Podcasts about horizon blue cross blue shield

Frank Melaccio, Vice President, Finance & Treasurer at Horizon Blue Cross Blue Shield of New Jersey, reveals how this mindset propelled his career from banking to executive leadership - and why it could do the same for you.Frank Melaccio is Vice President of Finance and Treasurer at Horizon Blue Cross Blue Shield of New Jersey, one of the United States' largest and oldest health insurers. With a career spanning banking, Big Four consulting, and health insurance, Frank brings a wealth of insight into strategic treasury, risk management, and the future of finance. He's also an adjunct professor at Hofstra University's Frank G. Zarb School of Business and a passionate advocate for continual learning and professional development.Frank holds an MBA in finance from Hofstra University and a BS in both finance and economics from Fordham University. He's also a Chartered Financial Analyst (CFA), Certified Public Accountant (CPA), and a Certified Financial Risk Manager (FRM).Main topics discussed:Franks career journey: from commuting into Manhattan and dreaming of Wall Street to rising through regional banks and transitioning to health insurance.Frank's move from consulting at PwC during the financial crisis to leading treasury at a health insurer.Building ORSA models and becoming Chief Risk Officer in response to regulatory changes.Franks thoughts on CTP, CFA, CPA, and FRM - how to choose the right one for your path.The importance of team building and how leadership evolves with responsibility.Leveraging AI, coding, RPA, and treasury management systems to modernize and streamline processes.How teaching derivatives and healthcare finance keeps Frank sharp and benefits his corporate leadership.The power of adaptability, planning your path, and the dangers of chasing money over opportunity.You can connect with Frank Melaccio on LinkedIn. ---

Enjoying the Podcast? Here's More to Boost Your Treasury Career!Subscribe to the Treasury Recruitment Newsletter today and get:

Alvin and German conduct a great conversation with Retired Vice Chairman of ShoreBank Corporation, Todd Brown, '71.  Todd brings a remarkable track record of success across senior leadership roles in both the corporate and nonprofit sectors. At Kraft Foods, he led three major business divisions, including the company's e-commerce, foodservice, and desserts units. He has also served on the corporate boards of Horizon Blue Cross Blue Shield of New Jersey, Diversey, Inc., and ADVO, Inc., as well as on the board of the School of the Art Institute of Chicago. A proud trustee emeritus of Colgate University, Todd began his journey in higher education as the second Director of Colgate's Cultural Center. He later earned an M.B.A. from the Wharton School and a master's degree in college administration from Columbia University. Todd holds a bachelor's degree in Sociology from Colgate.

Anita Ramsetty, MD, Director of Health Equity at Englewood Health, sits down with Steve Adubato to discuss how social determinants of health contribute to health disparities. Steve Adubato is joined by Suzanne Kunis, President and Chief Executive Officer of NovaWell and Vice President of Behavioral Health Solutions at Horizon Blue Cross Blue Shield of New … Continue reading "Anita Ramsetty, MD; Suzanne Kunis; Tai Cooper"

This episode is part of Pear VC's series on Medicaid, covering the basics that founders need to know to build innovations that support communities in need. This week, we're excited to get to know Cesar Herrera. Cesar is the co-founder and CEO of Yuvo Health, a value-based care enablement organization for FQHCs. Yuvo Health is an industry-leading healthcare organization that partners with community health centers to help them gain an advantage in value-based care, a healthcare model that prioritizes patient-provided quality and outcomes of care over the quantity of services delivered.  Founded in New York City in January 2021 by a fully BIPOC team that has experienced the power of quality care firsthand, the entire company shares a common goal of bringing fair, quality care to underserved communities. Yuvo Health empowers health centers to succeed in value-based care arrangements by qualifying for meaningful value-based care contracts and achieving success in those arrangements with a dedicated Population Health partner — and with Yuvo Health taking on the risk in doing so.  Yuvo has raised $28M to date from  AlleyCorp, Mosaic General Partners, New York Ventures, HLM Venture Partners, Route 66 Ventures, VamosVentures, AV8 Ventures, Watershed, GreyMatter, Social Innovation Fund, and others Cesar's journey in healthcare spans over two decades, beginning with strategy and policy consulting at Kurt Salmon Associates, Booz Allen Hamilton, and Booz & Company. He also worked at Horizon Blue Cross Blue Shield of New Jersey, where he spearheaded marketing and competitive strategy initiatives. He then transitioned to Head of Existing Business at Zocdoc, and then Healthify, where he served as Chief Solutions Officer, shaping his vision for Yuvo Health. Cesar holds an MBA from NYU Stern School of Business, along with an MPH in Health Policy and Management from Johns Hopkins Bloomberg School of Public Health.

