Podcasts about Blue Shield

Raine shares about her journey as a social worker, including gaining her JD while winning runner up in the Ms. Hawaii pageant, starting as a frontline social worker in a hospital setting, to ultimately leading a social work team while building programs around the CalAIM initiative at Blue Shield California. Raine closes out the show discussing her next chapter and the start of her own consulting firm.

On today's episode of the America's Work Force Union Podcast, we are covering a massive amount of ground—from the halls of the Ohio Statehouse to the structural healthcare barriers facing union moms across the country. Segment 1: Ohio Labor Under Fire with Melissa Cropper Melissa Cropper, President of the Ohio Federation of Teachers (OFT) and Secretary-Treasurer of the Ohio AFL-CIO, joins the show to unpack three simultaneous attacks on Ohio workers and the democratic process: The Midnight Pension Raid: How a 1 a.m. budget amendment stripped elected educators of control over the State Teachers Retirement System (STRS) board, and the legal battle (plus House Bill 719) fighting to reverse it. HB 698 & Higher Ed Restrictions: How this compliance mechanism is weaponizing state funding to restrict collective bargaining and aggressively police DEI roles. Union Busting in the Stacks: A look at the Columbus Metropolitan Library administration's aggressive anti-union campaign ahead of a critical mid-June election—and details on the June 7 community rally at Franklin Park. Segment 2: Breaking the Silence on Perinatal Mental Health For Mental Health Awareness Month, we sit down with Merrilee Logue, Executive Director of the Blue Cross and Blue Shield's National Labor Office, and Arin McClune, Clinical Quality Senior Program Manager with the Blue Cross Blue Shield Association National, to tackle the leading cause of pregnancy-related deaths in America: maternal mental health disorders. The Stark Reality: Up to 20% of women experience these disorders, yet fewer than 20% are ever screened. The Racial Equity Gap: Why women of color are twice as likely to suffer from maternal mental health challenges but only half as likely to receive care. The Union Solution: With 68% of mothers with young children in the workforce, find out how labor leaders can advocate for remote work, flexible scheduling, and integrated mental health benefits to build a culture of solidarity and support. Go Behind the Scenes of the Labor Movement: Every victory starts with workers standing together. Subscribe to the America's Work Force Union Podcast to get the latest interviews with the leaders, organizers, and advocates building true worker power. If you or someone you know is struggling with mental health or in crisis, help is available. Call or text 988 to reach the Suicide & Crisis Lifeline.

In this episode, Dr. Tunde Sotunde, President and CEO of Blue Cross and Blue Shield of North Carolina & CuraCor Solutions, discusses the drivers of rising healthcare costs, the importance of value-based care and whole-person health, and how innovative programs and partnerships are improving access, affordability, and outcomes across the state.

Kristen Berglin, Senior Clinical Consultant for Regence BlueShield was honored as a Community Hero as part of the Behind the Shield series, a partnership between Regence BlueShield and Sounders FC. The content series, profiling both Sounders players and community leaders, celebrates humans showing extraordinary grit and determination in their everyday lives. Kristen has a background in clinical nursing and health care management, having worked as an RN on a busy medical-surgical and pediatrics unit before transitioning to nurse case management. Andrew Thomas is this episode’s featured player for Behind the Shield. Andrew discusses his development as a kid in the Watford Academy, his decision to play and attend Stanford University, and the guidance he’s received from coaches and mentors at the Sounders. See omnystudio.com/listener for privacy information.

367: Activate Good - Leading with Fearlessness and Purpose (Marjorie Maas)Episode SummaryNonprofit leaders carry the weight of the next grant, the next major gift, the next board meeting - and that constant worry doesn't make the work more productive, it just makes it heavier. In Episode #367, Patton talks with Marjorie Maas, CEO of Share Good, based in Omaha, NE, about what it actually looks like to lead with fearlessness when stakes are high and resources are tight. Marjorie leads a national technology and community-building nonprofit that helps cities position generosity in one place - now active in nine markets from Charlotte to Detroit to Omaha and beyond - and she shares the mindset shifts that have shaped both her organization's growth and her own “patchwork quilt” career path. She unpacks the difference between scarcity thinking and an abundance mindset rooted in logical thinking rather than blind faith, why emerging leaders shouldn't talk themselves out of their passion, and why governance fluency is something professionals should be building early — not waiting for an executive seat to learn. Listeners will walk away with a practical framework for leading through uncertainty, language for coaching the next generation of nonprofit professionals, and a clearer sense of how to keep moving forward when fear shows up.About MarjorieMarjorie Maas is the CEO of Share Good, a national technology and community-building nonprofit that connects passion to action in hyperlocal communities by giving nonprofits a shared megaphone to tell donors and volunteers what they need. She leads the growth and expansion of Share Good's national footprint and supports the SHARE Family of community partners across the country. Before joining Share Good in December 2022, Marjorie launched and directed SHARE Omaha, building a platform that promotes more than 700 nonprofits across the Greater Omaha and Council Bluffs metro, and earlier created and implemented the corporate social responsibility strategy for Blue Cross and Blue Shield of Nebraska, redesigning their corporate giving and volunteerism programs. Her 20-plus-year career spans arts marketing, statewide grantmaking, and CSR — a winding path she calls a “patchwork quilt” and credits as the very thing that prepared her for the work she does now.ResourcesConnect with Marjorie on LinkedInLearn more about Share Good at ShareGoodUSA.org — visit the About Us page for community case studies and video testimonialsConcept referenced: Ikigai — the Japanese framework for the overlap of mission, vocation, profession, and passionBook recommendation: The Dip by Seth Godin — a quick, essential read on knowing when to push through a setback and when to walk awayAlso mentioned: Mindset by Carol Dweck (Patton's reference on growth vs. fixed mindset)Follow Your Path to Nonprofit Leadership — and please leave a review!Learn more about the leadership resources at Armstrong McGuire — ArmstrongMcGuire.com

In this episode, Dr. Tunde Sotunde, President and CEO of Blue Cross and Blue Shield of North Carolina & CuraCor Solutions, discusses the drivers of rising healthcare costs, the importance of value-based care and whole-person health, and how innovative programs and partnerships are improving access, affordability, and outcomes across the state.

This episode recorded live at the Becker's Spring 2026 Payer Issues Roundtable features Ellen Sexton, Executive Vice President and Chief Growth Officer, Blue Shield of California. She discusses tackling healthcare affordability, scaling virtual care and digital tools like Virtual Blue, and using AI and data-driven strategies to improve access, reduce ER utilization, and enhance member experience while maintaining trust and quality.In collaboration with Hippocratic AI.

In this episode, Tim Lieb, Senior Vice President of Commercial Markets at Blue Shield of California, discusses the three-year impact of Virtual Blue, including lower costs, reduced ER utilization, improved access to care, and how virtual first models are reshaping employer and individual health plans.

