Kristie Lee

Kristie Lee

Kristie Lee

A health policy analyst and regulatory expert, Kristie Lee has worked on the analysis and implementation of federal regulations from a health plan perspective. She has a deep understanding of the actions required when new regulations are released and experience establishing oversight and project management-driven initiatives.

Kristie joins HMA after serving with an information technology/health plan operations vendor supporting Medicare Advantage health plans, where she was manager of the internal regulatory operations team. In this role, she monitored and analyzed the latest federal Medicare regulations that informed strategic and tactical business implementations. Kristie was the primary lead for health plan operations-related topics, such as enrollment, billing, claims, risk adjustment, and quality.

At the start of the COVID-19 pandemic, Kristie led and implemented a cross-functional oversight workgroup to review the unprecedented influx of federal regulations that were released during the first few months of the public health emergency. She also supported internal and client audits, including an Office of Inspector General risk adjustment payment audit, maintained the vendor’s Third Party Administrator license in more than 40 states, and triaged compliance issues.

Kristie also has experience with strategic business implementations of Affordable Care Act (ACA) requirements and analyzing ACA regulations at a large Blue Cross Blue Shield health plan. She also has developed internal training programs and employee communications while working at a local hospital revenue cycle consulting firm.

Kristie earned a bachelor’s degree in political science at Duke University and Master of Public Health from the University of Michigan School of Public Health.

 

Michelle Ford

Michelle Ford

Michelle L. Ford has more than 20 years of executive leadership, change management and fund development experience across several industries, including corporate, non-profit, healthcare and foundations.

Prior to joining HMA, she served as the director of Health and Well-Being with the Alliance for Strong Families and Communities (Alliance) and the Council on Accreditation. She worked to position the organization’s strategic action network of community-based organizations as a central resource and authority for achieving health equity by addressing the social determinants of health, building organizational capacity to contract with the health industry, and developing best practices, necessary systems, and respective policy change.

Serving in a series of executive positions with non-profit organizations, Michelle is the former executive director of the United Neighborhood Centers of Milwaukee, where she managed organizational operations and financial oversight whiles working to advance the organization’s mission, culture, goals, and outcomes while serving as spokesperson and community representative.

Michelle served as director of regional corporate relations, senior director of community engagement, and director of community partnerships for the American Cancer Society in the Midwest division. Additionally, she managed community partnerships and fund development for Wisconsin’s largest hospital system, Aurora Healthcare, and led its annual giving campaign.

She was recently awarded an honorary doctorate in humanities from the Medical College of Wisconsin. She earned a Master of Business Administration from Cardinal Stritch University, where she served as an adjunct instructor in the College of Business and Management, and a Bachelor of Arts degree from Alverno College.

Michelle serves as a national thought leader working on several advisory boards, including the Morehouse School of Medicine’s National Resiliency Network, Camden Coalition’s National Center for Complex Health and Social Needs, Field Coordinating Committee, Social Interventions Research Evaluation Network (SIREN), Root Cause Coalition and the Expert Advisory Group for Raising the Bar through the National Partnership for Women and Families.

She is an active servant leader in the greater Milwaukee area and dedicates her time and talents to several local and national organizations including the Alpha Kappa Alpha, Inc., African American Women’s Fund, Cardinal Stritch University’s School of Nursing, and the Board of America’s Black Holocaust Museum. Outside of work, she enjoys traveling and spending time with her children and grandchildren.

 

Nora Carreras

Nora Carreras

Nora Carreras is a proven leader and team builder with expertise in social determinants of health (SDOH) and non-profit management. She has broad cross-cultural experience management, community and government relations, program development and program evaluation. She has more than 20 years of experience in the public, academic, private, and non-profit sectors.

Before joining HMA, she served as special advisor to the secretary in the executive office of the Pennsylvania Department of Human Services. Her role there included leading large-scale projects for the secretary, including the procurement of a statewide platform to address SDOH in collaboration with managed care organizations, providers, non-profits, local government entities and other state agencies. As an advisor, Nora provided guidance on priority initiatives and topics. Her work also included the formation and oversight of several advisory committees of internal and external stakeholders.

Her work with the Commonwealth also included serving as a policy analyst and specialist for program offices including the Office of Medical Assistance Programs, and the Office of Mental Health and Substance Abuse Services. She has experience conducting research, developing policy recommendations, and leading executive staff on projects and initiatives.

