Rise

Jeannine Bumford Director, Risk Adjustment Operations

Christus Health

As Director of Risk Adjustment Operations, Jeannine Bumford has successfully planned, designed, and overseen the business and strategic objectives in creating and optimizing a Risk Adjustment Program. Her team has effectively managed all risk adjustment programs pertinent to Medicare, Medicare Advantage, and ACA lines of business. Jeannine's extensive experience in risk adjustment, spanning over twelve years, has significantly improved provider engagement, finance, HCC coding, RADV audits, and data submissions. She holds certifications for Professional Coder (CPC) and Risk Coder (CRC). 

Emily Crooks APRN, FNP-C, Director, Population Health

Affinity Health Group, LLC

Emily Crooks is the Director of Population Health for Affinity Health Group (AHG) in Monroe, LA. She has 22 years of nurse practitioner experience with the past 11 years focused on preventive care, risk stratification, quality performance, and provider education. Emily currently leads operations, strategy, and process improvement for AHG’s Population Health Department. AHG Population Health partners with Blue Cross Blue Shield of Louisiana to provide in-home health assessments for MA and ACA lines of business. These comprehensive in-home assessments focus on disease prevention and early detection, risk identification, patient education, and access to care which contributes to improved patient outcomes. Emily also serves as a Population Health Advisor and Clinical Documentation Supervising Lead for eleHealth, a physician-led management services organization. She oversees clinical documentation and coding reviews for eleHealth’s Network and Medicare ACO practices. As a subject matter expert in clear, accurate clinical documentation and coding best practices, she delivers effective, provider centered education and tools that promote improved performance in quality and gain sharing programs. 

Deborah Curry Risk Adjustment Programs Director

Paramount Insurance Company

Deb joined Paramount Healthcare in May 2013 and oversees the Risk Adjustment, Coordination of Benefits, and Subrogation departments.
Prior to her position with Paramount she had 21 years’ experience working with the State of Ohio workers’ compensation program, both for the government and a contracted managed care organizations. She came to Paramount with extensive knowledge in medical coding, provider billing and education, Medicare payment methodologies, quality assurance, and regulatory compliance.

Deb attended The University of Toledo for both her undergraduate and graduate degrees and currently holds a Masters of Business Administration with major in Healthcare Systems Management. She is an active member of the American Health Information Management Association (AHIMA) and is a Registered Health Information Administrator (RHIA) and Certified Coding Specialist, physician based (CCS-P). Deb is also an active member of the America Academy of Professional Coders (AAPC) and is a Certified Risk Adjustment Coder (CRC). Also, Deb is a member of RISE and holds certificates as a Risk Adjustment Practitioner (RAP) and Advanced HCC Auditor
(AHCCA).
Additionally, Deb is a Board Member of the University of Toledo Health Information Administration Advisory Board, Health and Human Services Alumni Affiliate at The University of Toledo, and Health Information Technology Advisory Committee at Owens Community College.

Dr. Shannon Decker PhD, MBA, MBA, M.Ed., M.Ed, Founder & CEO

VBC One

Dr. Shannon Decker is Founder & CEO at VBC One, a consulting firm assisting physician groups, health plans and vendors maximize the performance of their value based contracts and offerings. Dr. Decker has more than 25 years experience in health care and most recently led teams in risk, quality, data and analytics, telehealth, COVID response and delegation compliance. Of her more than 25 years of experience in healthcare--17 include working with risk adjustment, quality and Medicare. Dr. Decker has a PhD. in Interdisciplinary Studies, dual MBA degrees--in Finance and in Marketing, as well as an M.Ed. in Secondary Education and a M.Ed. in Administration and Leadership. Dr. Decker is on the faculty at Arizona State University and is also an associate professor in the social and behavioral sciences for Walden and Capella Universities where she chairs and oversees the dissertations of doctoral students. An author of two books and several peer-reviewed articles, and a prolific national public speaker, her interests include the study of human behavior and how social and behavioral theories may be brought to bear in value based care and population health management as a whole. 