In this episode, Tim Lieb, Senior Vice President of Commercial Markets at Blue Shield of California, discusses the three-year impact of Virtual Blue, including lower costs, reduced ER utilization, improved access to care, and how virtual first models are reshaping employer and individual health plans.

A blizzard, a body in the snow, and a case that's divided a town—and the internet. In this episode, we break down the mysterious death of Boston police officer John O'Keefe and the explosive murder trials of Karen Read, where accusations of drunken rage collide with claims of a massive police cover-up. What really happened on Fairview Road… and who, if anyone, is telling the truth? Merch and more: www.badmagicproductions.com  Timesuck Discord! https://discord.gg/tqzH89v Want to join the Cult of the Curious PrivateFacebook Group? Go directly to Facebook and search for "Cult of the Curious" to locate whatever happens to be our most current page :) For all merch-related questions/problems: store@badmagicproductions.com (copy and paste) Please rate and subscribe on Apple Podcasts and elsewhere and follow the suck on social media!! @timesuckpodcast on IG and http://www.facebook.com/timesuckpodcast Wanna become a Space Lizard? Click here: https://www.patreon.com/timesuckpodcast. Sign up through Patreon, and for $5 a month, you get access to the entire Secret Suck catalog (295 episodes) PLUS the entire catalog of Timesuck, AD FREE. You'll also get 20% off of all regular Timesuck merch PLUS access to exclusive Space Lizard merch. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In this episode, Mike Stuart, President and CEO of Blue Shield of California, shares how his finance and provider background shapes a systems approach to improving health outcomes, strengthening provider partnerships, and addressing rising healthcare costs. He also discusses the growing impact of chronic disease and why collaboration across the healthcare ecosystem is critical to making care more affordable and accessible.

In this episode, Mike Stuart, President and CEO of Blue Shield of California, shares how his finance and provider background shapes a systems approach to improving health outcomes, strengthening provider partnerships, and addressing rising healthcare costs. He also discusses the growing impact of chronic disease and why collaboration across the healthcare ecosystem is critical to making care more affordable and accessible.

Payers are operating at the center of converging pressures: rising costs, accelerating utilization, heightened public scrutiny, and a wave of CMS reforms that are reshaping expectations around transparency, interoperability, prior authorization, and accountability. Medicare Advantage has become the front line for these shifts—exposing tensions between regulatory oversight, margin compression, and growing demands for better member and provider experiences. Against this backdrop, health plans are being asked to do more with less—while proving real value through measurable outcomes, trust, and access. In this episode, recorded in February at the ViVE digital health and healthcare innovation conference, Rae Woods moderates a conversation with payer and technology leaders on how AI and data are being used to reduce payer–provider friction, rethink prior authorization, and improve the member experience—without losing sight of accountability or return on investment. Panelists include: Ali Khan, MD, Chief Medical Officer, Medicare at Aetna (a CVS company) Kay Judge, MD, Chief Medical Officer, Medicare at Blue Shield of California Syed Mohiuddin, MD, Head of Healthcare, Anthropic We're here to help: Podcast | 276: The AI gold rush is changing how humans (and clinicians) make decisions Research | How to succeed using AI: Lessons from 4 leading organizations Expert Insight | Inside CMS' final rule changes for 2026 Learn more about the ViVE conference Register today for the 2026 Advisory Board Summit in Washington, D.C. Updating COVID-19 management protocols may help address long-term impacts A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

What happens when a high-performing leader hits a wall they never saw coming? Kimberly Arnold knows firsthand. After she spent decades leading large-scale transformations at PwC, Salesforce, and Blue Shield of California, a perfect storm of personal and professional pressures sent her on a 15-week stress-induced medical leave. That experience opened her eyes to what most leadership development overlooks: the powerful role your nervous system plays in how you show up under pressure. Now, as founder of the Mastering Pressure System™, she teaches leaders simple, body-based practices that restore composure in seconds.Kimberly reveals the neuroscience behind why your body reacts before your mind even catches up—and why that matters for every decision you make. You'll hear how she walked into a room of 12 distraught stakeholders at Salesforce and used a quick physical reset to stay open, curious, and collaborative when blame was flying in every direction. She shares her PACE framework (Pause, Acknowledge, Center, Engage) and practical techniques you can use in minutes to interrupt stress reactions, prevent cortisol buildup, and lead from a place of clarity rather than reactivity.Kimberly helps leaders and teams master their performance under high pressure without compromising their relationships or their health. As founder of the Mastering Pressure System™, she teaches repeatable tools leaders apply to interrupt reactive patterns and reset in minutes. Drawing on decades of leadership at PwC, Salesforce, and Blue Shield of California, plus 15 years as a certified somatic teacher, Kimberly brings lived experience to turning high-pressure moments into clear thinking, sound judgment, and collaborative solutions. You'll discover: Why your body signals danger before your mind doesHow the PACE framework interrupts stress in secondsWhat pushing harder actually costs your leadership credibilityThe simple posture shift that boosts your confidenceHow a long exhale can prevent cortisol from building up Connect with Kimberly Arnold on Social MediaLinkedIn YouTube Kimberly's ResourcesResilient Reset   Newsletter   Meet with Kimberly   Check out all the episodesLeave a review on Apple PodcastsConnect with Meredith on LinkedIn

“Blue Cross and Blue Shield of Panama con el respaldo de Internacional de Seguros presenta la undécima edición de la Semana Más Saludable “Fit 4 all”, a desarrollarse del 20 al 25 de abril. Un espacio que conecta a personas, familias y organizaciones alrededor de un mismo propósito: Promover estilos de vida más saludables, y al mismo tiempo apoyar con una causa que transforma vidas”. ¡No te lo pierdas!  Hoy, en vivo, a las 5 de la tarde, por Omega Stereo,1073 FM. LIVE por Facebook. También por omegastereo.com#fit4all#semanasaludable#bcbs#is#fanlyc#pautaenradio

V tejto časti sa pozrieme na systematický prehľad o vapingu a rakovine, trochu porozprávame o prebiehajúcej misii Artemis II a ešte preskúmame ako je to s blue shieldom. Zdroje The carcinogenicity of e-cigarettes: a qualitative risk assessment https://www.nasa.gov/mission/artemis-ii/ https://en.wikipedia.org/wiki/Artemis_II https://www.nasa.gov/missions/artemis-ii/arow/ Blue shield pseudovedu nepropagujeme tak zdroje nebudu. Image by Nasa