Nora is a seasoned program administrator, budget and grant manager, and coalition builder. Her non-profit and association work includes serving as chief program officer and planner for the York County Community Progress Council where she oversaw program operations, budgets, and administration of the county’s Community Action Agency. Her work included developing and overseeing programs aimed at improving the lives of residents. She also worked in fund development for the Alzheimer’s Association Greater Pennsylvania Chapter and the Penn State Hershey Medical Center.

She earned a Master of Public Administration from the University of Puerto Rico and a bachelor’s degree in business administration from Puerto Rico Interamerican University. She is pursuing a PhD in public administration from Pennsylvania State University and holds a certificate from the Fostering Diversity and Inclusion program at Yale University, School of Management.

Karl Matzinger

Karl Matzinger

Karl Matzinger is an experienced leader with more than 30 years of financial and business expertise helping both state and local governments improve the efficiency and accountability of their financial operations. He is skilled at helping organizations improve services by integrating the program operational needs with sound business plans.

Before joining Burns & Associates, now a division of HMA, Karl spent 30 years in government, where he worked for the City of Phoenix in executive positions in the human services, transit, and housing departments. He also has more than 15 years’ experience in state government with the Arizona Department of Economic Security, where he held a number of senior level management positions in business and finance and information technology areas including serving as the department’s chief financial officer.

In addition, Karl works with the North Carolina Department of Health and Human Services on implementing a resource allocation budgeting system for individuals with developmental disabilities, assists states with developing rates for home and community-based services, and has helped his local government clients with completing community needs assessments.

Karl earned both his Master of Business Administration and bachelor’s degree in finance from Arizona State University.

Jay Shannon

Jay Shannon

A physician leader with more than two decades of executive experience, John Jay Shannon, MD, is the former chief executive officer (CEO) of Cook County Health (CCH) where he also served as the system’s chief of clinical integration.

Before joining HMA, Dr. Shannon led efforts for the Illinois Department of Public Health in the wake of the COVID-19 pandemic. He worked on clinical issues including assessment of medical equipment inventory and distribution including mechanical ventilators, as well as navigated relations between various state agencies and provider communities. He developed and communicated strategies aimed at preserving surge capacity, and staffing and equipping care facilities. He also worked with the Illinois Department of Public Health on strategies regarding elective hospital procedures during various phases of the pandemic and on measures reflecting progress during Restore Illinois.

During his time as CEO of CCH, the system undertook a transformative journey, developing an innovative and integrative approach to the fulfillment of the system’s mission by aligning its role as a provider of care, both in traditional and correctional settings, and as a public health authority and health plan. In addition to fulfilling the health system’s mission to protect the health of all Cook County residents, Dr. Shannon was steadfast in his commitment to ensure CCH was a good steward of taxpayer funds. Through significant operational improvements, CCH reduced its reliance on local taxpayers by more than 75 percent between 2009 and 2019. Today, local tax dollars represent 3 percent of CCH’s operating revenue.

Dr. Shannon spent much of his professional career at John H. Stroger, Jr. Hospital of Cook County, formerly Cook County Hospital, joining the medical staff in 1990 and serving in several roles, including as director of the Adult Asthma Clinic where he led several quality improvement collaborations aimed at improving the delivery of care for asthma patients within the health system and across the county. He also served as an associate chair of the Department of Medicine and chief of the Divisions of Pulmonary and Critical Care Medicine at Stroger Hospital.

In addition, Dr. Shannon served as executive vice president for medical affairs and chief medical officer at Parkland Health & Hospital System in Dallas. While there, he served for two years as a trustee of the Dallas-Fort Worth Hospital Council.

His other board and community service work includes serving as a director on the board of the Greater Chicago Food Depository, and as a trustee of Spring Hill College. Previously, he served on the board of the Illinois Health and Hospital Association, the executive board of the American Lung Association of Metropolitan Chicago (now the Respiratory Health Association), and on the executive board of the Chicago Asthma Consortium.

Dr. Shannon earned his bachelor’s degree from Spring Hill College and his medical degree from Rush Medical College. He trained in Internal Medicine and was a chief resident at the University of Texas Southwestern Affiliated Hospitals in Dallas (Parkland Memorial Hospital and the Dallas Veterans Administration Medical Center), and later earned specialty training in Pulmonary and Critical Care Medicine at the University of Michigan Medical Center in Ann Arbor.

