URAC

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Award Judges

Jeanne Boling, MSN, CRRN, CDMS, CCM offers a national perspective on case management, integrated care management and collaborative practice trending.  She has served as Executive Director of Case Management Society of America for eleven years. CMSA is a leading rapidly growing multidisciplinary professional association with over 10,000 members, over 22,000 member/subscribers, 70 chapters in the United States and an international outreach to CMS-UK and CMS-Australia, the Ontario Canada Case Management Association and member countries and territories including Argentina, Australia, Bahamas, Bermuda, Canada, Hong Kong, Ireland, Japan, New Zealand, Puerto Rico, Singapore, and the United Kingdom.  She is a founding leader and former Executive Director of the Case Management Leadership Coalition, a newly formed group of over 35 organizations with a stakeholder interest in the future of case management.  Jeannie has served on the Utilization Review and Accreditation Commission (URAC) Board of Directors, the Commission for Case Manager Certification (CCMC) and Advisory Boards for numerous publications and insurance, managed care, biotechnology and pharmaceutical companies. Previously, Jeannie was Executive Director of the Individual Case Management Association, Conference Director for the Medical Case Management Conference and Associate Editor of The Case Manager magazine.  Jeannie is former President of Case Management, Inc., a Little Rock, Arkansas based association management company and education provider.

Judith A. Cahill, as Executive Director of the Academy of Managed Care Pharmacy, has responsibility for policy creation and implementation, administrative operations, and overall staff leadership of the Academy of Managed Care Pharmacy (AMCP).   The Academy is a professional society with over 5,000 members nationwide which is dedicated to the continuing professional development of pharmacists and other health care practitioners engaged in the practice of pharmacy in managed care settings. Judy has been working in the dynamic area of managed health care for over 20 years.  For 11 years she helped direct the activities of the Group Health Association of America, the leading trade association representing health maintenance organizations in the United States.  Her area of responsibilities included policy development, medical management issues embracing quality measurement and management, and development of education programs, publications, and research projects.  Prior to her duties with GHAA, Ms. Cahill served as contracting officer for the HMOs that participated in the United States Federal Employees Health Benefits Program. Ms. Cahill holds a Bachelor of Arts degree from LeMoyne College, a Masters of Arts degree from the University of Cincinnati, and certification as an Employee Benefits Specialist from the Wharton School of Business.  She serves on several editorial advisory boards and Boards of Directors for organizations dedicated to serving the pharmacy profession.

François de Brantes is the National Coordinator for Bridges To Excellence (BTE), a national program focused on rewarding physicians for better quality care.  In that capacity, Mr. de Brantes is responsible for supervising the implementation of BTE programs in different regions in the country.  He is also responsible for creating and developing new programs for BTE such as the emerging Internal Medicine Care Link in collaboration with the American Board of Internal Medicine and the Spine Care Link in collaboration with the National Committee for Quality Assurance. Mr. de Brantes is also the National Coordinator for Prometheus Payment, Inc., a multi-stakeholder effort to implement a reformed payment model anchored in Evidence-based Case Rates.  In his capacity, he coordinates the activities of the Prometheus Design Team, the Clinical Working Groups and supervises the pilot sites. Prior to that, Mr. de Brantes was Program Leader for healthcare initiatives at GE Corporate Health Care, responsible for developing and implementing GE's Active Consumer strategy. He is currently serving as a Director of the Massachusetts Quality Improvement Organization, MassPRO, the American Health Quality Association, and Connecticut’s new regional health information organization, eHealthConnecticut. He lectures at Harvard, Wharton and the University of Connecticut. Mr. de Brantes earned a Masters in Finance and Taxation at the University of Paris IX - Dauphine, and he earned an MBA at the Tuck School of Business Administration at Dartmouth College.

Jeri Gillespie is vice president of Human Resources Policy at the National Association of Manufacturers.  Jeri leads workforce policy issues including health care, education and skills development, employment and labor, and occupational safety. Before joining the NAM in August 2006, Jeri served over 10 years in a variety of posts with NCR Corporation, most recently as Director of Government Affairs in NCR’s Washington, D.C office.  In this role, Jeri was responsible for promoting NCR’s interests before Congress and the Administration in the areas of health information technology, data privacy and pension reform.  Prior to that, she was based out of Dayton, Ohio and served as Corporate Environmental Health & Safety Compliance Director and Global Environmental Health and Safety Director, leading the company’s environmental health and safety program.  Jeri has extensive experience in occupational safety and health policy, management systems and compliance assurance. Jeri holds an M.S. in Environmental Health and Industrial Hygiene from the University of Cincinnati School of Medicine and an B.S. in Environmental Health Sciences from Wright State University in Dayton, Ohio.  She also serves on the Advisory Board for the College of Science and Math at Wright State University. Jeri is a native of Cincinnati, Ohio and resides in Washington, D.C.