On this episode of Fostering Change, Rob Scheer is joined by leaders and advocates working directly with young people transitioning out of foster care: Sarah Baumgartner of Anthem Blue Cross and Blue Shield, Brian Robinson of Kids' Voice of Indiana, and Princess Martinez Casanova, a foster youth leader and member of the Youth Impact Board at Kids' Voice.For Comfort Cases, partnerships have always been central to the mission. The organization's first corporate Packing Parties began in Indiana with Elevance Health and Anthem Blue Cross and Blue Shield in 2008. Since then, Anthem has remained a longstanding partner, demonstrating an ongoing commitment to corporate responsibility and to supporting children and youth experiencing foster care.Today, that commitment continues through collaboration with Kids' Voice of Indiana, working together to raise the voice of youth transitioning out of foster care by creating resources, providing transition support, and expanding opportunities for education and career advancement.As Foster Care Awareness Month approaches in May, this conversation highlights the importance of recognizing the needs of young people preparing to age out of the system — and the role partnerships play in helping them build strong, independent futures.Episode HighlightsThe importance of supporting youth as they transition out of foster careHow corporate partnerships can expand resources and opportunities for young peopleThe role of Kids' Voice of Indiana in advocating for older youth and preparing them for independenceThe impact of mentorship, advocacy, and youth voice in shaping better outcomesReal-life success stories, including pathways to higher education and career developmentAbout the GuestsSarah Baumgartner is the Older Youth Case Manager on the Foster Care Team at Anthem Indiana Behavioral Health Services. She brings more than 20 years of experience in mental health, including residential treatment, school-based counseling, and private practice. Her work focuses on supporting older youth as they transition from foster care to adulthood.Brian Robinson is the Director of Older Youth Initiatives for Kids' Voice of Indiana. With more than 25 years of experience working with children and families, including serving as a Guardian ad Litem since the early 1990s, he centers his work on preparing older youth in foster care for independence.Princess Martinez Casanova is a bilingual education advocate, foster youth leader, and member of the Youth Impact Board at Kids' Voice of Indiana. After immigrating from Mexico as a teenager and entering foster care at fourteen, she is now attending DePauw University on a full scholarship, studying Education Studies and Spanish, and advocating for foster youth and immigrant communities.About the WorkThe collaboration between Anthem Blue Cross and Blue Shield and Kids' Voice focuses on:Transition support for youth aging out of foster careElevating youth voice and advocacyExpanding access to education and career pathwaysThese efforts reflect a shared commitment to helping young people move from foster care into adulthood with the tools, support, and opportunities they need to succeed.Connect & Learn MoreKids' Voice of Indiana: https://kidsvoicein.org/Facebook: @AnthemMedicaidInstagram: @anthembcbsX (Twitter): @AnthemBCBSLinkedIn: Anthem Blue Cross Blue Shield – Medicaid Health Plans

Doc Reed has worn many hats in his time as a business owner. From being one of the founders of HUK adn NOMAD hunting and fishing apparel, where he took these brands to more than $50 million in sales in just four years, to to being an auditor for Blue Cross and Blue Shield to his current venture as president of Marsh Hen Mill out of Edisto Island, SC. Marsh Hen Mill is revitalizing the old trade of stone ground grits and heirloom rice in the low country of South Carolina.  Doc shares with us the challenges of the appareal business and his transition into Marsh Hen Mill as President. He goes on to share how his faith has been instrimental to his companies and their success. 

Send us Fan MailLisa Davis is a technology executive who has served as CIO and tech leader for some of the world's most complex organizations, including Intel, Blue Shield of California, the U.S. Marshals Service, and the Department of Defense. She is now focused on shaping the next generation of leaders and advocating for women and diverse talent in STEM through her board work, executive coaching, and her forthcoming book, The Only Woman in the Room: How to Win in a Workplace Still Built for Men.In this episode, Lisa draws on 30+ years leading technology at the highest levels of government and enterprise to make the case that the future of AI depends on who gets to build it, and as long as women remain locked out of those rooms, we are getting it dangerously wrong.In this conversation, we discuss:Why women's representation in STEM has fallen from 34% in the mid-1980s to 22% today, and why that decline is a crisis for the future of AI, not just the workplace.Why the real risk isn't the technology itself but the leadership teams making AI decisions without diverse voices at the table.The structural systems that were never designed for women to thrive, and why redesigning them is a business imperative, not a social favor.Why current corporate layoffs are being falsely attributed to AI, and what leaders need to start saying out loud.Why girls begin dropping out of math and science as early as middle school, how cultural norms around "bossiness" suppress leadership potential, and what parents and organizations can do to intervene earlier.What Lisa says women who finally reach the executive table must do differently, and why most don't.Resources:Subscribe to the AI & The Future of Work NewsletterConnect with Lisa on LinkedIn or visit her website to learn more about her book.AI fun fact articleOn how to navigate life transitions with Bruce Feiler, award-winning author and popular TEDx speaker 

It’s like something out of Indiana Jones - art curators scrambling to save priceless artworks as bombs rain down. When it comes to casualties of war, the most confronting are human, but what about the cultural soul of a nation, with collections valued into the billions also being in the firing line? Find out more about The Front podcast here. You can read about this story and more on The Australian's website or on The Australian’s app. The weekend edition of The Front is co-produced by Claire Harvey and Jasper Leak. The host is Claire Harvey. Audio production and editing by Jasper Leak who also composed our theme.See omnystudio.com/listener for privacy information.

I'm excited to share the 45th episode of This is Ag! featuring Chris Devers, CEO of Rancho Cielo, who is no stranger to transforming lives and communities. Rancho Cielo, a nonprofit in Salinas, California, provides at-risk youth with education, mentorship, and hands-on training in agriculture, culinary arts, automotive, and construction, giving them the tools to build practical skills and sustainable careers. Under Chris's leadership, the school has launched groundbreaking initiatives, including the first Future Farmers of America chapter at a charter school, dual enrollment with Hartnell College, and innovative projects like mobile refrigeration units for local organic farmers. Chris's approach puts students first, ensuring their foundational needs are met while connecting them to opportunities that empower them to thrive. Through stories of alumni like Ashley Soto, who went from a work crew member to running her own construction company, and Samuel, who became a hotel engineer and entrepreneur, Chris demonstrates how mentorship, opportunity, and community investment create lasting impact. This conversation highlights why investing in people with empathy, opportunity, and purpose isn't just good for individuals but also strengthens entire communities. Rancho Cielo: https://www.ranchocieloyc.org/ Kirti Mutatkar, President and CEO of UnitedAg.  Reach me at kmutatkar@unitedag.org, www.linkedin.com/in/kirtimutatkar UnitedAg website - www.unitedag.org UnitedAg Health and Wellness Centers - https://www.unitedag.org/health-benefits/united-agricultural-benefit-trust/health-centers/ Episode Contributors - Chris Devers, Kirti Mutatkar, Dave Visaya, Rhianna Macias The episode is also sponsored by Brent Eastman Insurance Services Inc. - https://brenteastman.com Blue Shield of California - https://www.blueshieldca.com Elite Medical - https://www.elitecorpmed.com Gallagher - https://www.ajg.com/ SAIN Medical https://sainmedical.com/ MDI Network - https://www.mdinetworx.com/about-us