Linda Follenweider

Linda Follenwider

With more than two decades of clinical expertise and system transformation experience, Linda Follenweider is an accomplished consultant and practitioner.

An advanced practice registered nurse (APRN) and board-certified family nurse practitioner, Linda has worked directly with patients and populations including in team-based and corrections settings. Her experience includes design and implementation work with health systems and health plans across the country particularly in the areas of innovative models of care and care delivery including Patient-Centered Medical Homes (PCMH), Health Homes, and specialty practices.

Linda has extensive experience in correctional healthcare delivery, from leadership to boots-on-the-ground delivery of care. Most recently as chief operating officer (COO) of Correctional Health and as a direct result of systems established under her leadership, Cook County Jail was able to contain and mitigate spread of COVID-19 in a complicated congregate setting while providing access to care. This included creating new efficiencies and processes as well as expanding telehealth services for patients.

Linda utilizes a data-driven approach and quality science to measure and move systems and groups to improve patient outcomes and create efficiencies in processes. She has been recognized for her work using robust data gathering and quality improvement science to elevate care for detainees, engage and elevate staff, and sustain these changes.

Linda has led and expanded care for patients with opioid use disorder which included a fully licensed medication-assisted treatment program for detainees as well as a naloxone on release education and provision program. She has assisted in diversion and intercept modeling for communities seeking solutions for complex issues surrounding the justice involved population.

In community and ambulatory settings, she has created and operationalized curriculum and training, including nurse competencies, for all members of practice staff to increase confident functioning at their highest level of licensure and skill set as part of a larger team. She also created and implemented a train-the-trainer protocol for nurse care managers for multiple large health systems including LA County, San Francisco, and Cook County with a special focus on chronic disease, multimorbidity, and behavior change.

As interim clinic director for a large mental health service provider in Detroit, she opened its physical health clinic to provide clinical services for patients with serious and persistent mental illness, and/or substance abuse that included linkages with recently released detainees. Linda has also done extensive work in the area of workforce development and training, including curriculum and competency development to support right staffing and system redesign as models of care and expectations for staff change.

Linda re-joined HMA in 2020 after serving as COO for Correctional Health at Cook County Health (CCH), which provided healthcare services to patients at the Juvenile Temporary Detention Center and the Cook County Jail. As COO she led the creation of a national model for correctional health that has resulted in better outcomes for patients and the dissolution of 10 years of U.S. Department of Justice oversight at the jail. In addition, under her leadership, the Juvenile Temporary Detention Center was recertified by the National Commission on Correctional Health Care, and she created robust reporting for data-driven care using electronic health records and jail management systems. Her system contributions in leadership also led to her recognition with the Pinnacle Nurse Leader at Cook County Health awarded by UIC Power of Nursing Leadership, having been nominated by CCH leadership.

She has served on the Board of Illinois Society for Advanced Practice Nursing (ISAPN) as the founding member and three-term regional chair and the co-chair of the Reimbursement Committee. In these roles she served as an advisor to employers, practices, and APNs in Illinois around practice and licensure as well as the practice act, rules and regulations that guide APN and physician assistant practice in Illinois. She is an expert in billing and practice for Advanced Practice Providers.

Linda was named the Advanced Practice Nurse of the Year in 2009 by the Illinois Society for Advanced Practice Nursing and has served as graduate school adjunct faculty for Loyola University, University of Illinois-Chicago, Rush University and the University of St. Francis in Joliet, Illinois. Linda earned her Bachelor of Science degree in nursing and Master of Science degree at St. Xavier University.

Robert Muschler

Robert Muschler

Robert Muschler has experience designing and executing strategy development and capacity building projects for nonprofit organizations, having worked with more than 50 organizations to enhance their impact.

He joins HMA Community Strategies (HMACS) after serving as a consultant with NPO Solutions, now a division of HMACS, where he specialized in strategic planning, strategic restructuring, and the development of community needs assessments. In this role, he has led and co-led numerous engagements working directly with nonprofit executives, boards of directors, and staff on a wide variety of strategy-related projects.