Coming off a road win at Virginia Tech, Rutgers football opens Big Ten play hosting Washington Friday at SHI Stadium. The Blackout is presented by Horizon Blue Cross Blue Shield of New Jersey and is set for an 8 p.m. start on FOX.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Chris Barton, senior director of Integrated Systems of Care & Network Innovation at Horizon Blue Cross Blue Shield of New Jersey, discusses how the Youth Behavioral Health Strategy program focuses on addressing the specific needs of youth with mental health and substance use issues through a comprehensive approach

Matias interviews Lili Brillstein about how to work collaboratively with healthcare payers (the ones that reimburse for medical expenses).Lili is a pioneer in the field, having previously led one of the largest bundled payment initiatives at Horizon Blue Cross Blue Shield. She currently is the founder of her own advisory firm, BCollaborative, where she helps startups and providers develop value propositions that resonate with payers and create models that can be successfully administered. In this episode, they discuss:What payers want and their key prioritiesStrategies to communicate startup value propositions to payersThe role of interim successes for chronic conditionsHow to align payers, providers, and startupsFee-for-service vs. value-based care modelsCredits:Created by Greg Kubin and Matias SerebrinskyHost: Matias Serebrinsky & Greg KubinProduced by Jonathan A. Davis,  Nico V. Rey & Caitlin NerFind us at businesstrip.fm and psymed.venturesFollow us on Instagram and Twitter!Theme music by Dorian LoveAdditional Music: Distant Daze by Zack Frank

Rutgers football is back at SHI Stadium for the final time in 2023 to host Maryland on Saturday in a game presented by Horizon Blue Cross Blue Shield of New Jersey. Kickoff is set for 3:30 p.m. The Scarlet Knights enter 5-1 at home this season.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Healthcare leaders from Health Net, Horizon Blue Cross Blue Shield of New Jersey and Socially Determined shared successful Medicaid Redetermination strategies and best practices to help ensure your plans' most vulnerable populations do not lose essential health coverage.   With the end of the Public Health Emergency and the Medicaid continuous coverage provision in April, Redetermination could cause 18M Americans to lose health coverage, creating care gaps for the most vulnerable & widening health disparities. Our expert panel provides you with important information about navigating the disenrollment storms ahead.   Mildred Menos, Director, Medicaid Product Administration, Horizon Blue Cross and Blue Shield of New Jersey Darrel Ng, Vice President, Communications & Marketing, Health Net Trenor Williams, MD, Co-Founder & CEO, Socially Determined Bios: https://www.brightspotsinhealthcare.com/events/the-disenrollment-tsunami-how-to-fix-your-medicaid-redetermination-strategy/   This episode is sponsored by Socially Determined Socially Determined is leading the transformation of health care delivery and payment through social risk analytics and solutions. Our SocialScapeⓇ SaaS platform, data and industry-leading expertise empower health systems, plans and other risk-bearing organizations to better manage risk, improve outcomes and advance equity at scale. Recently named by Fierce Healthcare as one of the 15 most promising healthcare companies, Socially Determined is headquartered in Washington, DC. Visit: www.sociallydetermined.com

Alex is a Managing Partner at J2 Ventures. His diverse career has seen him build the enterprise venture investing arm at Horizon Blue Cross Blue Shield, serve as a Military Intelligence Officer in the U.S. Army Reserve, and contribute to national security through his work at the Defense Innovation Unit and AFWERX. As a reservist he managed the DIU's investment efforts in deep tech through its early-stage funding vehicle, National Security Innovation Capital. Alex has a B.A. from Columbia University and an MBA from Harvard Business School.

