Ms. Dunn is Chief Operating Officer of St. Louis-based First Class Solutions, Inc. Rose’s career started at Barnes Hospital, the flagship of BJC Healthcare, where she ultimately was Vice President and responsible for 1,600 employees.
After Barnes, she worked for MetLife as national AVP, where she gained a solid understanding of managed care. Rose also served as the CFO of an Illinois dual-hospital system and participated in their bond issue.
Rose is an AHIMA Distinguished Member, Legacy, and Outstanding Service award recipient and has served as the elected President and employed interim CEO of the 80,000-member professional association. She has served on numerous AHIMA committees, councils, and the Foundation.
She is active in ACHE, AICPA, HFMA, HIMSS, ARMA International, and AHIMA. Rose has authored more than a dozen texts including ACHE/HAP’sDunn & Haimann’s Healthcare Management, published 200+ articles, and made numerous healthcare related presentations. She authored and supports theFundamentals of HCCscourse for Libman Education.
In her spare time, she bakes cheesecakes and tends to feral cats.
Niejadd Evans Director of Corporate Compliance Assurance
MedImpact Healthcare Systems
Niejadd Evans is currently the Director of Corporate Compliance Assurance at MedImpact Healthcare Systems, the nation’s largest privately-owned pharmacy benefit manager (PBM), offering health and prescription drug insurance plans to self-funded employers and professional organizations. There, he is responsible for all aspects of compliance for the company’s corporate compliance program. For 20+ years, he has held compliance leadership positions at numerous health insurers, payors, and third-party administrators, focusing primarily on government programs compliance (Medicare, Medicaid, Health Insurance Exchange).
Niejadd has a Bachelor of Science degree in Health Care Management from Florida A & M University (FAMU) and a Master of Business Administration degree from Benedictine University. He is also Certified in Healthcare Compliance (CHC) by the Compliance Certification Board.
Colleen Gianatasio
Director Clinical Documentation Integrity and Coding Compliance
Colleen Gianatasio Director Clinical Documentation Integrity and Coding Compliance
Capital District Physician’s Health Plan (CDPHP)
Colleen Gianatasio CPC, CPC-P, CPMA, CPC-I, CRC has 18 years of experience in the health insurance field. She has experience in customer service, claims, quality and coding. As Risk Adjustment Quality and Education Program Manager for Capital District Physician’s Health Plan (CDPHP) Colleen’s primary responsibilities are provider engagement and clinical documentation improvement for accurate coding. Colleen specializes in developing innovative coding curriculum and instruction to support compliance with federal guidelines and appropriate reimbursement processes. She is a certified AAPC instructor and enjoys teaching a variety of coding, documentation and auditing classes. Colleen serves as President-Elect of the AAPC National Advisory Board.
Mary Inman is a partner in Constantine Cannon’s London and San Francisco Offices. After 20+ years representing whistleblowers in the U.S., she moved to London in July 2017 for four years to launch the firm’s international whistleblower practice and now splits her time between the London and San Francisco offices. She specializes in representing whistleblowers from the U.S., U.K., Europe and worldwide under the American whistleblower reward programs, including the federal and various state False Claims Acts and the SEC, CFTC, IRS, DOT and Treasury Department AML and sanctions whistleblower programs. Ms. Inman’s efforts to export the American whistleblower programs to the United Kingdom, including her efforts on behalf of a successful British whistleblower, were featured in a recent New York Times article “Law Firm Sees Britain as Hunting Ground for U.S. Whistleblower Cases.” Ms. Inman’s successful representation of three whistleblowers exposing risk adjustment fraud in the Medicare Advantage program was featured in the February 4, 2019 issue of the New Yorker magazine in an article entitled “The Personal Toll of Whistle-Blowing.” Ms. Inman represents renowned SEC whistleblower Tyler Shultz who exposed the now infamous Silicon Valley blood testing start-up Theranos, and regularly speaks on lessons to be learned from this scandal surrounding corporate governance.
Ava Johnson is the Associate Director of the Outpatient Clinical Documentation Quality Improvement department at Mount Sinai Hospital in NYC. Ava is a seasoned coding instructor, physician educator, multispecialty coder, CDI specialist and public speaker with a focus on executive leadership and career development.
Donna Malone
Director Risk Capture, Population Health Management
Donna Malone Director Risk Capture, Population Health Management
Mass General Brigham
Donna Malone, CPC, CRC, AAPC Approved Instructor, AHCCA, RAP, RISE Fellow: Director Risk Adjustment with Mass General Brigham in MA, Adjunct Professor with MassBay Community College, Chair of the RISE Risk Adjustment Academy HCC Coding Faculty Advisory Group as well as content developer RISE designations and workshops, and 2022-2025 AAPC National Advisory Board. Donna has over 28 years’ experience (Payer, Provider System and Vendor) in healthcare with primary focus on Value-Based Care.
Donna has also served as President of the Watertown AAPC Chapter (2017-2022) and Education officer (2016)
Kenneth (Ken) Nuñez, MBA, CHC is the Chief Compliance Officer for Provider Partners Health Plans. He has held this position since August 2020, and in this role he is the main contact with the Centers for Medicare & Medicaid Services (CMS) for all regulatory, compliance, and audit issues. He has over 29 years combined experience in MA-PD and Large Hospital/Facility Compliance. In his career, he has been involved in dozens of regulatory and OIG Audits including, CMS Program Audits, 1/3 Financial Audits, Data Validation Audits (DVA), Ad-hoc audits, etc.
Here are some notable employment experiences in the MA-PD and Health Care Industry: Worked at United Health Group for seven (7) years as the National Director, Medicare Operational Compliance. Employed at Cigna/HealthSpring for six+ (6+) years as Vice President, Medicare Compliance Audit & Risk Assessment, Worked at WellCare (Centene) for almost four (4) years as the Director, Medicare Regulatory Affairs, and then as the Senior Director, Medicare Compliance Audit. Employed by Mercy Hospital System (HCA)/Doctor Care Mercy PHO for three (3) years as their Corporate Integrity Officer and then as Vice President, Compliance.
He also served for several years as a senior compliance consultant for boutique national firms assisting Medicare and Medicaid Health Plans in preparation for state and federal audits, compliance re-builds, operational optimization, and post-audit distress.
Laura Sheriff, RN, MSN, is currently working as a consultant with physician groups and health plans to capitalize on risk adjustment performance and operations. Laura is an MSN with >12 years’ experience in Medicare, Medicaid, and Marketplace Managed Care and has led teams in risk, quality, telehealth, and population health analytics. Laura demonstrates effective leadership, innovative problem-solving techniques, and goal-oriented focus to execute business objectives and meet performance metrics. Laura designed and coordinated activities including provider education, training, auditing, data mining, and data analysis to direct program success and achieve all risk goals. Laura is also a certified professional coder and a certified risk coder.
As Director of Risk Adjustment, Susan Waterman has been empowered to plan, design and oversee business and strategic objectives in creating and optimizing a Risk Adjustment Department responsible for ensuring the accuracy of risk adjustment payments while successfully managing all activities related to Medicare Advantage, ACA and Exchange Risk Adjusted lines of business. In that capacity Susan directed department changes that resulted in multi-million dollar gains in Risk Adjustment, brought all chart review activity in-house, and partnered with the hospital CDI/Quality Physicians to create an Outpatient CDI Department focused on documentation quality, Risk Adjustment activities and clinic training.
A proven leader in her field, Susan’s professional experience includes coding and compliance management, auditing and provider training, system management, and consulting services.