Ryan Dodson Risk Adjustment Consultant

Choice Medical Group

His background is in management and operational processes for 15 years, and began working in the Risk Adjustment arena 12 years ago. Ryan has proven himself by helping Medical Groups raise their RAF scores to their proper levels. He directed the movement of a 10,000 member group up 43% over a two year period, and an 1800 member group up 53% in the first year. Ryan achieves these results through chart documentation audits, provider and staff documentation training, and provider relationship building. In his most current role Ryan works with multiple groups to optimize their RAF score, while at the same time achieving CMS 5 Star quality. Ryan explains to these groups that getting their RAF score to the correct level will not only drive revenue, but it will also lead to better patient care with improved documentation habits. Ryan is a Certified Risk Adjustment Coder (CRC) credential through the AAPC.

Tina Dueringer BSN, RN, CCM, PCC, CEO, Principal Advisor

Dueringer Advisors Inc

Tina Dueringer, BSN, RN, CCM, PCC, is the CEO and Principal Advisor at Dueringer Advisors Inc., a distinguished consulting firm dedicated to supporting health plans, vendors, and leaders in the health insurance and provider sectors. With a robust background spanning Medicare Advantage, Medicaid, Duals, ACA, and commercial markets, Tina brings extensive expertise in care management, utilization management, clinical quality, Model of Care development, Stars ratings, HEDIS measures, and accreditation standards such as NCQA and URAC. 

Tina's career is marked by strategic insights into health plan operations, including strategic planning, joint ventures, partnerships, delegated relationships, and the advancement of value-based care models. She is deeply committed to advancing Health Equity, Population Health, and integrated care initiatives across the industry. 

Previously, Tina served as Vice President of Clinical Quality and Stars at Rebellis Group, specializing in Medicare Advantage and government consulting. Her leadership journey includes pivotal roles at Cityblock, Blue Cross Blue Shield of Arizona, and the Wisconsin Department of Health Services, Medicaid Policy Division. 

Tina earned her Bachelor of Science in Nursing and holds a post-graduate certification in Population Care Coordination from Duke University. She is also a Board-Certified Case Manager (CCM), underscoring her dedication to enhancing healthcare delivery and outcomes through comprehensive care coordination strategies. 

Eden Anne Encarnacion Sr. Manager, HEDIS - Medicare Star Program

Blue Shield of California

Colleen Gianatasio Vice President of Compliance

CoventBridge Group

Colleen Gianatasio CPC, CPCO, CRC, CDEO, CPC-P, CPMA, CPPM, CCS, CCDS-O, CHC, AHFI, and AAPC Approved Instructor is a strategic value-based care expert with over 20 years of experience in the health care field. Colleen specializes in supporting healthcare programs by ensuring compliance with federal guidelines and appropriate reimbursement processes. Colleen is known for driving program integrity and cost savings, increasing provider engagement and developing innovative coding curriculum. Colleen served as President of the AAPC National Advisory Board for the 2022-2025 term.

Rafael J. Gonzalez Director of Clinical Coding & Clinical Documentation Integrity

Leon Medical Centers

Eric Hansen DO, FAAFP, Physician

Hansen Medical

Dr. Hansen currently practices in the High Desert area of San Bernardino County. He has been in independent practice, Family Medicine, since 2002. He has been involved in organized medicine the entire time he has been in practice. He was awarded his fellowship from the American Academy of Family Practice in Legislative Advocacy in 2017. He was recently elected to serve as the Vice Chair of the Board for the California Medical Association, representing all of the Independent Solo and Small Group Practicing physicians of California to the California Legislature through the CMA. He also serves on the Governing Board of the California Political Action Committee (CalPac), he serves as Vice Chair of the Legislative Commission for the San Bernardino County Medical Society, as well as serves on the Legislative Committee for Cap-MPT and on the California Legislative Committee for Aledade. Dr. Hansen is a past president of the San Bernardino County Medical Society from 2017–18, and serves as a clinical faculty member for Western University College of Osteopathic Medicine, and Associate Clinical Professor for the California University of Science and Medicine; School of Medicine. 