About Suzanne Kunis:Suzanne Kunis is the Founder, President, and Chief Executive Officer of NovaWell, an affiliate of Horizon Healthcare Services, Inc. She also serves as Vice President of Behavioral Health Solutions for Horizon Blue Cross Blue Shield of New Jersey. She brings over 30 years of experience in the healthcare industry with a significant focus on behavioral health. Suzanne is a registered nurse and moved from care delivery to healthcare management early in her career.   Suzanne is a nationally recognized industry expert and leads NovaWell, an organization born out of her success at Horizon. She was recruited to Horizon in March 2017 to develop and lead Horizon's first-ever internal Behavioral Health strategy and team. Suzanne is responsible for all behavioral health strategic development and execution including the organization's commitment to the integration of physical and behavioral health. Suzanne led the successful insourcing of behavioral health and a cultural and philosophical shift and commitment to integration within Horizon. NovaWell will be helping other health plans to achieve similar results.  Suzanne is the ultimate behavioral health champion – the opioid crisis and continued battle to eliminate mental health stigma are priority items on her agenda and she works tirelessly to drive the message that “mental health is health” nationwide.    Before joining Horizon BCBSNJ, Suzanne served for 22 years as Senior Vice President of Behavioral Health Services for Magellan Health Services. She was the business owner for Magellan's health plan (Commercial, Medicare, and Medicaid) and employer-client relationships. She was responsible for oversight and management of nationwide service delivery including member services, clinical operations, network development and management, quality, sales, EAP, and finance. During her tenure with Magellan, Suzanne developed a deep understanding of the behavioral health care issues facing our country and the long overdue recognition of the impact of behavioral health issues on comorbid medical conditions.   Suzanne also served as Senior Vice President of Account Management and Implementations for ComplexCare Solutions (CCS). CCS provided in-home risk adjustment assessments and care management services for its health plan clients. After graduating from Thomas Jefferson University, College of Allied Health Sciences in Philadelphia, Suzanne began her nursing career at the East Orange Veterans Administration Hospital. She then began a 12-year career journey with which was then Blue Cross Blue Shield of New Jersey where she served many roles including Vice President of the Individual Market segment. Things You'll Learn:NovaWell and Horizon's alliance seeks solutions to help people access behavioral healthcare when, where, and how they need it.Behavioral health can impact more than 20% of the total medical cost, which is why treatments should also include a behavioral health perspective.Horizon developed a platform with tools available like educational research, podcasts, a provider directory, and assessments, among others.Horizon established a program centered around identifying patients that need different care options. This program works with a community mental health provider that can refer them to get them the care they need.Between 40 and 50% of adults have a diagnosable mood disorder.67% of people needing mental health care don't seek it out because of stigma.Stigma has historically prevented patients from accessing care. It doesn't matter the condition a patient comes in with, we need to view it through a behavioral health lens.  Resources:Connect with and follow Suzanne Kunis on LinkedIn.Follow NovaWell on LinkedIn.Follow Horizon Blue Cross Blue Shield of New Jersey on LinkedIn.Discover the NovaWell Website!Visit the Horizon Blue Cross Blue Shield of New Jersey Website!

On this episode of “Inside Health Care,” we hear from Tracy Parris-Benjamin, Director for Community Health and Health Equity at Horizon Blue Cross Blue Shield of New Jersey, about its 2022 NCQA Innovation Award-winning program “Neighbors in Health.”“Neighbors in Health” is a statewide Community Health Workers program delivered through a collaboration of payers, hospital systems and community-based organizations. Community Health Workers, in consultation with a Personal Health Assistant, support members while empowering them to take greater control of their health. The program also provides education and training to Community Health Workers, helping them earn certification and training in a number of necessary health care-related skills.Later in the show, we observe February's National Children's Dental Health Month. I include tips on oral care for children from the American Academy of Pediatrics, as well as from the American Dental Association and its Mouth Healthy family-oriented website. I also mention NCQA's Annual Dental Visit [ADV] HEDIS measure.

As we turn the page from 2022, health plans are facing new challenges impacting member experience, retention, and, most importantly, their member's health. This panel will offer insights on the priorities to focus on as we enter 2023. Topics include: the new reality health plans and members will face once the PHE ends and how getting ahead will avoid significant membership losses; CMS' increased weight on CAHPS surveys will lead to more focus on member satisfaction; New Social Need Screening and Intervention (SNS-E) requirement means that plans will need to get more serious about members' social needs by 2025 Panel: Mikal Sutton, Managing Director, Medicaid Policy, Blue Cross Blue Shield Association; Mildred Menos, Director of Member Advocacy and Community Outreach Transformation, Horizon Blue Cross Blue Shield of New Jersey; Steve Wigginton, CEO, Icario Link to bios: https://www.sharedpurposeconnect.com/events/2023-strategy-session-member-redetermination-cahps-and-social-needs/ This Bright Spots in Healthcare episode is sponsored by Icario Icario is a health action platform that unites pioneering technology, data science, and behavioral insights to connect everyone to better health. Icario develops personalized healthcare experiences that move people to better health with every action while reducing member abrasion through extrinsic and intrinsic motivations. Learn more at icariohealth.com.

Dr. Mitchell Fogel, Senior Medical Director of Provider Transformation and National Accounts at Horizon Blue Cross Blue Shield of New Jersey, joined the podcast to talk about the pilot programs his organization has with health systems to improve access to care and the patient experience.

Lisa White, Director of Value-based Partner Transformation for Horizon Blue Cross Blue Shield of New Jersey, joined the podcast to talk about cultivating the relationship between payers and providers for the future of value-based care.

