Stephan Yelenik has over 35 years of experience in health care administration, strategic planning, business intelligence and informatics, business start ups, and application software development. Stephan has a bachelor’s degree from Clarkson University and a Master’s in Hospital and Health Administration from The George Washington University.
During college, Stephan did several administrative internships at Rutgers Mental Health Center, an affiliate of the New Jersey University of Medicine and Dentistry. He satisfied his graduate school administrative residency at St. Joseph Hospital in Bangor, Maine. During the years subsequent to his education, Stephan held various administrative positions including Director of Planning, Associate Administrator, Chief Operating Officer, and Chief Executive Officer of various hospitals in Maryland, Florida, and Texas. He has worked for AMI, now Tennant Health and Universal Health Services.
Stephan has been a part‐time and full‐time health care consultant periodically since 1988. Stephan has consulted with health plans on strategic initiatives, medical economics and business intelligence and informatics. Stephan has assisted many health plans with methods to control and mitigate medical cost inflation. This has included initiation of improved case management models, predictive modeling, disease management, operational efficiencies, medical policies, underwriting and actuary methods and much more. His health plan sector experience includes Medicaid, Medicare, commercial, corporate self‐funded, Federal employees, and state employees. Stephan has also developed software applications to support sales and marketing, provider contracting, physician office infusion management, and billing. Stephan has built operations data stores, data warehouses, and reporting portals for managed care organizations and self‐funded employer groups.
In 1994, Stephan co‐founded Harmony Health Plan a de novo Medicaid HMO in North New Jersey. As this plan grew, Stephan and Harmony started two more de novo Medicaid plans; one in Illinois and one in Indiana. Stephan was a Board member of Harmony Health Systems until 2005.
After working for Independence Blue Cross of Philadelphia, PA as Senior Director, Strategy, Stephan returned to his passion for startups in 2005 and built a de novo Medicare HMO in New Jersey for Unison and then successfully bid and built a Medicaid HMO in Delaware for Unison. He was Chief Operating Officer of AmeriChoice New Jersey, a nearly 300,000‐member Medicaid and Medicare plan owned by United HealthGroup.
In August, 2009, Stephan returned to his roots as an entrepreneur and consultant as the founder and Chief Executive Officer of Continuance Health Solutions, Inc. His new company has developed an innovative CMS Medicare Compliance software for Medicare managed care organizations and is providing consultation for several managed care clients including AmeriHealth New Jersey, Elderplan in Brooklyn, NY and MMM Puerto Rico.
Jon Harris‐Shapiro’s projects help clients improve the health status of their covered population, promote the use of quality health care services, and control medical and productivity‐related costs.
Jon has been developing innovative data‐driven solutions for his clients for nearly 30 years. His approach integrates actuarial, clinical, and statistical methods to uncover the core factors influencing the direct and indirect consequences of illnesses. His portfolio includes projects that focus on physician treatment patterns, patient behavior, benefit plan design, provider network configuration, adverse selection, incentive programs, and health care financing. Some of those projects include:
Jon was formerly the Vice President for Business Advisory Services for ProfSoft, Inc., a nationally recognized leader in developing and applying episode of care‐based analytics to address the challenges faced by both health plans and self‐funded employers. He also held senior‐level consulting positions with regional and national consulting practices where he provided actuarial and management consulting services to health plans, provider‐sponsored organizations, hospitals, and employers. His clients value his ability to demonstrate the linkages between medical need, treatment patterns, patient behavior, clinical outcomes, benefit design, and financial performance.
He also brings extensive experience with payers to the table. He has held leadership positions in the actuarial services departments of Blue Cross Blue Shield Oregon/HMO Oregon and US Healthcare, Inc. (prior to its merger with Aetna, Inc). In those roles, Jon worked very closely with other executives tackling a full range of financial and actuarial matters. He has extensive experience addressing product development and provider reimbursement and risk‐sharing issues for Medicare, Medicaid, and commercial lines of business.
Jon is frequently invited to speak at industry and professional meetings and has a number of publications to his credit.