Mary Inman Partner  

Whistleblower Partners

Mary Inman is a partner and co-founder of Whistleblower Partners LLP, a law firm dedicated to representing whistleblowers under the various U.S. whistleblower reward programs.  Mary and her colleagues have pioneered a series of successful whistleblower cases against prominent health insurers, hospitals, provider groups, and vendors under the False Claims Act alleging manipulation of the risk scores of Medicare Advantage patients.  Mary is a recognized expert and frequent author, commentator, and speaker on frauds in the healthcare industry, particularly those exposed by whistleblowers.   

Amy Jack Director of Risk Adjustment

Select Health

Ava Johnson Associate Director, Ambulatory CDQI

Mount Sinai Hospital, NYC

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.

Jenn Kerfoot Chief Strategy & Growth Officer

DUOS

Jenn is a visionary healthcare leader with deep expertise in Medicare Advantage and Value-Based Care. She leverages her extensive background in healthcare policy, regulation, and business development to drive strategic growth and innovation at DUOS, developing tailored solutions that meet the evolving needs of Medicare Advantage plans. A seasoned podcast host, Jenn regularly explores critical issues like the looming threat of Medicare insolvency, the challenges of financing care for an aging population, the impact of rising healthcare costs, and disparities in care access. With previous leadership roles at FarmboxRx, Excelera Health, and NationsBenefits, Jenn has a proven track record of navigating complex healthcare regulations and aligning strategies with market demands. Beyond her executive role, she is a recognized thought leader and advocate for progressive healthcare practices, advising venture capital and private equity firms on investments in transformative healthcare solutions. Jenn’s pragmatic optimism and relentless problem-solving approach are key to her success in fostering collaboration and pushing the boundaries of what’s possible in healthcare.

Jimmy Liu VP Analytics and MRR Solutions

Advantmed

Jimmy Liu is Vice President of Analytics and MRR Solutions at Advantmed. He has been helping health plans with their risk adjustment strategy across all lines of business for more than 15 years. Jimmy is a risk adjustment thought leader, conference speaker, and author of numerous white papers and articles. Jimmy started in consulting doing 10 years of application design and development for the financial services industry. He then spent the next 6 years at Independence Blue Cross in Philadelphia working on HIPAA EDI and eBusiness initiatives. He has designed and developed more than 20 large scale applications in his career, several of which became risk adjustment products. Jimmy has also spent more than 10 years doing risk analytics and developing suspecting algorithms that are used to create prospective and retrospective chase lists. Jimmy is a graduate of the University of Pennsylvania and lives in the greater Philadelphia area.

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)

Donna speaks nationally for RISE, AAPC and AHIMA

She also received the 2021 MaHIMA Champion Award

Jenni Monfils CPC, CDEO, CRC | AVP, Risk Adjustment Coding and Compliance

Molina HealthCare

Jenni Monfils, CPC, CDEO, CRC has over 20 years of healthcare experience in revenue cycle, coding, and documentation improvement. She is an accomplished risk adjustment professional with extensive experience in both the Medicare and HHS HCC model. Jenni specializes in developing provider risk adjustment education and HCC quality oversight programs to ensure compliance. She has project managed HHS-RADV audits, Medicare Advantage Contract Level RADV audits and Part C Improper Payment Measure (National RADV) audits. Jenni demonstrates effective leadership and innovative problem-solving skills to plan and execute the necessary oversight in the everchanging risk adjustment space. 

Hemanshu Patel MD, CMO, CMtO,

CareMD Inc

Laura Sheriff Risk Adjustment Industry Expert

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. 

Kei Shao Tikkanen Senior Manager, BoI Strategic Initiatives

Cityblock Health

Chris Trygstad Vice President, Product

Biomedix

Chris Trygstad is a Vice President with Biomedix, a market leader in font-line diagnostic solutions. Chris oversees all aspects of Product at Biomedix, including functional and technical product design, security, interfacing, promotion, and support. Chris has over 20 years of experience in technology-based products and over 10 years concentrating on designing and delivering innovative medical technology products and services that improve and save lives. Chris is an expert in both commercial and public Fee-For-Service reimbursement models as well as commercial and public Value-Based-Care coverage models.

Susan Waterman Director of Risk Adjustment

Baylor Scott and White Healthcare

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.