Comprehensive Digital Strategy for Healthcare in a Hybrid Care World Join the HealthIMPACT Community today to get access to every session and join us July 14th-16th for the 2nd Annual Virtual HealthIMPACT Live Summer Forum. https://www.healthimpactsummer.com +150 Expert Perspectives +100 Sessions +75 Hours of Content +30 Partner Booths +25 Solution Sessions +15 Keynotes HealthIMPACT Live Spring Forum May 19th - 21st, 2021 by Purpose EventsCOVID-19 has forced us to question what's possible in healthcare delivery and to challenge our thinking. Our expectations of what we want and expect from contact with the health system, what a “safe” distance, procedure, or interaction looks like, and how satisfied each participant is with an increasingly digital experience of healthcare are wildly different than they were a few months ago. True transformation is always a result not just of the availability of new technologies, but also of the willingness of patients, providers, and health systems to adopt it, and insurers to pay for it. This sea change of expectations has the potential to be the most transformative aspect of our new world. However, both traditional and virtual healthcare come with a bunch of, for lack of better words, stupid stuff that slows down providers, costs money, and hampers the patient experience. Forward-thinking health systems have the opportunity to create and implement a new, hybrid strategy, keeping and strengthening the best parts of telehealth expansion, a virtual workforce, and increased remote care while bringing back the most valuable and effective elements from traditional, in-person care. This will require a critical look at new and existing technologies, an honest evaluation of the merits of new and legacy processes, and a willingness to think outside the box and if needed, build a new one. This discussion will focus on building an effective digital care strategy to meet the new challenges of 2021. • Viewpoints on the changing Business model • Shift to virtual care, what to expect • Impact on organizational strategy • Proactive measures to thrive in the post-COVID business environment • How are technology budgets allocated, and is the way things have always been the way they should be going forward?   Sara Vaezy, Chief Digital Strategy & Business Development Officer, Providence St. Joseph HealthDivya Paliwal, MD, Chief Clinical Transformation Officer, Horizon Blue Cross Blue Shield of NJLee Schwamm, MD, VP of Virtual Care, Mass General BrighamShahid Shah, Chairperson, HealthIMPACT Forum, Publisher, Netspective Media (Moderator)

Dr. Mitchell Fogel, Senior Medical Director of Provider Transformation and National Accounts at Horizon Blue Cross Blue Shield of New Jersey, joined the podcast to talk about the pilot programs his organization has with health systems to improve access to care and the patient experience.For more episodes like this, tune in to Becker's payer Issues Podcast.

Dr. Mitchell Fogel, Senior Medical Director of Provider Transformation and National Accounts at Horizon Blue Cross Blue Shield of New Jersey, joined the podcast to talk about the pilot programs his organization has with health systems to improve access to care and the patient experience.

Vijay Venkatesan, VP and Chief Analytics Officer at Horizon Blue Cross Blue Shield of New Jersey, joined the podcast to talk about automation, healthcare data and the workforce of the future.

October is Breast Cancer Awareness Month Special Guest: Natasha Coleman, MPH is the Senior Director of Cancer Control Strategic Partnerships for the American Cancer Society, Inc. Northeast Region. Natasha provides strategic direction to a team of cancer control managers who oversee a portfolio of integrated health systems, primary care networks and state health system partnerships.  The team is responsible for the implementation of evidence-based strategies to address the cancer burden and advance cancer control priorities. Natasha joined the American Cancer Society in 2001 and held previous roles as the health educator for Horizon Blue Cross Blue Shield of NJ.  She received her graduate degree from Rutgers University, School of Public Health and her undergraduate degree from Rutgers University in biological sciences.  

On this episode, Marisol is joined by two representatives for Horizon Blue Cross Blue Shield of New Jersey. They join her as they discuss the importance of having health insurance in the United States and also the affordability, prerequisites, and ultimately understanding, the health insurance is available to everyone.To hear more information or reach out to our guest directly, they can be contacted at www.horizonblue.com/connect where you can set up a call, in person meeting, or a zoom call.Mention the podcast for a free $25 gift card.-----------------------------------------------------------------------------------------------------------------------En este episodio, Marisol se une con dos representantes de Horizon Blue Cross Blue Shield de Nueva Jersey. Se unen a ella para discutir la importancia de tener un seguro médico en los Estados Unidos y también la asequibilidad, los requisitos necesario y, en última instancia, la comprensión de que el seguro médico está disponible para todos.Para escuchar más información o comunicarse con nuestro invitado directamente, puede comunicarse con ellos en www.horizonblue.com/connect, donde puede programar una llamada, una reunión en persona o una llamada de zoom. Mencione el podcast para obtener una tarjeta de regalo de $25 gratis.