Robert Wagner has nearly 30 years of experience as an innovative IT professional with a proven track record for successful completion of multi-million dollar projects for Fortune 100 corporations in the managed healthcare, insurance and financial services industries. Bob has a Bachelor of Science degree in computer science and mathematics from the University of North Carolina.
Prior to joining Continuance as its CIO, Bob was director of applications development and data governance at UnitedHealth Group since 2004. While at UnitedHealth Group, he directed several large-scale initiatives. Some of which include:
Designed and implemented the Transactional data store (“Claims Repository”) used by the enterprise for claims adjudication and historical claims inquiry. Containing over 50 Terabytes of information, the Claims Repository supports 200+ transactions per second in an IBM Mainframe DB2 environment.
Designed and implemented the Operational data store (“Claims ODS”) to be used by the enterprise for operational reporting and web portal applications to provide improved response time and cost reduction in transactional processing
Modified the legacy claims adjudication system (“TOPS”) and web portal applications to read and write to the Claims Repository in a transactional environment, resulting in a single source-of-truth for all claims data feeds downstream for reporting and web portal access.
Defined, created, staffed and managed the Claims Data Governance team, which was responsible for oversight and approval of all database changes in the claims domain, as well as creation and maintenance of all associated metadata and cradle-to-grave data lifecycle requirements, resulting in data continuity and consistency across the claims domain.
Prior to UnitedHealth Group, Bob was senior manager of Medco Health Solutions where he managed a team of 20+ analysts & developers, in the design, development, implementation, and support of the IBM mainframe & distributed platforms (VB, .NET) of the “Alpha” order entry system. As the interface between the image processing system, which receives the order, and the pharmacists, who key the order into the system for processing, this multi-million dollar project is a key component of the automated pharmacy system that is currently in use across the U.S.
Bob is respected in the industry for his ability to design and deliver innovative, large-scale information technology solutions that enable organizations to more efficiently fulfill their business objectives.
Christopher Adams has over 30 years of experience in hospital and medical group management and in managed care start-ups and operations. Chris has a bachelor’s degree from University of Wisconsin and a Master’s in Management from Northwestern University.
From 1978 to 1984, Chris held various administrative positions with Lutheran General Medical Center, a 700-bed non-profit tertiary teaching hospital in Park Ridge, IL including assistant administrator for the hospital’s affiliated 85-physician medical group and administrator of the 250-physician IPA associated with the hospital/medical staff joint venture. He then worked for AMI, a hospital management company, supporting their program to enter the managed care market in South Florida where AMI operated six hospitals.
In 1986, Chris founded Family Health Plan, the first Medicaid HMO in Florida to contract with an independent network of physicians and hospitals. From a base of Medicaid members, he was able to expand the plan into the commercial market resulting in a total of over 40,000 members.
After a brief stint as Prudential’s market director for the Tampa Bay area, Chris joined Stephan in founding Harmony Health Plan in North New Jersey and served as the Chairman of Harmony Health Plan until its sale to WellCare in 2004.
In August, 2009, Chris joined Stephan as Chairman of Continuance Health Solutions, Inc. Since late 2011 Chris has participated with continuance as a consultant including managed care design responsibilities for Medicaid, commercial HMO/PPO, marketing and sales, financial projections and reinsurance.
Peter Bell has wide-ranging experience in the healthcare payer market, ranging from system configuration to data analysis of resultant claims. Some of his projects include:
- Claims system conversion with provider file transformation, benefit design and fee schedule configuration as key tasks.
- Data analysis with HEDIS measures, utilization dashboards, provider reimbursement models and risk adjustment being recurring objectives.
- Interfacing directly with operations staff to identify data anomalies that impact downstream workflows, utilization and cost prediction trends related to preauthorization.
- Validation of financial wellbeing via encounter reporting, IBNR models, ROI analysis and early prediction of high-cost outliers.
- Operating with regional health information organizations to define the manner in which healthcare organizations communicate with partners.
Lisa Roszko is an experienced data analyst with over eleven years of experience at Independence Blue Cross and AmeriHealth Administrators specializing in healthcare informatics.
Lisa’s projects include:
- Development of a standard suite of health plan performance reports automatically distributed to over 100 clients on a monthly basis.