Episode Topic: Bridging Gaps, Empowering CommunitiesAI holds immense promise, yet Ketan Paranjape warns the “last mile” remains a formidable barrier. From rural Indiana to India, infrastructure gaps and cultural nuances challenge the scalability of digital health. Explore how we can bridge this divide by prioritizing human kinship and ethical innovation over mere algorithmic speed. Featured Speakers:Dr. Ketan Paranjape, Bioscope AIBukata Hayes, Blue Cross and Blue Shield of MinnesotaEmily Ho, NorthwesternErwin Tan, AARPShelley Kendrick '10 MNA, EcumenRead this episode's recap over on the University of Notre Dame's open online learning community platform, ThinkND: https://go.nd.edu/418575.This podcast is a part of the ThinkND Series titled The Rural Health Revolution. Thanks for listening! The ThinkND Podcast is brought to you by ThinkND, the University of Notre Dame's online learning community. We connect you with videos, podcasts, articles, courses, and other resources to inspire minds and spark conversations on topics that matter to you — everything from faith and politics, to science, technology, and your career. Learn more about ThinkND and register for upcoming live events at think.nd.edu. Join our LinkedIn community for updates, episode clips, and more.

Concern is growing for the large number of UNESCO World Heritage sites in Iran, after the famed Golestan Palace was damaged in bombing over the past few days. Joining Seán is a man from an organisation which seeks to protect sites of cultural heritage in conflict zones.Professor Peter Stone is the President of the Blue Shield and joins to discuss.

In this episode of the podcast, Ross and Jeana discuss a range of topics, from the recent imposition of daylight saving time to the ongoing conflict in Iran. They also delve into the world of finance, discussing the impact of the war on oil prices and the stock market. Additionally, they talk to Paul Markovich, CEO of Blue Shield of California, about the complexities of healthcare pricing and potential solutions. The conversation also touches on a settlement between Live Nation and the Department of Justice, and Jeana shares her experience hosting a special International Women's Day show on KBCO.See omnystudio.com/listener for privacy information.

In this episode, we're joined by Paul Markovich, CEO and president of Blue Shield of California, as he breaks down the complexities of the US healthcare system. He shares his insights on why healthcare is so expensive, citing the profit-driven nature of the industry and the lack of transparency in pricing. Paul also discusses the impact of the Affordable Care Act and the potential solutions, including the Trump administration's efforts to simplify prescription drug distribution. He highlights the need for consumers to have more control over their healthcare costs and the importance of making healthcare more affordable for all Americans.See omnystudio.com/listener for privacy information.

Today's guest is Carey Smith, Former President and CIO of XcelerateHealth and Chief Technology Innovation Officer (CTIO) of Blue Cross and Blue Shield of Minnesota. XcelerateHealth is a health-tech startup and business unit of Blue Cross and Blue Shield of Minnesota, focused on AI-driven digital products to transform healthcare insurance experiences. Carey joins Emerj's Nick Gertsch to discuss how leaders can structure talent and workforce AI so decisions are consistent, reviewable, and aligned with organizational controls. Smith also shares practical steps for tightening decision rights, improving data readiness, and designing workflows where AI accelerates hiring and mobility without increasing risk. This episode is sponsored by Eightfold AI. Learn how brands work with Emerj and other Emerj Media options at go.emerj.com/partner Want to share your AI adoption story with executive peers? Click emerj.com/expert for more information and to be a potential future guest on the 'AI in Business' podcast!

Blue Cross and Blue Shield of Kansas City Welfare v. United States

In this episode, Jennifer Schirmer, VP of Growth and Community Engagement and interim VP of Duals Program Integration at Blue Shield of California Promise Health Plan, breaks down the sweeping Medicaid changes under HR1 and their impact on California's Medi-Cal members. She shares how her team is investing in high touch outreach, community partnerships, and duals integration to help vulnerable populations maintain coverage and access to care amid rising administrative complexity.

What happens when a Wall Street bond analyst, urban planner, freelance filmmaker, and investment banker all become the same person, and that person ends up running healthcare benefits for 215,000 people at the University of California? Laura Tauber didn't follow the rulebook. She followed curiosity. Laura Tauber is the Executive Director of Self-Funded Health Plans at the University of California, Office of the President. She oversees PPO plans, HMO plans, and benefit partnerships with Anthem and Blue Shield for a workforce that spans everything from Nobel laureates to gardeners — active employees, early retirees, and families spread across California and beyond. 60% of that workforce is unionized. 5 of her campuses have no medical center. And 50-60% of total plan spend runs through UC's own health system, meaning she's constantly negotiating with the very hospitals she depends on. It started not in healthcare — but in natural resources. Laura studied environmental policy, nearly became a forester, spent a summer in rural Montana, and realized that wasn't the life for her. She pivoted to urban planning, moved to San Francisco in 1982 in the middle of a recession, couldn't find work, and called a friend in New York who happened to be hiring at a bond insurance company. That one phone call put her in healthcare. She became a healthcare bond analyst — spending years doing deep financial analysis for hospitals, understanding how CFOs and CEOs think, what keeps them up at night, what their numbers actually mean. Then she moved to Blue Shield of California. Then Accenture as a healthcare strategy consultant. Then a stint in investment banking — where her biggest revelation wasn't finance, it was that she hated banking but loved strategy. Then Scan Health Plan. Then Kaiser. And somewhere in the middle of all of it, she took what she calls "a long sabbatical or a midlife crisis" — left healthcare entirely, got a BFA in cinematography, worked freelance for the BBC, worked on a travel show, and worked on a Spike Lee film. Then she came back. And everything clicked. In this conversation, Laura breaks down what it actually takes to make high-stakes benefit decisions across a system this complex — balancing member needs, budget constraints, union contracts, provider negotiations, pharmacy costs, and the constant pressure of doing right by people whose lives depend on the decisions you make. We go deep on: How her background across hospitals, health plans, investment banking, and consulting gives her a different lens when she looks at data — and why that multi-perspective thinking shapes every decision she makes The GLP-1 decision that consumed 18 months of her life — every study, every doctor conversation, every ethical consideration — and the hard call she ultimately made The $2 million hemophilia cure problem and the question underneath it: if a drug pays for itself over time and it's the right thing to do for the member, can you afford not to cover it? Why she still pulls up the raw spreadsheet herself instead of reading the summary — and why that habit has repeatedly led her to insights her own team missed What "making room at the table" actually looks like in practice — and how her first boss at UC gave her the opportunities that shaped everything that followed How she thinks about developing the next generation of leaders: understanding where people want to go, clearing the path for them, and supporting them even when that means helping them leave Why healthcare is fundamentally different from every other corporate environment — and why that emotional dimension is exactly what draws her to it Every detour Laura took — the bond analysis, the urban planning, the film set — gave her a way of thinking about problems that a straight-line career never could have built. This conversation is about what that actually looks like in practice.