You can hardly swing a cat these days and not hit somebody talking about the Cybersecurity Maturity Model Certification program. The Defense Department's strategy for buttoning up the Defense industrial base. My next guest says the CMMC approach is good in theory, but lacks anywhere near the resources to get it done. He's not only director of information security at Horizon Blue Cross Blue Shield of New Jersey, but also a founding member of the CMMC Accreditation Body, Chris Golden joined the Federal Drive to discuss.

Lisa White, Director of Value-based Transformation at Horizon Blue Cross Blue Shield of New Jersey, joined the podcast to talk about how payers are working collaboratively with health systems today, the transition to value-based care and technology simplifying healthcare delivery. This episode is sponsored by Ontrak.

This panel discussion covers essential ground for any institution that is trying to make real and lasting change. What do we need to know? What do our patients need to know? Who is responsible for questions of safety? How important are checklists? What about "patient advocates"? Presented by Sol Aronson with Mike Ramsey, Chair of the department of Anesthesia and pain management at the Baylor University Medical Center in Dallas and Board Chair of the Patient Safety Movement Foundation, Lee Fleisher, CMO and director for the Center for Clinical Standards and Quality for the centers of Medicare and Medicaid, Sarah Lenz Lock, Senior Vice President for Policy Research and International Affairs for the AARP, Lili Brillstein, Director of Specialty Care Value Based Models for Horizon Blue Cross Blue Shield of New Jersey and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London.

This week, Dr. Fred Rosenberg talks with Lili Brillstein, CEO of BCollaborative, a consultancy that helps payers, providers, pharmaceutical companies, start-ups and other stakeholders progress the movement from fee for service to patient-focused, value-based care models. As the director for episodes of care with Horizon Blue Cross Blue Shield of New Jersey, Lili provided strategic direction and leadership for Horizon's internationally recognized Episodes of Care program. Join Dr. Rosenberg and Lili as they discuss her experience working collaboratively with GI practices in New Jersey and what the future holds for value-based care models in specialty medicine. Produced by Andrew Sousa and Hayden Margolis for Steadfast Collaborative, LLC Original score by Hayden Margolis Gastro Broadcast, Episode 20

This panel discussion covers essential ground for any institution that is trying to make real and lasting change. What do we need to know? What do our patients need to know? Who is responsible for questions of safety? How important are checklists? What about "patient advocates"? This piece was generously supported by Massimo.com it follows on from this piece here: https://www.topmedtalk.com/ebpom-chicago-patient-safety-how-do-you-make-the-changes-that-change-culture/ Presented by Sol Aronson with Mike Ramsey, Chair of the department of Anesthesia and pain management at the Baylor University Medical Center in Dallas and Board Chair of the Patient Safety Movement Foundation, Lee Fleisher, CMO and director for the Center for Clinical Standards and Quality for the centers of Medicare and Medicaid, Sarah Lenz Lock, Senior Vice President for Policy Research and International Affairs for the AARP, Lili Brillstein, Director of Specialty Care Value Based Models for Horizon Blue Cross Blue Shield of New Jersey and Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London.

Learn more at www.tlptraining.com April L. Everett is an in-demand public presenter on career success and black women and girl's issues. She has been involved with organizations helping girls and women in need throughout the Philadelphia region for more than 15 years. With over 20 years of experience in corporate America, April's rise to professional success has been nothing short of amazing, given the many obstacles she has had to overcome. Her path has been both educational and rewarding. She has been a manager in the healthcare industry for several years having worked for such companies as Cyberonics, Siemens, Independence Blue Cross and Horizon Blue Cross Blue Shield of New Jersey. Preparing other young women for success, by sharing information and her lessons learned, is April's way of giving back. She hopes to build a "Village" that is proud of its youth. April believes in the abilities of our girls and accepts the charge to see them overcome all challenges as they exceed all expectations. April's passion is to help young girls and women realize their visions and the manifestation of those visions. She currently holds a Bachelor of Business Administration degree from Temple University, a Masters of Business Administration from Liberty University and a Masters of Jurisprudence from Widener University School of Law. She is the proud owner of Sassy N Classy Closet, an online boutique with a focus on the EVERYDAY WOMAN. She also is the owner of A L Everett Solutions, a business consulting firm dedicated to thrusting entrepreneurs into their destiny. Learn more at: https://sassynclassycloset.com/collections Email: April.L.Everett@outlook.com --- Send in a voice message: https://anchor.fm/tlpedu/message Support this podcast: https://anchor.fm/tlpedu/support

Susan Haspel, State Director of the Boys and Girls Clubs in New Jersey, joins Lisa Anderson to discuss the critical need of providing food at a time when families are in need and clubs are closed.  This past week, the clubs were able to open their Summer camp programs with twenty-five percent capacity. The in person activities have mostly been replaced with virtual learning programs such as culinary instruction, college readiness programs, and support for children and their families by trained staff and volunteers.  Susan also discussed how a 50,000 grant from Horizon Blue Cross/Blue Shield has enabled the Clubs to provide much needed supplies, food and program support to families in need. For more information or to become a volunteer, please visit bgcnj.org. See omnystudio.com/policies/listener for privacy information.