- Development of 80 – 100 ad hoc client analysis requests per month with extensive contact with the client to fully assess their reporting and analytic needs.
- Development, deployment and training for an end user distributed reporting solution utilizing Data Models and the Report Builder tool, reducing the need for internally developed reports and putting reporting into the hands of the client.
- Development and distribution of performance dashboards.
- Development of portal and web pages using both HTML and SharePoint technology.
Lisa earned her Bachelor of Science degree in Elementary Education from West Chester University. In 2007, she successfully completed the Kimball Group program ‘Data Warehouse/Business Intelligence Lifecycle in Depth.
Alison’s projects include
- Extracted, manipulated, analyzed and presented medical & pharmacy utilization, enrollment, provider and quality/disease management data for ad-hoc and standard reporting
- Developed an interactive, user friendly, hospital and ancillary facility contracting model used during negotiations to model the impact of various contract pricing scenarios
- Recipient of corporate “Best of the Best” award for creation of an $85M hospital contracting model which aided a successful negotiation with one of NJ’s largest hospital systems
- Created standard reporting tools to increase efficiency and accuracy
Trained new employees and reviewed work of other analysts to ensure accuracy
- Prepared numerous PMPM cost comparisons, fee schedule analysis, reconciliations, recoveries, HEDIS specs for quality management mailings, loss ratios, etc.
Alison earned her MBA from Centenary College and BS in Business Administration, Specialization in Health Service Management from Robert Morris University.
Beth has over 25 years of programming experience. Beth received a bachelor’s degree in Computer Science and has enjoyed developing application software for workflow management, data warehousing and transaction processing applications.
Beth started her career with a manufacturing company and worked in a startup computer consulting firm before joining her husband’s software consulting firm. Beth has worked in a variety of settings, including hospitals, insurance companies, HMO, manufacturing, fundraising, book distribution vendor, and a startup specializing in turnkey systems for financial institutions. Clients from around the country value the dedication and commitment to her work. Beth still supports software developed in 1990.
Beth is currently consulting with a large insurance company with responsibilities ranging from programmer training classes, software support and new development. Each project requires analytical work, database design, programming, training, reports and documentation.
Sample work experience includes:
- Membership and Claim Data Warehouse
- Provider Credentialing
- Provider Outreaches
- Provider Appeals
- Issue Tracking
- Data Submission extracts
- Vendor Performance
- Disease Management Claim Authorizations
- Claim Recovery
- Purchasing and Inventory
- Mass mailings
- Order Entry
Beth is a member of the SQL Server Worldwide Users Group and CT Chapter of Access User support group. She has been the keynote speaker at CTAUG meetings.
Bruce has over 25 years of experience developing software applications. He has designed and programmed projects for data‐driven tracking and reporting systems, for complex process‐flow handling, and for many other system types. He has created database applications, web‐based applications, programs handling multiple users in a networked environment, and embedded software.
Bruce started his career as an Electrical Engineer working on both software and hardware, before specializing in software. He developed instrumentation for companies in the medical device, communication, and petroleum industries. In addition to design work, Bruce had project manager responsibilities and led projects to successful deployment.
Bruce has run his own software consulting firm since 1988. The guiding principles for Bruce are quality of work and responsiveness to his clients’ needs. His clients are located around the country and include insurance companies, manufacturers, health care companies, an aerospace company, and a commercial printer maker.
Bruce’s work includes:
- A system for tracking and handling inventory, purchasing and billing status, and patient appointments for a health care management company with multiple sites across the US.
- A web‐based application for tracking and facilitating Medicare reporting for insurance companies. The application streamlined the reporting process and performed data‐integrity checks to prevent commonly made errors.
- Real‐time machine control for operating large commercial printers and for operating a computer‐ controlled router. This software controls precision motion and the operator interface for machines used throughout the world.
- An application to process health care provider issues for an insurance company. The application tracks each issue and the responsible person for each stage in the issue definition/resolution/appeal process. Supporting documents are tracked and multiple reports are generated. Tens of thousands of issues are handled annually.
- A program to monitor the manufacturing process in a chemical plant, insuring that the chemical synthesis was proceeding correctly at each step in a multi‐step process.