He has engaged clients ranging in industry and scale, from start-up stage agencies still formalizing their operations to organizations with multimillion-dollar budgets and more than 100 years of working in the community. Robert’s work has been focused on behavioral health nonprofits, as well as organizations addressing youth development and early childhood education.

He earned a Master of Public Administration from the University of Southern California and a bachelor’s degree from St. Cloud State University.

Outside of work, Robert is an avid triathlete having completed a full Ironman as well as numerous half Ironman distance races.

Gelmy Ruiz

Gelmy Ruiz

With an intimate knowledge of Medi-Cal and California healthcare, Gelmy Ruiz ensures regulatory compliance and prepares clients for successful audits. Working at the intersection of policy and practice, she has significant experience collaborating with governmental payers, safety net systems and health plans. Gelmy analyzes contracts, interprets reporting requirements, and translates new regulation into sustainable action.

Gelmy joined HMA from California Health & Wellness (CHW), a Centene-operated Medi-Cal managed care health plan serving California’s 18 northern rural counties and one southern border county. As a compliance manager, she coordinated with business team leads to prepare regulatory audits. Gelmy was among the first wave of hires brought on to implement the health plan in 2013 – assisting in the creation of policies and procedures and the review of processes and documents to ensure compliance with the California Department of Health Care Services contract and state regulations.

In various compliance-focused roles with CHW, Gelmy managed the plan’s relationships with both the state Medicaid and health plan regulators and reviewed and submitted regulatory reports. She created a new committee to streamline review and approval of all departmental policies and procedures, and she supervised clerical compliance and collaboration within departments.

Prior to CHW, Gelmy served as a senior compliance analyst at Health Net, Inc., a California-based Medicaid, Medicare and commercial health plan. She oversaw day-to-day operations of the Healthy Families contract and administered the Medicaid required reports. Gelmy managed the regulatory relationship with the Managed Risk Medical Insurance Board. Additionally, she directed the plan’s activities to shift Health Net’s Healthy Families enrollees into the Medi-Cal M-CHIP successor program.

Gelmy has also held positions with the Health Plan of San Mateo as a long-term care specialist and with San Mateo County’s correctional health unit where she coordinated the accreditation review of the medical unit.

Gelmy received her master’s degree in public administration from California State University in Hayward. She received her bachelor’s degree in psychology with a minor in Spanish from Saint Mary’s College of California. Following her graduate studies, she served as a CSU executive fellow with the California Conservation Corps.

Fluent in Spanish, Gelmy was born in Nicaragua and loves to travel. When she is not globetrotting, she is reading, gardening or playing volleyball.

Cara Henley

Cara Henley

A policy expert in insurance, managed care and value-based purchasing, Cara Henley provides leadership and guidance on the impact of state and federal statutory and regulatory activity on operational decision making. She offers clients detailed knowledge of Medicaid reform, the Delivery System Reform Incentive Payment program, Medicare payment requirements, and requirements for Medicaid managed care organizations.

In over 8 years with the Healthcare Association of New York State (HANYS), Cara evaluated the rules impacting contractual entities and providers, including accountable care organizations, independent practice associations, health plans, hospitals and physicians. She led the analysis on the Medicaid Managed Care final rule and directed the implementation and roll-out of the Medicaid Redesign Team’s Care Management for All initiative – including the transition of behavioral health and long-term care populations from Medicaid fee-for-service to managed care programs. Cara provided hospitals and health systems with operational and financial support, including strategic team building on denials management, revenue cycle management, contracting, regulatory compliance, and other best practices related to relationships with managed care entities.

Cara significantly contributed to strategic activities, including education, analysis and interpretation of value-based purchasing requirements tied to New York’s Medicaid reform. She has fostered strong relationships with key stakeholders including representatives from government agencies, health plans and healthcare institutions throughout New York State.

A frequent speaker on topics related to reimbursement, managed care, health reform and policy changes, Cara has experience facilitating education sessions in diverse healthcare settings for both small and large teams, including clinical teams and hospital boards.

Prior to joining HANYS, Cara worked for the New York State Senate and provided regulatory support to law practices. She is a member of the Healthcare Financial Management Association.

Cara received her bachelor’s degree in political science from the University at Albany. She earned a certificate in healthcare leadership and advancement from Cornell University and is certified in Lean and Continuous Improvement.

Cara lives in the Saratoga area with her husband and daughter and enjoys cooking with ingredients found at the local farmer’s market.