Susan Haspel, State Director of the Boys and Girls Clubs in New Jersey, joins Lisa Anderson to discuss the critical need of providing food at a time when families are in need and clubs are closed.  This past week, the clubs were able to open their Summer camp programs with twenty-five percent capacity. The in person activities have mostly been replaced with virtual learning programs such as culinary instruction, college readiness programs, and support for children and their families by trained staff and volunteers.  Susan also discussed how a 50,000 grant from Horizon Blue Cross/Blue Shield has enabled the Clubs to provide much needed supplies, food and program support to families in need. For more information or to become a volunteer, please visit bgcnj.org. See omnystudio.com/listener for privacy information.

Healthcare has historically lagged behind other industries in the adoption of emerging cybersecurity protections. Innovative blockchain technology has the potential to shift that trend as more healthcare entities have started to explore a variety of use cases for applying blockchain technology. Does blockchain have a future in healthcare or are we caught up in another hype cycle for emerging cyber technologies? In this podcast, industry thought leader Chris Golden helps us take a closer look at blockchain and its potential applications in healthcare. Chris is the Director of Information Security for Horizon Blue Cross Blue Shield of New Jersey and shares his insights on blockchain, enterprise risk management, and governance risk and compliance approaches. Topics discussed include: Defining blockchain and an overview of its capabilities both within and outside healthcare Use cases for blockchain in healthcare including back office, financial systems, patient identification, and more Adoption timeline for blockchain in healthcare What could go wrong? Downsides and potential pitfalls for blockchain and managing PHI/PII on the ledger Enterprise risk management approaches including quantitative vs qualitative risk data Governance risk and compliance tools, processes, and automation best practices

Today on the podcast I had the pleasure of speaking with Frank Melaccio. Frank is the Treasurer at Horizon Blue Cross Blue Shield of New Jersey. It was interesting speaking with Frank and learning about the difficulties within the health and hospital sector.   On the episode: I asked Frank how he became to be in the treasury department. Frank talks about his career and the transition from banking into treasury. We talk about the challenges that Frank faces in his current role and how it differs to previous roles he has been in.  We talk about the healthcare systems in place and how it effects the treasury department of the businesses. Frank talks through technology within the healthcare system and how it shapes the way patients pay and the insurance companies work with it. I ask Frank what the biggest achievements in his career have been. I ask Frank what advise he would give to those who are starting their careers in the treasury department. Frank tells me what he thinks makes a successful treasurer in the eyes of the CFO. I ask Frank how he sees technology in the treasury department and how it will effect it in the future. I ask Frank what he looks for in a potential employee. We talk about diversity within the treasury industry and how it is becoming more positive.  I ask Frank about mentors throughout his career and if they have helped him. We talk about networking and how Frank has used it within his career.

Hear CIOs from JPMorgan Chase, Siemens and Horizon Blue Cross Blue Shield of New Jersey discuss how technology leadership is changing. Each issue of Workflow Quarterly publishes new research on workflow digitization. The latest installment offers insights into what it means to be a best-in-class CIO today. Read the full issue at https://workflow.servicenow.com/quarterly for expert tips, a CIO leadership maturity model and more.

Guest 1: Vijay Venkatesan Title: Chief Analytics Officer, Horizon Blue Cross Blue Shield of New Jersey You want to use AI and sophisticated analytics to enable business outcome. Is your workforce data literate? Do you have a refined, automated, and process-oriented methodology for your data management and analytics needs? How can you enable your organization to exploit digital opportunities through Data Literacy and DataOps?