Today's conversation will transform your thinking about emotions. Instead of viewing emotions as negative experiences to push away or control, our guest helps us understand them as our body's guidance system, much like a compass that helps us navigate. Fear and anger, often thought of as negative emotions, are the body's survival mechanisms that are designed to protect our lives. You'll discover practical insights on recognizing physical sensations, befriending your feelings, and using emotional intelligence to become a better coach and leader. Want to know more about relating to your own emotions and showing up as your best for your clients? Join us to learn more!Joie Seldon, MA, is the founder of the Emotional Evolution Institute and the author of Emotions: An Owner's Manual. An innovator in emotional intelligence, she is a life and professional success coach and EQ trainer. She has worked with clients at NASA, AT&T, Wells Fargo, Blue Shield, Dolby, and others. Her clients range from tech professionals and healthcare workers to C-suite executives. With 25 years of experience as an actor and acting teacher, 10 years as a somatic psychology therapist, and a lifetime of personal growth engagement, Joie has developed an innovative approach to teaching people how to release limiting behaviors and use their emotions as the powerful guidance system they are meant to be.Show Highlights:Misconceptions, judgments, and misunderstandings about emotionsGrowing the relationship with your emotions, especially fear and anger, by recognizing and tolerating the sensations you experienceOur feelings and thinking have to work together.The message of fear is “pay attention.”The results when people shift their perspective on emotionsDealing with emotions that arise in coaching conversationsUnderstanding the difference between stress tears and sad tearsThe value of taking private time to process your grief and effectively giving others space for their grief and discomfortA coach's job is not to rescue or “fix”; everyone just wants to be seen and heard.Joie's top “Aha moments” with clientsWhat coaches should understand about emotions being used as a compass“Emotions are energy in motion.” (Be curious about emotions.)Joie's key takeaway for listeners: “Emotions are the link between the tangible and intangible. Pay attention to how you feel, and listen to what information emotions give you.

C.B. v. Blue Cross and Blue Shield of

Health care costs are now rising faster than inflation, wages, and the overall economy. Government programs are being scaled back rather than expanding to cover these costs. To make progress, we need to focus on the delivery of medical care and insist that payment be tied to the value of the services. Two of the country's leading experts on redesigning U.S. health care to focus on value will join us for a discussion with Minnesota legislators to identify a practical agenda for action. About this series: For over ten years the Center for the Study of Politics and Governance has convened a series of public forums to explore health care reform issues. By fostering discussions among policy makers, stakeholders, and citizens, these forums examine the challenges and opportunities in health care reform and help ensure Minnesota's legacy as a leader in individual and community health. This series is sponsored by Blue Cross and Blue Shield of Minnesota.

Cara Munnis was wearing an N95 mask while taking care of her daughter with norovirus all night because she had a critical meeting the next day and "I cannot get this thing." She showed up, ran the meeting, and afterward couldn't tell if anyone noticed she was operating on "one brain cell processing everything." Welcome to being a Chief Product Officer and a mom. Here's what most people don't know about the CPO role: it has the shortest tenure of any C-suite position—less than half that of other executives. You're supposed to be "Switzerland," the neutral party among competing stakeholders. But you're constantly telling your C-suite peers—very kindly—why their ideas are going to sink or swim. The real transformation wasn't navigating those politics. It was what happened when Cara's daughter was born seven years ago. "For someone who's led massive technology transformations multiple times, it's very ironic how hard this transition was for me." The evening checkboxes—that sacred 5-8pm window where she prepared for the next day—vanished instantly. It took five years to build a new operating system where she hired without compromise and delegated with her eyes closed. In this conversation, Cara explains why she's "obsessed" with finding the economic denominator, why Conway's Law means your product will mirror your org structure, and why staying close to technology was the best career advice she ever got. After describing her relentless discipline and surgical precision, she deadpans: "I haven't been fired yet, so I dunno, I guess it's okay." This is a masterclass in product leadership that scales, parenting that doesn't apologize, and ruthless prioritization when you're scraping for minutes in your day. Key Takeaways: How to choose the right ladder to climb—make career decisions based on intentionality, not just opportunity or speed How to turn constraints into leadership advantages—use the pressure of working parenthood to force yourself to hire without compromise and delegate with confidence How to stay close to technology in any role—even as a non-technical leader, understanding architecture helps you defend budgets, win deals, and articulate competitive advantages How to shift your communication style as you move into executive roles—listen more, ask questions even when you know the answer, and bring others along instead of leading with your opinion How to design org structures that create better products—use Conway's Law (products mirror internal communication structures) to intentionally build teams that will produce the outcomes you want About the Guest: Cara Munnis is Chief Product Officer at Care Lumen and Operating Partner at Newfire Global Partners, bringing over 15 years of healthcare technology product leadership to organizations navigating the intersection of clinical outcomes and business results. She spent six years at Amwell advancing from Senior Director to VP of Product Management, previously served as Head of Product for Digital Health at Blue Shield of California, and held leadership roles at Iora Health and Best Doctors. With a pre-med degree from College of the Holy Cross and an MBA from Bentley University, Cara is Pragmatic Marketing Certified – Level III and known for her ability to balance strategic product vision with rigorous execution while fostering collaborative team environments. Chapters [Placeholder for Chapters] Guest & Host Links Connect with Laurie McGraw on LinkedIn Connect with Cara Munnis on LinkedIn Connect with Inspiring Women Browse Episodes | LinkedIn | Instagram | Apple | Spotify

Whoo BOY! This week's episode is packed with info and stats. How did the US healthcare system get so expensive and complicated? Is it still better than some form of universal care? Throwing a lot of history and stats at you today, and comparing our model to the healthcare models of some other countries to show that there are other ways. Ways far cheaper for the average citizen that work as well as ours. So... why don't we change? Merch and more: www.badmagicproductions.com Timesuck Discord! https://discord.gg/tqzH89vWant to join the Cult of the Curious PrivateFacebook Group? Go directly to Facebook and search for "Cult of the Curious" to locate whatever happens to be our most current page :)For all merch-related questions/problems: store@badmagicproductions.com (copy and paste)Please rate and subscribe on Apple Podcasts and elsewhere and follow the suck on social media!! @timesuckpodcast on IG and http://www.facebook.com/timesuckpodcastWanna become a Space Lizard? Click here: https://www.patreon.com/timesuckpodcast.Sign up through Patreon, and for $5 a month, you get access to the entire Secret Suck catalog (295 episodes) PLUS the entire catalog of Timesuck, AD FREE. You'll also get 20% off of all regular Timesuck merch PLUS access to exclusive Space Lizard merch. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

