketing Outreach Specialist
UnitedHealthcare Community & State
(office) 206.749.4304 | (mobile) 206.972.3206|
(email) [email protected]
**Please note upcoming PTO, Nov 25th – Nov 29th 2013** 1
Sylvia Aguilar
206.972.3206 [email protected]
PO Box 68355 Seattle, WA. 98168
Healthcare, Marketing & Outreach Professional
Accomplishments
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More than 10 years of successful extensive experience in Sales, Marketing and Outreach, supporting MidLarge, National and Global Group Healthcare Campaigns, Products and Initiatives.
Healthcare experience also includes successful expert knowledge in Healthcare Administration/Support,
Benefits and Coverage, Member Services, Medical Claims and Billing and Provider Relations, etc.
Numerous years of hands on experience working with diverse communities including Medicaid, Medicare
and CMS populations.
Thorough knowledge of all WA Health Plans including Individual, Medicare/Medicaid, and Employer health
plans including HMO, PPO and POS plans offered by Regence Blue Shield, Group Health, Aetna, United
Health Care, Cigna, Pacific Care, LifeWise. Expert knowledge in Medicaid/ Medicare including Apple
Health for Kids, CHIP, Adult Blind & Disabled, etc
Current knowledge and training on the Affordable Healthcare Act with HCA/HBE policies and procedures
including successful training on WA Healthplan Finder, etc. Also currently licensed with WA State Office of
Insurance Commissioner (OIC) for Health, Life and Disability Insurance Sales Agent.
Thorough knowledge of all aspects of the WA Affordable Healthcare Act, WA Health plan Finder, WA
Benefit Exchange and Medicaid Expansion policies and guidelines. Also well Health Insurance
Administration, Sales and Retention policies, benefits/ coverage, medical terminology , including
successful training in WA guidelines policies and procedures in Underwriting, COBRA, HIPAA,
Coordination of Benefits and Medicare/ Medicare part D.
Excellent experience as Lead Community Outreach Rep sitting on several Nonprofit work groups and
boards.
Successful experience as Lead Service Representative II for Group Health Open Enrollment Prospective
Member Team generating record number enrollment.
Developed and coordinated successful advertising campaigns and events targeting new member
enrollment and re-enrollment resulting in record high membership growth and retention.
More than 7 years experience as lead Grants Administrator and Program Manager for Regional Non-profit
agency that included program development and monitoring, creating of grant and RFPs/ and maintaining
key relationships resulting in successful responses from major U.S. Corporations such as Starbucks,
United Way, The Seattle Foundation, The Bill & Melinda Gates Foundation, Weyerhaeuser, World Vision,
etc.
Possess solid Executive Level Administrative/ Account Management Support. Extensive, solid experience
in Consumer Relations, Employee Support and Employer / Broker/ TPA Relations.
Possess solid computer and typing skills (40+ WPM, 10Key, etc.) Excellent working knowledge using both
IBM and Mac systems including all Microsoft office applications (Word, Excel, Access, PowerPoint.) Lotus
Notes, Group Schedules, Last Word, HPSS, Adobe PhotoShop. Excellent working knowledge of all latest
office equipment including multi line telephone systems, fax machines, commercial printers, etc.
Dedicated, responsible and driven young women with proven excellent customer service, written and
verbal communication skills along with exceptional organizational skills with the ability to multi task and
work well as a self starter or as part of a team.
Professional Experience
Medicare Insurance Sales & Membership Representative, Puget Sound Health Partners
Seattle, WA ▪ 2010
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As a Sales Support Representative, provided support for the sales team by handling all incoming
sales calls, assist walk-in members and all outgoing sales calls in addition to following up on leads.
Also processed enrollment forms from initial data entry to finalized status and worked with
Administrative Teams to ensure timely receipts of all member enrollments & benefit materials, etc.
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Daily responsibilities included assisting new and current member’s, brokers and providers with
benefits and election/enrollment assistance including resolving member service inquires related to
medical benefits, eligibility, provider networks, enrollment and/or billing claims.
Also required to partner with other departments including Provider and Billing department to resolve
escalated issues. Completed all additional and ongoing advancement training & seminars’.