H. Stephen Lieber, CAE joined HIMSS as President and CEO in April 2000. In addition to his role as President and CEO of HIMSS, Steve serves on the following Boards of Directors:  HIMSS, HIMSS Foundation, HIMSS Analytics (chairman), MedTech Publishing, Center for Information Technology Leadership, the Healthcare Information Technology Standards Panel (HITSP) and the Certification Commission for Healthcare Information Technology (CCHIT).  Also, serves as a member of the Steering Committee for the Markle Foundation’s Connecting for Health Initiative, the Integrating the Healthcare Enterprise (IHE) strategic committee, the Healthcare Leadership Alliance, the EHR Collaboration, and the Board of Sponsors of the Commission for Accreditation of Healthcare Management Education. Steve previously served as CEO of the Emergency Nurses Association (ENA) for nearly nine years before accepting a position with the American Hospital Association as Vice President, Division of Personal Membership Groups. Prior experience includes Vice President of Operations for the Illinois Hospital Association; Senior Budget Analyst for the Illinois Bureau of the Budget; and Assistant Administrator, Research and Statistics for Arkansas Social Services.  Steve earned an MA from the School of Social Service Administration at the University of Chicago, a BA in Psychology from the University of Arkansas, and has completed additional course work at the graduate schools of business at both universities and at the Keller Graduate School of Management.  Steve has been a Certified Association Executive (CAE) since 1994, is a member of the American Society of Association Executives and Association Forum of Chicagoland and has been awarded honorary life memberships at the American Hospital Association and the American Society of Healthcare Risk Management.

John J. (Jack) Mahoney, MD, as Strategic Healthcare Initiatives Director at Pitney Bowes, is a key team leader for the company’s innovative healthcare programs. Dr. Mahoney’s current responsibilities include advanced healthcare planning for employees, integrating disease management and wellness initiatives, and benefits planning for employees and retirees. Dr. Mahoney joined Pitney Bowes in 1997 as Corporate Medical Director and Global Health Care Management Director.  In this role he was responsible for designing health benefits for employees, and integrating disability and disease management and wellness initiatives.  He also had oversight for all clinical support services.  Dr. Mahoney was instrumental in revamping the company’s health insurance system in 2002. At this time, Pitney Bowes became the first company in the country to fully implement the strategy known as value-based insurance design, in which the employer uses financial incentives to encourage workers to stay healthy.  Medical plan design, as well as services related to direct on-site medical care delivery, wellness, fitness, employee assistance and disability management programs are included in this integrated approach to health. Prior to joining Pitney Bowes, Dr. Mahoney served as Vice President of Integrated Health Management at Aetna Inc., where he was responsible for integrating all health-related employee programs within Aetna to achieve improved employee productivity and effectiveness. Dr. Mahoney was also a partner with Hewitt Associates LLC, designing a wide array of managed medical benefits programs. He also served as the Corporate Medical Director for GTE Corporation and held medical management positions in the airline industry. Dr. Mahoney received his undergraduate degree from Boston College and his Medical Degree from the Medical College of Virginia.  He also received a Masters Degree in Public Health from UCLA. 

Tobe Mizels, MPH has a B.A. in Biology from Boston University and a Master of Public Health from Columbia University.  She currently manages IBM's Managed Pharmacy Program, covering 400,000 lives.  She has been an integral member of IBM's health benefit team for nearly ten years.  Her previous experience includes Johnson & Johnson and the March of Dimes where her primary responsibilities were in the areas of health promotion, customer support, and operations.  Her focus on relationship building has made her a highly regarded collaborator amongst her peers.  When not working, Tobe relishes international travel and has visited all seven continents.  Her adventures have included cuddling a koala and pandering with pandas. 