On this episode host Fred Goldstein invites Janna Evans, Director of Pharmacy Sales Support at Blue Cross and Blue Shield of Texas, as they continue their rare disease series with a focus on hemophilia and the substantial clinical, financial, and psychosocial burdens it places on patients and families. We discuss how health plans manage high-cost therapies, balance individualized patient needs with access requirements, and navigate prior authorization and step-therapy processes. Janna also highlights the need for better patient-reported outcomes, the day-to-day impact of the disease, and the broader considerations for employers and caregivers within managed care. This activity is supported by an independent medical education grant from Genentech Inc., and Pfizer Inc. AMCP offers CPE for this podcast through December 31, 2026. For additional information and to claim credit, please visit: ⁠The Power of Partnership: Bridging Patients and Payers in Hemophilia Management. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

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See more: https://thinkfuture.substack.comConnect with Zoher: https://www.linkedin.com/in/zzkaru/---Everyone talks about AI—but it's data that still decides what works and what fails.In this episode of thinkfuture, host Chris Kalaboukis speaks with Zoher Karu, data and analytics leader with a PhD in engineering and experience at McKinsey, eBay, Citibank, Sears, and Blue Shield of California. Zoher now works with Taelor, a men's clothing rental subscription service using data and AI to personalize style at scale.Zoher explains why “dirty data” remains one of the biggest unsolved problems in business—and why the issue isn't technology, but how organizations are structured. Teams build data in silos to solve short-term problems, creating fragmented systems that AI can't magically fix.The conversation moves from fashion and personalization to a much bigger question: what happens when AI quietly takes over everyday decision-making?We cover:- How Taelor uses data, metadata, and human stylists to curate clothing- Why clothing sizes are a data nightmare—and what that teaches us about AI limits- The real reason data quality is still broken across industries- How siloed teams create long-term data problems- Why AI will reduce the effort of finding information, not eliminate thinking -A future where tasks like planning events, shopping, and inventory management become automated- What humans should focus on when machines handle the mundaneZoher's view of the future isn't flashy—it's practical. As AI handles more low-level optimization, human value shifts toward judgment, creativity, and deciding what actually matters.If you're interested in AI, data, personalization, or the future of everyday decision-making, this episode offers a grounded look at where we're really headed.

Faye Sahai is the Managing Director at Vinaj Ventures - advisor and investor  to companies and startups. Previously, she was a 3x startup founder and held leadership positions in healthcare, financial, and technology innovation at AIG, Blue Shield, Deloitte, Kaiser Permanente, and Schwab.

This week, we close out our three-part series on pharmaceuticals with a must-listen encore episode. After detailing the scope of the drug price crisis with Mark Cuban and how we can re-use drugs to treat rare illnesses with David Fajgenbaum, we now turn to a leader who is actively changing the dynamic: Paul Markovich. Now the CEO of Ascendiun (the parent company of Blue Shield of California), Paul argues that healthcare affordability isn't just a patient pocketbook issue - it's a massive economic crisis for the nation. In this episode, Paul and Claudia discuss:His conviction that reducing healthcare costs is essential to averting a national fiscal crisis.The argument for a new national mandate on health data sharing to improve efficiency and care.Paul's candid advice on what it takes to be a brave leader in a dysfunctional system.The path is long and challenging, but as Paul Markovich shows, solutions are possible - if the right players are willing to take accountability for their role in the market:“Almost everybody in the entire value chain, whether it's health plans or hospitals or all the way through, they want to explain why healthcare is so expensive and why there's this inflation rate as if that absolves them of any responsibility to make it different. And so, what I really want is accountability, and a level of accountability that just doesn't exist yet in our industry, to say, “Hey, we own this”. Relevant LinksPart 1: Listen to our episode “New Life for Old Drug with David Fajgenbaum”Part 2: Listen to our episode “Lessons in Disruption with Mark Cuban”Rethinking how Americans get affordable medicationsCalifornia's new data sharing law Blue Shield of California (BSC) announcement of new Humira biosimilar BSC investment in nonprofit Civica for lower cost genericsBSC's new prior authorization platform with SalesforceAbout Our GuestPaul Markovich is president and chief executive office of Ascendiun, a nonprofit corporate entity as part of the new parent to the family of organizations that includes Blue Shield of California.Paul Markovich was president and chief executive officer at Blue Shield of California, a nonprofit health plan with $25 billion in annual revenue, serving 6 million members in the state's commercial, individual, and government markets. Paul launched and led numerous initiatives to drive innovation and help reimagine health care, including funding support for a statewide provider directory to make it easier for Californians to find physicians and facilities in their

In this episode, Ellen Sexton, Executive Vice President and Chief Growth Officer at Blue Shield of California, discusses the impact of major policy changes on Medicaid and commercial markets, how her team is preparing for uncertainty, and the strategies needed to support members, stabilize employer coverage, and advance innovation across California's health care landscape.

On November 7, Commonwealth Club World Affairs of California, the nation's oldest and largest public affairs forum, will host The Asian American Foundation's (TAAF) first-ever AAPI Youth Mental Health Summit. Under the theme “Sparking Solutions Together,” the summit will convene hundreds of experts, advocates, funders, and business executives to address the urgent and often overlooked mental health challenges facing Asian American and Pacific Islander (AAPI) youth. From 2018 through 2022, suicide was the leading cause of death among Asian Americans aged 15–24, and the second leading cause of death among Native Hawaiians and Pacific Islanders. Yet despite being deeply impacted by the nation's mental health crisis, AAPI youth remain largely invisible in the national mental health conversation, and the data needed to understand their mental health is scarce at best. To fill the gap, TAAF released "Beyond the Surface" in December 2024, the most comprehensive study to date on AAPI youth mental health, which revealed: Nearly 1 in 2 AAPI youth screen positive for moderate depression; 1 in 3 have planned or attempted suicide; Stigma, family pressure, and silence keep many from seeking help; Only 53 percent feel comfortable talking with their parents; Just 1 in 4 have accessed formal care; and 46 percent have never seen a mental health provider. Building on these findings, the November 7 summit will bring together leading experts to spark dialogue on breaking stigma, closing gaps in care, and exploring how community partners and technology are reshaping the ways young people seek and receive support.  Join us online to hear from: Midori Francis, Actor, "Grey's Anatomy" Ryan Alexander Holmes Owin Pierson, Creator and Mental Health Advocate Lisa Ling, Journalist Noopur Agarwal, VP of Social Impact, MTV Norman Chen, CEO, The Asian American Foundation (TAAF) Philip Yun, Co-President and Co-CEO, Commonwealth Club World Affairs Rushika Fernandopulle, MD, Practicing Physician; Co-Founder and Former CEO, Iora Health; TAAF Board Member Juliana Chen, MD, Chief Medical Officer, Cartwheel Perry Chen,Director of Programs and Partnerships, Behavioral Health at Blue Shield of California Rachel Miller, Founder & CEO, Closegap Meena Srinivasan, Founding Executive Director, Transformative Educational Leadership Ayesha Meer, Executive Director, Asian Mental Health Collective Henry Ha, Program Director, Community Youth Center of San Francisco Anne Saw, PhD, HOPE Program Reid Bowman, MPH, CHES, Outreach & Program Manager, UCA Waves Rupesh Shah, COO of Crisis Text Line Tone Va'i, LCSW, Clinician, Samoan Community Development Center Amy Grace Lam, PhD, Chief Program Strategist, Korean Community Center of East Bay Christine Yang, ASW, Korean Community Center of East Bay Christina Yu, LCSW, Clinical Supervisor, Korean Community Center of East Bay William Tsai, PhD, Associate Professor, New York University Cindy H. Liu, PhD, Associate Professor, Department of Pediatrics and Psychiatry, BOBA Project, Harvard Medical School Tiffany Yip, Professor of Psychology, Fordham University Quynh Nguyen, TALA (Thriving AANHPI Leadership Accelerator) Fellow   This program is presented by The Asian American Foundation and Commonwealth Club World Affairs.   For full program, please visit:  https://www.commonwealthclub.org/events/archive/video/youth-mental-health-summit-sparking-solutions-together Learn more about your ad choices. Visit megaphone.fm/adchoices