International Customer Service Rep-Lead., Aetna Global Benefits (AGB) – Aetna Healthcare
Seattle, WA ▪ 2009- 2010
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As a Lead Customer Service Consultant provided high quality, customer-focused service to
escalated accounts via incoming call center, emails and all other inquires to Aetna International
Global Customers and Clients from around the world while leading a small team of level 1 Reps.
Services included but were not limited to providing stellar Account and Member support to
International High-Profile Groups including The UNITED NATIONS, World Health Organization, WalMart International Div., and others
Handle a wide variety of admin duties as well as member and customer inquires and requests that
included insuring appropriate enrollment and account set up, identifying service problems, resolving
benefits and claims issues, and initiating appropriate action to resolve inquiries and/or concerns from
members, providers, plan sponsors, Brokers. Etc.
Utilized latest technology to navigate through systems to track research and document all events and
outcomes and educate customers on a daily basis through routine contacts.
Provided high quality ‘Concierge Level’ Client focused service using knowledge of plans, products,
systems, and procedures to ensure first time contact resolution.
Account Specialist, Marketing & Sales, National Accounts – Group Health Cooperative
Seattle, WA ▪ 2005 – 2008
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Provided executive administrative support to Senior Executive Account Managers in the achievement of
targeted membership growth & retention for Mid-Large Commercial National Accounts Book of Business,
Complex Federal Accounts and New Sales Accounts.
Assisted in an effective and timely manner with all Large Commercial Group renewals and new sales.
Including creations, preparation and processing of renewal packets, proposals, summary of benefits, large
commercial group / account reporting and tracking including experience & ad hoc reports, as well as cross
selling of additional products, plans and riders.
Responsible for day to day service needs of prospective and current Clients, HR Directors and Brokers
including member retention & servicing functions that required collaboration with other service departments
such as Underwriting, Legal and others for Rate Quotes, Experience reports, Contracts, Summary of
Benefits, etc. all to ensure accurate satisfaction to the clients needs.
Responsible for complete set up, coordination and staffing of events that included open enrollment fairs,
forums, sales events and presentations for top Brokers and Large National Client Accounts, etc.
Providing administrative support to Clients in managing their existing accounts including renewals, rate
request, fulfillment request & daily inquiries.
Extensive knowledge in Broker Relations. Daily working experience with Brokerage, TPA and Consulting
firms including direct group contacts such as HR Directors, CEO’s, etc.
Well educated in other department functions and policies such as Underwriting, Medicare, Individual and
Small Business Group.
WA State Agents License in Health Insurance and Disability.
Consumer Relations Specialist II – Group Health Cooperative, Tukwila, WA ▪ 2000 – 2005
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Five years of providing Outstanding Customer Service to current and prospective members regarding all
aspects of Health insurance coverage including medical referrals, billing issues, provider networks and
appointments, etc. Including taking escalating inquiries from employer groups, brokers, providers,
employees and members.
As a key member of the Prospective Member Team provided excellent service to prospective members
regarding Group Health as their Health Plan. Answered coverage and service inquires all while promoting
our World Class Service theme.
As a PT Financial Svc. Rep analyzed billing and claims issues including posting payments and
adjustments. Research and resolve credit balances to ensure proper financial reporting.
Thorough knowledge of all health plans offered by Group Health, HMO, Alliant, Alliant Select, Options and
Options Prime. Including Basic Health and Healthy Options.
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Extensive knowledge of all IGP and Contracted Medical Centers as well as Group Health Service Areas in
all regions (Puget Sound, NW, EW, CWA, and Spokane Districts.)
Always able to maintain a performance score of 95% for quality and 105% for quantity.
Maintain solid knowledge of all Group Health Systems with advance training in Medicare Policies, Medical
Terminology and HIPAA guidelines.
Sales & Marketing – Equally Yoked Christian Singles, Seattle, WA▪ 2003 - 2008
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Key member of sales & marketing team for the largest Christian Singles Membership Organization in the
United States. In charge of new member sales, account management, and strategic coordination and
planning of advertising campaigns for all of Western Washington.
Helped developed and implement business, sales, marketing, and PR strategies to acquire new
customers and retain existing members.
Secured a record-setting average monthly membership growth and membership renewals.