Asha Saxena discusses the importance of data in the rapidly changing healthcare industry with guest Vijay Venkatesan, Chief Analytics Officer of Horizon Blue Cross Blue Shield of New Jersey. In this episode, Vijay Venkatesan discusses how consumer expectation of healthcare is shifting, why the relationship between providers, patients and payers needs to evolve, and how advances in technology have the potential to reshape healthcare to the benefit of everyone involved. New technologies in computer science and data analytics can be powerful tools, but only if they are used to answer the right questions. What you’ll learn in this episode: How Vijay’s career journey has taught him lessons about the use of data and its application in healthcare How the healthcare industry is using data to adapt to today’s market and legal realities The challenges and opportunities of collecting and sharing data within the healthcare industry How new technologies such as AI and deep learning have the potential to change the way data can be gathered and utilized Why data technology needs to be used in the service of benefiting patients Which potential applications for decision automation present the greatest opportunities within the healthcare industry Steps you can take to best understand the role of data analytics in your own business Why the difficulty of predicting human behavior is the most challenging problem data analytics must solve Which changes and opportunities in healthcare data Vijay believes will take place in the next decade Why “listening to understand” is the key to solving problems and making an impact within your organization Ways to contact Vijay: LinkedIn: www.linkedin.com/in/vijaybvenkatesan

In this episode, host Maryfran Johnson talks with Douglas Blackwell, senior vice president and CIO at Horizon Blue Cross Blue Shield of New Jersey, about digital transformation in the healthcare industry, including voice enablement and cutting-edge digital tools.

This interview is part of our HIMSS18 coverage and was recorded live in the exhibit hall. On this episode we talk with Stuart Goldberg, MD, Chief Scientific Officer at Cota. Dr. Goldberg tells us all about Cota's physician-led journey to organize and classify real-world evidence about every type of cancer. This effort led to something they call the Cota Nodal Address (CNA), and it's enabling health systems to get very specific about the types of patients they're treating, the costs associated with them, and the outcomes being achieved. This apples-to-apples comparison allows Cota to identify variation and address it in ways that are beneficial to the provider, payer and patient. It enables a concept Dr. Goldberg calls "Precision Payment", which in turn enables proper bundled payment design, and precision medicine.  And Cota is not only physician led, but the payers are on board too. Literally. Horizon Blue Cross Blue Shield lead their Series A funding round. Plus, they just closed a $40 Million Series C funding round in February. Cota is clearly a company to watch. This was one of the most intriguing conversations I had at HIMSS '18 and one that I'll be exploring some more. I'm very excited to share it with you... ~ Don Lee About Cota Cota is a healthcare data and analytics company that enables providers, payers and life science companies involved in diagnosing and treating complex diseases to optimize the outcomes of individual patients and lower the overall cost of the patient population served. It is powered by the patented Cota Nodal Address™ (CNA) system, a unique digital classification methodology built by leading physicians and data scientists. The CNA is the first and only system that precisely categorizes patient factors, their diseases and intended therapies, enabling precision medicine at scale. Cota's technology enriches medical records to create research-grade data and joins it with a suite of analysis, visualization and management tools. This enables providers, payers and life science companies to analyze, report on and research outcomes, costs, treatments and quality at any granularity and stage of the patient journey. The result is a constantly improving system that merges technology and medicine to improve the lives of patients everywhere. For more information, go to www.cotahealthcare.com  About Stuart Goldberg, MD Stuart Goldberg, MD is Chief Scientific Officer at Cota, Inc. and Associate Clinical Professor of Medicine at Rutgers: The New Jersey Medical School. He also maintains an active clinical practice in the Division of Leukemia at the John Theurer Cancer Center. Dr. Goldberg obtained his medical degree at the Milton Hershey Medical Center of Pennsylvania State University. After completing internal medical residency and hematology-oncology fellowships at George Washington University Medical Center, he served as a BMT fellow at the Mayo Clinic and Associate Director of the BMT Program at Temple University. Dr. Goldberg's clinical research has focused on new treatment strategies for patients with chronic myelogenous leukemia and myelodysplastic syndromes. Recognizing the wealth of information contained in electronic health record data, he and his partners at JTCC founded Cota, a data and analytics company that seeks to optimize patient outcomes while reducing population healthcare costs. In the field of “big data” analysis he has used databases to redefine the incidence and complications related with myelodysplastic syndromes (published in JCO and Transfusion) and has reviewed observational databases (including SIMPLICITY) to foster adherence with evidence based CML monitoring guidelines (published in JOP, CRMO and CLML). Most recently he has used the Cota database to explore rates and implications of EGFR mutational testing among community oncologists (published in Clin Lung), patterns of care in T-cell lymphoma (published in CLML), end-of-life care decisions (published in Palliative Med) and cost-effectiveness of genomic profiling in lower risk breast cancer (published in AJMC). This research earned him the 2015 David King Clinical Scientist Award from the Association of Community Cancer Centers (ACCC). He is listed as a Castle Connolly Top Doctor for Medical Oncology in the NY Metro and NJ areas. You can find the rest of our HIMSS '18 Interviews here. Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter. You'll get one email from me each week detailing: New podcast episodes and blog posts. Content or ideas that I've found valuable in the past week. Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else.   Plain text and straight from the heart :) No SPAM or fancy graphics and you can unsubscribe with a single click anytime. The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media. Music by StudioEtar