Dallas real estate CEO Robert “Bob” Lovell was ordered this week to pay $5.7 million in damages and fees after a judge determined he repeatedly forced a former employee to perform sex acts and then retaliated against her when she refused. In other news, some Texans are finding out from their doctor's offices that Blue Cross and Blue Shield of Texas insurance plan would no longer be considered in-network; the Texas Rangers are not interested in trading Corey Seager. The Red Sox, Yankees, and Braves have all expressed interest though; and for years, officials at the highest level of Dallas city government knew crime was a problem at Roseland, a public housing complex in Old East Dallas. In twenty eighteen, the city entered into a special agreement with Dallas Housing Authority to keep crime in check. That arrangement was different from what was at the time a new, aggressive plan to protect the public at high-crime private properties. Police reports show that since the agreement was signed, at least seven people have been killed at Roseland, including a nine-year-old girl. Twenty others were wounded by gunfire. A Dallas Morning News investigation shows that over the following seven years, the agreement was never fully followed, and the violent crime at Roseland persisted. The News found numerous ways in which D-H-A and the city fell short in addressing crime and protecting residents, including failures to follow their own agreement. See the full investigation dallasnews.com. Learn more about your ad choices. Visit podcastchoices.com/adchoices

In this Bright Spots in Healthcare episode, host Eric Glazer brings together Medicare Advantage leaders who are rethinking how digital first and whole person strategies can meet rising Stars expectations. The conversation explores how plans are simplifying engagement, strengthening provider alignment, and integrating specialty and virtual care models to improve quality, experience, and overall performance in the new ratings era. Our guests include: Lisa Franklin, Director of Medicare Business, Product, and Marketing, Strategic Growth and Government Programs, Carefirst Christine McKinney, Vice President Customer Experience and Digital Transformation Blue Shield of California Mary O'Connor, MD, Chief Medical Officer & Co-Founder, Vori Health Together, they explore: How CareFirst reduced member friction by consolidating 175 touchpoints a year into a coordinated digital first experience built around scrolling content cards, real time click behavior, and simplified onboarding. How Vori Health is integrating whole person MSK care with payers through value based arrangements that support coaching, nutrition, behavioral health screening, and earlier risk identification. How Blue Shield of California built a continuous CAHPS simulation program to uncover pain points and used those insights to create the Care Navigation Desk for real time access help. How digital tools like online scheduling, integrated member health records, and proactive pharmacy cost transparency are reducing friction and helping seniors navigate the ecosystem more independently. How plans are using AI and preference based engagement to support new Medicare members, improve medication adherence, and scale outreach during market disruptions. Panelist Bios: https://www.brightspotsinhealthcare.com/events/falling-stars-rising-standards-how-digital-first-whole-person-care-is-fueling-success-in-the-new-ratings-era/ Download the Episode Guide: Get key takeaways and expert highlights to help you apply lessons from the episode. https://www.brightspotsinhealthcare.com/wp-content/uploads/2025/12/Episode_Guide_120425_Vori-Falling-Stars-Rising-Standards.docx.pdf Key Insights Summary: Find key insights from the discussion, guest takeaways, and detailed moderator notes captured by Eric during the conversation. https://www.brightspotsinhealthcare.com/wp-content/uploads/2025/12/Key-Takeaways-Erics-Notes-Falling-Stars-Rising-Standards.docx.pdf Resources:  Report: How Physician Led MSK Care Supports Stars Improvement and Whole Person Outcomes This companion report highlights how Vori Health's physician-led, virtual first musculoskeletal care model helps Medicare Advantage plans strengthen performance in the new ratings environment. It includes data and real member stories showing how hybrid specialty access, early gap closure, and whole person support improve outcomes, reduce unnecessary MSK spend, and enhance member experience. Inside you will find insights on Improving access through forty eight hour specialty appointments Reducing opioid use and unnecessary surgeries Supporting preventive screenings and chronic condition management Elevating member satisfaction across measures tied to the 2026 Stars program To request your copy, email nroberts@brightspotsventures.com. Buyer's Guide: The Comprehensive Guide to MSK Care for Health Plans This companion report gives health plans a clear framework for improving MSK strategy, highlighting how fragmented, high cost pathways drive unnecessary imaging, procedures, and surgeries without resolving pain. It outlines four MSK care models and the key elements of a high value program such as physician led care, holistic support, non opioid management, strong engagement, and real claims based ROI. It also shows how solutions like Vori Health bring these components together through coordinated, hybrid access and measurable improvements in outcomes and cost. Inside you will find insights on Improving MSK access and coordination across care models Designing physician led, whole person programs that address root causes of pain Reducing unnecessary imaging, procedures, and surgeries Driving stronger engagement, better outcomes, and meaningful cost savings To request your copy, email nroberts@brightspotsventures.com. Thank You to Our Episode Partner, Vori Health: Vori Health is a physician-led musculoskeletal care practice that delivers fast, evidence-based hybrid care for back, neck, and joint pain. Their whole person approach improves outcomes, reduces unnecessary MSK costs, and supports stronger Medicare Advantage Star Ratings. Learn more at vorihealth.com. Schedule a Meeting with a Dr. Mary O'Connor of Vori Health: To explore how Vori Health can help your organization strengthen whole person MSK care and support better Stars performance, reach out to nroberts@brightspotsventures.com to schedule a meeting with Dr. Mary O'Connor, CMO and Co-founder, Vori Health. About Bright Spots Ventures: Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation.   We help healthcare leaders discover what's working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the "bright spots" in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.  

In this episode of The Retail Perch, Shekar Raman is joined by Zoher Karu to discuss data, analytics, and what it takes to make information truly actionable. Zoher shares his journey from earning a PhD in Electrical Engineering at MIT to building a career focused on customer data and enterprise wide analytics, including his role as VP and Chief Data and Analytics Officer at Blue Shield of California. They explore how companies with growing data sets can approach leveraging them effectively, and Zoher also highlights his current work with Taelor.Style, an AI powered menswear rental platform.