In charge of all partnering and pre planning with local Faith based agencies for outreach events including
on site set up of marketing events and presentations targeted at membership growth. Events including
occasional out of town travel.
Provided administrative and production support including shipping, travel arrangements, maintaining office
supplies and files for company executives.
Still employed on a consultant and/or project manager basis. Used only on Large Outreach Events and
Sales and Marketing projects.
Executive Marketing & Outreach Coordinator– Victory Outreach Seattle, Burien, WA ▪ 20012012
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Held various roles and responsibilities including Executive Outreach, Donor and Funding Coordinator,
Project / Case Manager and Event /Marketing Coordinator for established State Wide Non-Profit
Organization in the Regional Headquarters Office, successfully targeting disadvantaged, inner city issues
since 1990.
Responsible for all Outreach planning and events coordination for all 5 chapters in WA including Victory
Outreach Tacoma, Yakima, Spokane and Tri Cities for annual events and campaigns targeting inner cities
including Back to school, Free Summer Lunch, Healthfair and Holiday Meals and gift giveaway programs,
etc.
Successfully lead a small team of volunteers that were responsible for identifying outreach opportunities
and researching and writing all grant proposals and project donation request for multiple projects and
funding needs. Researching specific RFP’s and listing all required statistical information, financial budgets,
project summaries and plans, follow up reports, etc. Successful responses from funders such as King
County, City of Seattle, Starbucks, Pepsi and Muckleshoot Tribe, etc.
Responsible for identifying opportunities for strategic alliances and partnerships with other agencies,
corporations, news media and City and County Officials to further our business, programs and mission
plans for the local communities in need.
Public Relations and Marketing coordinator in charge of Event planning, coordination and client services
for assigned projects. Including complete coordinating, planning and promoting of local, city and statewide
events that drew national news media attention. (USA Today, Seattle Times, King 5, Spirit 1053.)
Also provided outstanding customer service and executive administrative support to Executive Directors,
current clients, donors and their staff of major US Corporations that resulted in long term partnerships as
well as with local news media and City and County Officials for ongoing sponsorships, endorsements, etc.
References:
John and Kathy Heredia
Sr. Pastors/ Executive Dir.
Victory Outreach Seattle
206.244.8184
10821 1st Ave S. Burien, WA 98168
Jessica Tijiboy
AENTA Healthcare- Case Mgr.
206.271.5065
421 Pike Street Seattle, WA 98101
Daphne Pie
Program Manager
206.838.8340
King County Public Health
401 5th Ave #1000 Seattle, WA 98164
Mary Wood
Section Manager
Health Care Authority
360.725.1329
12401 E Marginal WY S. Tukwila, WA 98124
Kathryn Clark
Director of Health Plan Services
Group Health Cooperative
206.901.4636
12401 E Marginal WY S. Tukwila, WA 98124
Miriam McHardySales & Marketing Dir.
Group Health Marketing
206.448.4169
521 Wall Street Seattle, WA 98121
Audrey Wu Hansen, Erica
Subject:
From: Audrey Wu [mailto:[email protected]] Sent: Monday, November 18, 2013 2:39 PM To: WAHBE Info Subject: Advisory Committee Nominee Dear Washington Health Benefit Exchange Staff,
Thank you for the opportunity to nominate myself to serve on your Advisory Committee. With over a decade
of pharmaceutical policy and advocacy experience across a variety of therapeutic areas, I would be a
tremendous asset to your Advisory Committee and complement the skill sets of your other Committee
Members.
I am currently an independent consultant based in Seattle providing marketing strategy, development, and
communications services to health care companies. My signature accomplishments in the area of consumer
access include:
* Collaborative initiatives with policymakers (Hill, state government)
* Results-oriented alliances with non-profit organizations such as The Partnership for a Drug-Free America
* Relationship building with healthcare professional societies, patient advocacy groups, and national thought
leaders
Most importantly, as a self-employed independent consultant, I am also one of the Washington Health Benefit
Exchange's customers.
Attached is my CV for your review. I welcome the opportunity to speak with you about my qualifications.
Sincerely,
Audrey Wu
[email protected]
734-717-3317
1

Advisory Committee Member Recruitment The Washington Health

Transcription

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