March 1, 2018 Showers with high temperatures in the upper 50s. Storms moving in later. CONDITIONS CALLED ‘INHUMANE’ AT IMMIGRANT DETENTION CENTERS A human rights organization says immigrants being held at three detention centers in New Jersey are subjected to “harsh and inhumane” conditions, The Record writes. A report released this week by Human Rights First says detainees are served raw and spoiled food, given dirty drinking water and provided insufficient clothing and hygiene products. "Legal professionals who participated in the tours were surprised to note that the conditions of detention were poor or worse than those they had previously observed in criminal correctional facilities,'' the report says. LEGISLATIVE COMMITTEE ADVANCES 6 GUN-CONTROL MEASURES The Assembly Judiciary Committee approved six bills that would tighten New Jersey’s gun-control laws, which are already among the strictest in the country, The Record reports. One of the measures, known as a “red flag” law, would allow police to temporarily take guns from people who are ruled by a judge as a threat. Other legislation would impose a 10-round limit on the capacity of gun magazines, expand background checks to include private gun sales and ban bullets capable of penetrating body armor. HEALTH INSURER TO USE PART OF TAX WINDFALL FOR POLICYHOLDERS The largest health insurer in the state says it will use at least $275 million of its federal tax refund to benefit policyholders, NJ Spotlight says. Horizon Blue Cross Blue Shield of New Jersey provide rebates or discounts to its 3.8 million members. It will also focus on improving mental health services, increasing access to substance abuse treatment, and expanding primary care. The money comes from the Trump administration’s tax overhaul, which changed the process used by some corporation to file income tax. EMAIL THREAT CLOSES TWO SCHOOL DISTRICTS Two Gloucester County school districts are closed today after a threatening email message was received by a staff member overnight, NJ.com reports. The Franklin Township and Delsea Regional school districts have been in close contact with each other and the police since the threat was received, authorities said. The threat was directed at a Franklin Township district employee but the Delsea district also closed because its facilities are in close proximity to Franklin Township’s. In a statement posted on Facebook, the Franklin Township Police Department said, "We are working diligently to identify the sender of that email at this time." NOR'EASTER EXPECTED TO BRING HEAVY RAIN, HIGH WINDS It looks like March is coming in like a lion. High wind and flood watches have been issued for most of the state as weather forecasts are indicating a nor'easter is approaching, News 12 says. Rain is expected to move in Thursday evening with urban and coastal flooding possible early Friday through Saturday. In addition, a winter storm watch has been issued for Sussex and western Passaic counties with the possibility of 2 to 6 inches of snow.

Healthcare organizations are rapidly adopting container technology to drive innovation.  In this session, join Horizon Blue Cross Blue Shield of New Jersey and ClearDATA to learn about how to integrate Amazon ECS into your deployment pipeline while maintaining compliance for healthcare workloads, how to harden container environments for sensitive workloads, and how to leverage AWS tooling and microservices to provide new views and analysis for data stored in on-premises data centers.

When a patient or couple is considering using assisted reproduction technologies (ART) to have a baby, there are many things to consider. In addition to the physical, mental and emotional tolls that infertility treatment can cause, there is the financial aspect to consider. Insurance coverage may be limited or non-existent and in vitro fertilization (IVF), and other fertility treatments can be costly. The Reproductive Science Center of New Jersey accepts most major insurances including Horizon Blue Cross Blue Shield of New Jersey.Listen in as William Ziegler, DO explains your insurance options at The Reproductive Science Center of New Jersey.

While it does not immediately eliminate fee for service, a retrospective upside-only payment model is helping to transform the spirit of the payor-provider relationship, notes Lili Brillstein, director of the Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ) Episodes of Care (EOC) initiative where this methodology has been implemented. Listen as Ms. Brillstein describes how Horizon’s application of retrospective methodology across all episodes expands the program’s reach and opportunities while fostering a no-risk environment conducive to collaboration.

Although the healthcare industry is well-acquainted with the patient-centered medical home, the model is still quite new and novel to patients, notes, Jay Driggers, director of consumer engagement at Horizon Blue Cross Blue Shield of New Jersey. In this interview, Driggers describes what's at stake when moving from a reactive provider model to a proactive model. Driggers will present during "Patient Engagement in the Patient-Centered Medical Home: A Continuum Approach," a 45-minute webinar on August 22, 2012, during which he will describes some of Horizon BCBS's novel consumer engagement tactics that involve everything from smartphone apps to telemonitoring.