Tracey Moorhead is President and Chief Executive Officer of the Disease Management Association of America (DMAA), the only organization effectively representing all stakeholders in disease management and care coordination.  Based in Washington, D.C., DMAA represents more than 200 corporate and individual members by advancing the promise of disease management for cost-effective, quality health care.  Ms. Moorhead is recognized as a leading health care advocate with considerable experience in public policy and coalition management.  She effectively directs policy formulation and strategic advocacy efforts, as well as represents the disease management community before the media, allied organizations and constituents, and all levels of government. Ms. Moorhead previously served as Executive Director of the Alliance to Improve Medicare (AIM), a bipartisan coalition advocating comprehensive Medicare improvements.  AIM supported enactment of the Medicare Prescription Drug, Improvement and Modernization Act of 2003.  As AIM’s Executive Director, Ms. Moorhead coordinated and moderated educational and policy briefings for congressional staff; directed AIM’s policy research, development and communications efforts; and developed grassroots programs in conjunction with AIM member organizations. In addition to her role with AIM, Ms. Moorhead served as Vice President, Government Relations, for the Healthcare Leadership Council (HLC). In this role, she coordinated a nationwide, multi-million dollar grassroots outreach campaign to senior citizens and partner organizations to increase awareness and participation in new Medicare benefits.

David B. Nash, MD, MBA, FACP is The Dr. Raymond C. and Doris N. Grandon Professor and Chairman of the Department of Health Policy at Jefferson Medical College of Thomas Jefferson University in Philadelphia.  Jefferson is one of a handful of medical schools in the nation with an endowed professorship in health policy.  Dr. Nash, a board certified internist, founded the original Office of Health Policy in 1990.  From 1996 to 2003, he served as the first Associate Dean for Health Policy at Jefferson Medical College.  In 2004, he was named Co-director of the Masters Program in Public Health at Jefferson and was named as a finalist in the 15th Annual Discover Awards for Innovation in Public Health by Discover magazine. Internationally recognized for his work in outcomes management, medical staff development and quality-of-care improvement, his publications have appeared in more than 100 articles in major journals.  He has edited seventeen books, including A Systems Approach to Disease Management by Jossey-Bass, Connecting with the New Healthcare Consumer by Aspen,  The Quality Solution by Jones and Bartlett, and most recently, Practicing Medicine in the 21st Century by ACPE.  In 1995, he was awarded the Latiolais (“Lay-shee-o-lay”) Prize by the Academy of Managed Care Pharmacy for his leadership in disease management and pharmacoeconomics.  He also received the Philadelphia Business Journal Healthcare Heroes Award in October 1997 and was named an honorary distinguished fellow of the American College of Physician Executives in 1998.   Finally, in 2006, he received the Elliot Stone Award for leadership in public accountability for health data from NAHDO. Dr. Nash received his BA in economics (Phi Beta Kappa) from Vassar College, Poughkeepsie, New York; his MD from the University of Rochester School of Medicine and Dentistry; and his MBA in Health Administration (with honors) from the Wharton School at the University of Pennsylvania.  While at Penn, he was a former Robert Wood Johnson Foundation Clinical Scholar and Medical Director of a nine physician faculty group practice in general internal medicine.

Laurel Pickering is Executive Director of the New York Business Group on Health (NYBGH), a 175 member business coalition representing over 1 million covered lives, committed to market-based health care reform, quality improvement and value-based purchasing.  NYBGH also provides the employer’s perspective on current health care issues to legislators and healthcare organizations.  Since becoming Executive Director in 1996, Ms Pickering has focused on mobilizing the business community to drive improvement in healthcare, providing access to health insurance for small businesses by creating a purchasing alliance and organizing health plans to work together to improve quality.   Recent initiatives include the New York Metro Mental Health Collaborative and the New York Multi-Payer Reporting Project.  As Executive Director, Ms. Pickering oversees the NYBGH role in the NYS Health Accountability Foundation, a joint venture between NYBGH and IPRO.  She is also Chair of the Board of Directors of the NYBGH subsidiary, HealthPass, a consumer-choice purchasing alliance for small businesses. NYBGH leads the Leapfrog Group regional rollout in the NY Metro area and Ms. Pickering is overseeing that initiative. Ms. Pickering has served as a researcher for Columbia and Emory Universities; has worked for the Centers for Disease Control and Prevention (CDC); and served as an assistant to George Pataki, now Governor, in the New York State Assembly. Ms. Pickering currently serves on the Board of Directors of the National Business Coalition on Health and the Educator Support Network, CDC’s Business and Labor Responds to AIDS Board of Business and Labor Partners and the Business Sub-Committee of NYCLIX (New York Clinical Information Exchange).  She was recently selected as one of New York’s rising stars by Crain’s and featured in the 2007 40 Under 40 issue. Ms. Pickering received her BA from SUNY Albany and MPH from Emory University.