This week's episode brings together three women whose stories show what support, connection, and second chances can spark.Michelle Thomas, senior manager of community relations at Blue Cross and Blue Shield of Oklahoma, shares how working in service shaped her life and how her sister's recovery deepened that commitment.Her sister, Melissa Casey, opens up about her journey through addiction, the impact of Family & Children's Services program Women in Recovery, and her work with the Tulsa County Alternative Court programs. Her story shows how courage and community can rebuild a life.Monica Hartweg, also with Blue Cross and Blue Shield of Oklahoma, talks about the moment she called Tulsa Area United Way's 211 Eastern Oklahoma 24/7 helpline and found a path toward stability, healing, and long-term recovery. Her experience shows how one call can change everything.Each story reveals a different doorway into hope. Together, they paint a clear picture of why community resources matter and why united is the way.

Blue Shield of California's Julianne Holloway joins host Gavin Ward to help explain the often conplex world of DSNP, or Duals Special Needs Plans, for individuals that qualify for both Medi-Cal (known as Medicaid Nationally) and Medicare

In this Bright Spots in Healthcare episode, host Eric Glazer sits down with three leaders reshaping one of healthcare's most overlooked — yet mission-critical — functions: provider credentialing. Credentialing is the quiet infrastructure of trust in healthcare. When it's done right, patients get timely access to high-quality care, providers get paid faster, and health plans stay compliant. When it fails, backlogs grow, compliance risk skyrockets, provider satisfaction plummets, and member access suffers. Joining Eric for this discussion: Sandra Clarke, Former CFO & COO, Blue Shield of California Brett Dooies, Head of Product, Verifiable Janan Dave, VP of Operations, Verifiable Together, they explore how AI and automation are transforming credentialing from a slow, manual compliance task into a strategic capability that improves efficiency, trust, and network readiness. In this episode, you'll learn: Why credentialing sits at the intersection of compliance, provider experience, and member access How legacy processes, staffing limits, and messy data create hidden risk, and why backlogs can grow like quicksand Practical ways health plans are applying AI to reduce verification time, speed onboarding, and triage high-risk cases Why the most successful plans treat credentialing as infrastructure, not paperwork Key metrics to track when modernizing credentialing, including turnaround time, backlog clearance, audit readiness, and provider experience What to automate first,  and why humans still play a critical oversight role Bright Spots include: 97% automated verification in seconds across millions of records monthly New staffing and automation models that increase speed without compromising compliance Real-world examples where AI prevented risk exposure and accelerated network growth Leadership lessons in adopting AI responsibly and avoiding the "lift-and-shift" trap   This conversation offers payer leaders a real-world playbook to modernize credentialing and strengthen the foundation of your healthcare organization. Panelist Bios: Sandra Clarke is a healthcare executive and board advisor with over 25 years of experience leading finance, operations, and large-scale transformation across payer, provider, and life sciences organizations. As former CFO and COO of Blue Shield of California, she oversaw $25B in annual revenue and spearheaded initiatives delivering $700M in annualized savings while reimagining the company's pharmacy care model. Clarke has also held senior leadership roles at Daiichi Sankyo and Philips Healthcare and serves on multiple healthcare boards. She holds degrees from MIT, Bentley University, and Seton Hall University School of Law. Janan Dave is the VP of Operations at Verifiable, a start-up offering software and services solutions for healthcare organizations to ease the challenges surrounding provider network management. Janan has a background in public health and health policy, and has spent the last decade helping scale operations at various healthcare startups. She is passionate about building smart solutions to reduce waste in the healthcare system, and promote better care especially for the aging population, family caregivers, and women. Janan studied public health at the University of Pennsylvania, and lives in Brooklyn, NY. Brett Dooies is the Head of Product at Verifiable, where he leads the development of AI-powered solutions to simplify healthcare credentialing and monitoring. With a decade of experience building enterprise software, he specializes in applying advanced AI and analytics to enhance the customer experience and deliver transformative solutions. Drawing on his background in modernizing banking software, Brett is dedicated to creating products that drive operational excellence, uphold regulatory compliance, and improve data accuracy for Verifiable's partners, helping them scale with confidence in a complex ecosystem. Resources: MIT Sloan "Internet of AI Agents: State of AI in Business 2025" report finds that although over 80 % of organizations have piloted generative AI tools, only around 5 % have achieved meaningful business transformation—a gap dubbed the "GenAI Divide". It highlights that the primary barrier isn't model technology or regulation, but rather the failure of AI systems to integrate deeply into workflows, learn from feedback, and scale beyond the pilot stage. https://mlq.ai/media/quarterly_decks/v0.1_State_of_AI_in_Business_2025_Report.pdf Thank you to our Episode Partner, Verifiable: Verifiable is a credentialing and network monitoring platform built to help healthcare organizations optimize operations with error-free, fast verifications and to stay compliant with ease. Backed by their in-house NCQA certified credentialing team that bring a combined 60+ years of experience, Verifiable's innovation supports managing trusted networks at scale through 97% verification automation in seconds with millions processing each month. Verifiable works with leading healthcare organizations such as Humana Dental, Zelis, Talkspace, Headway, Empower Pharmacy, and many others.   Learn more about them at https://verifiable.com/ Want to go deeper or schedule a briefing with Verifiable? Email hkrish@brightspotsventures.com and we'll coordinate time with the Verifiable team to discuss how their approach can help your plan reduce costs, accelerate onboarding, and strengthen network integrity. About Bright Spots Ventures: Bright Spots Ventures is a healthcare strategy and engagement company that creates content, communities, and connections to accelerate innovation.   We help healthcare leaders discover what's working, and how to scale it. By bringing together health plan, hospital, and solution leaders, we facilitate the exchange of ideas that lead to measurable impact. Through our podcast, executive councils, private events, and go-to-market strategy work, we surface and amplify the "bright spots" in healthcare, proven innovations others can learn from and replicate. At our core, we exist to create trusted relationships that make real progress possible. Visit our website at www.brightspotsinhealthcare.com.  

Host Eric Glazer convenes senior leaders from Humana, Noom, and Blue Shield of California to explore how payers are integrating GLP-1 therapies into comprehensive cardio-metabolic care strategies. The conversation outlines how digital, behavioral, and clinical interventions can align to deliver sustainable outcomes, lower costs, and strengthen member engagement. Panelists share real-world playbooks on scaling GLP-1 programs responsibly—balancing access, affordability, and long-term adherence through consumer-centric design and data-driven clinical support.

On this episode of DGTL Voices, Ed interviews Susan Mullaney, COO of Blue Shield of California. They discuss Susan's journey in healthcare, the importance of collaboration between payers and providers, and the need for innovation in the industry. Susan shares her insights on leadership, personal growth, and the significance of empathy in healthcare. The conversation emphasizes the importance of teamwork, trust, and a shared vision for the future of healthcare.