Michael Pine, MD, MBA is president and founder of Michael Pine and Associates, Inc., an innovative analytic consulting firm that for 19 years has specialized in monitoring and improving the effectiveness and efficiency of health care services. He is nationally recognized as an expert in clinical risk-adjustment and quality improvement. Dr. Pine was a member of the Prometheus Design Team and has been selected to direct the development of two of Prometheus Payment’s four major operational systems. He led the analytic team that created HealthMarket’s episode-based reimbursement system and currently is doing ground-breaking developmental work in database design, pay-for-performance, and consumer-driven healthcare. Dr. Pine is a Fellow of the American College of Physicians and of the American College of Cardiology.  He has served on the medical faculties of Harvard, the University of California at Irvine, the University of Cincinnati, and the University of Chicago.  He is the author of numerous publications in basic science, clinical medicine, medical decision making, and healthcare performance monitoring and improvement.  He is a frequent speaker on such topics as reforming the healthcare market, assessing and improving clinical performance, and creating new databases to support innovative healthcare reimbursement and benefits design.   Dr. Pine is a graduate of Harvard Medical School and the University of Cincinnati School of Business.

Michael Thompson is a Principal in the New York office of PricewaterhouseCoopers. He has over 25 years of experience in healthcare and employee benefits strategy development and implementation, design, financing, pricing, operations and analysis. Mike consults with major employers and health plans on integrated health, wellness and consumerism, defined contribution retiree health, vendor performance management, human capital effectiveness and healthcare supply chain management strategies. Mike serves as one of PwC's national thought leaders for healthcare consumerism strategies for the health industries practice, participates on the steering board of the World Economic Forum "Working for Wellness" initiative as well as a delegate to the Montage Group focused on cross-sector collaborative solutions and is a frequent speaker on next generation health strategies. In the past few years, Mike has served as a leader promoting health industry efforts based on the principals of Six Sigma. Mike is a Fellow of the Society of Actuaries (SOA) and serves on the Federal Health Committee, Disease Management Committee, Medicare Committee as well as chairman of the Quality Initiatives Subcommittee of the American Academy of Actuaries (AAA). Mike also serves on boards of the New York chapter of the National Alliance on Mental Illness and the New York Business Group on Health. Prior to joining PwC, Mike served as an executive with a major health plan in both national and regional leadership capacities.
Mike is a primary author of multiple articles and publications including "Employer Driven Consumerism - Integrating Health into the Business Model" (Employee Benefits Quarterly), "The Factors Fueling Rising Healthcare Costs 2006" (AHIP Publication), "Pay for Performance - Rewarding Improvements in Quality of Healthcare" (AAA Issue Brief), "Healthcare Transformation, Leadership and the Evolution of Consumerism" (WELCOA), "The Healthcare Balancing Act: Aligning Objectives, Intentions and Incentives" (View).

Thomas Wilson, PhD, DrPH is a nationally known epidemiologist specializing in the evidence-based design and evaluation of defined population health programs and products. These population health interventions include: disease management, case management, wellness, payment-for-performance programs, predictive algorithms, and electronic medical records. Wilson is the principal of Trajectory(r) Healthcare, LLC--a strategic epidemiologic consultancy firm. He is currently the co-chair of the Patient Safety and Quality Committee of the Disease Management Association of America (DMAA), and a member of the editorial board of the Journal of Health and Productivity. Dr. Wilson is also the founder and board chair of the Population Heath Impact (PHI) Institute www.PHIinstitute.org, a non-profit organization advocating for credible, independent, and transparent evaluations of organized population health management programs. His former positions include the Corporate Epidemiologist at Anthem Blue Cross Blue Shield, faculty research positions at Columbia University and UC Berkeley, an NIH post-doctoral fellowship position in cardiovascular disease, and a Fulbright award lectureship. He did his doctoral work in epidemiology at UCLA.