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Speaker ProfilesMilliman Care GuidelinesJim Schibanoff, MD Breakout Session: Monday 2:30 PM | Tuesday 1:30 PM Dr. Schibanoff is Editor-in-Chief for Milliman Care Guidelines. His principal role is guideline development and documentation. He is also co-author of the Inpatient and Surgical Care, Home Care, and Recovery Facility Care products. His primary responsibilities include supervision of the editorial and peer review process of the Milliman Care Guidelines, analysis of the Care Guidelines evidence base, appointment and coordination of expert clinician panels, planning new guidelines and revision to existing guidelines. He also represents the Milliman Care Guidelines to consumer/patient groups, regulatory bodies and medical specialty societies and responds to clinical inquiries about the Care Guidelines from users. Dr. Schibanoff is board-certified in Internal Medicine and Pulmonary Medicine. He served as Chief Medical Officer of a San Diego healthcare system and led the implementation of total quality management as the most enduring method to simultaneously lower costs and improve quality. Dr. Schibanoff served for three years as Chief Executive Officer of two San Diego hospitals with a combined budget of $250 million. He was instrumental in system integration and in promoting physician participation in hospital governance. Dr. Schibanoff graduated from Princeton University and the University of Southern California School of Medicine. His postgraduate training was at the University of California, San Diego, including Chief Medical Residency and Fellowship in Pulmonary Diseases. John Agogliati Breakout Session: Monday 9:00 AM Mr. Agogliati became Chief Operating Officer of Milliman Care Guidelines in April 2001. He has over 30 years experience developing, implementing and managing Information Technology business based solutions. Mr. Agogliati’s experience base includes work with Fortune 100 corporations as well as smaller entrepreneurial firms. He has held management positions with CIGNA HealthCare, United HealthCare and The Travelers. His background includes an extensive array of information systems and technology management, development and production responsibilities including:
Mr. Agogliati has a Master of Science (Computer Science) from Rensselaer Polytechnic Institute and a Bachelor of Science (Mathematics) from Central Connecticut State University. Mr. Agogliati joined Milliman Care Guidelines in July 2000 as the Chief Technology Officer. He can be contacted via email at john@careguidelines.com. Sherrie Dulworth, BSN, CPHRM Breakout Session: Monday 9:00 AM Ms. Dulworth is a Principal and Vice President of Strategic Planning and Development for Milliman Care Guidelines. Her responsibilities include oversight of the domestic and international strategy and public affairs for Milliman Care Guidelines. Before joining Milliman Care Guidelines, Ms. Dulworth was a Health Care Management Consultant in the New York Milliman Health practice for eight years where she worked with healthcare payors and providers to develop effective medical management, operations, and marketing strategies. While at Milliman, Ms. Dulworth has published research on patient safety, quality, the economic impact of healthcare-associated infections, Hepatitis C, HIV and clinical best practices. Ms. Dulworth has over 20 years of experience in the managed care market. Prior to joining Milliman, she worked with Fortune 500 employers, insurance carriers, governmental bodies, and self-insured organizations on a national and international basis to help assess and implement cost containment strategies for group health and workers’ compensation. Ms. Dulworth is a registered nurse with experience in a majority of areas in critical care as well as cardiac and spinal cord rehabilitation. Ms. Dulworth is a Certified Professional in Healthcare Risk Management (CPHRM.) She previously served as a visiting professor at the Columbia University School of Nursing. She has published in the area of international healthcare and managed care and is a frequent guest lecturer on various topics of insurance, healthcare quality and managed care. Vikki Choate, RN, CCM, RN-BC, CCP Breakout Session: Tuesday 2:50 PM Vikki has over 25 years of nursing and social work experience in a diverse variety of clinical settings including inpatient, home health and hospice, geropsych recovery facility and mental health/substance abuse. She also has extensive managed care and health plan leadership experience including oversight of referral authorizations, pre-certification, medical necessity review, disease management, inpatient and ambulatory case management, catastrophic case management, and appeals. As a result of a unique risk share arrangement, she developed and implemented an Inpatient Case Management program in collaboration with targeted facilities, placing plan-employed Case Managers onsite performing utilization review and discharge planning. Vikki is a Certified Case Manager dedicating her managed care career to the growth, development, and visibility of the case manager role. As a result of her particular interest in how data can inform the Case Management process, she received "Best in Practice" recognition from URAC for her innovative Case Management programs. She is currently pursuing a Master’s Degree in Case Management. Lynn Nemiccolo, RN Breakout Session: Monday 3:30 PM Lynn Nemiccolo is Business Product Development Director at Milliman Care Guidelines, LLC. Prior to joining Milliman Care Guidelines, Lynn was the Director of Clinical Applications at a hospital during its move to a full EMR system. She has spent the last 12 years focused on providing clinicians with workflow and clinical decision-making software tools. She has been a Director of Product Management for products supporting managed care workflow, as well as working as a certified case manager. Her clinical background was in critical care nursing. John Ninomiya, PhD, MSc, FSA, MAAA Workshop: Wednesday 10:45 AM John is Director of Epidemiology and Health Services Research for the Milliman Care Guidelines LLC, a division of Milliman, out of the San Diego office. He is responsible for data analysis in support of clinical guideline development and healthcare utilization and modeling. He joined the firm in 1998. Prior to joining Milliman, John worked for 10 years at a well-known, publicly traded managed care company, the last five as corporate vice president for health data analysis. John was responsible for actuarial services, as well as data analysis in support of utilization management, quality assurance, and provider contracting. His projects included implementation of HEDIS®, reporting and sponsorship of the data warehouse project. He was also involved in strategic planning for the health services area. Robert (Bob) Conrad, RN Breakout Session: Tuesday 2:50 PM Bob has over 30 years of nursing and managed care experience. Bob’s clinical experience is primarily ED. Bob worked for a major Midwest insurer for 12 years and held a number of positions including Senior Coordinator for Quality Improvement for the Managed Care Division. Prior to joining Milliman Bob worked for another company involved with healthcare quality. His responsibilities included assisting clients with HEDIS® reporting as well as developing custom quality initiatives and reports. Marlese Pinney, RN, MBA Workshop: Wednesday 10:45 AM Marlese is an editor for the Milliman Care Guidelines in the San Diego office. She joined the firm in 1990 and was elected principal in 1996. She has actively worked with the Care Guidelines since 1990. Marlese has been involved in healthcare since 1970, both in clinical care and in medical management. She has extensive experience designing and implementing integrated patient care management systems for both payors and providers. At Milliman, Marlese was a healthcare consultant prior to rejoining the Care Guidelines in 2003. Helen Blumen, MD, MBA Breakout Session: Monday 2:30 PM Helen is editor for Milliman Care Guidelines® Ambulatory Care and Chronic Care Guidelines. Her responsibilities include management of the development of new guidelines and the revision of existing guidelines based on published evidence. Helen has over 20 years of clinical and medical management experience. She practiced internal medicine in Santa Monica, California, and served as Chief of Medicine at Saint John Hospital and Health Center. She has worked on clinical development and implementation of software embedding complex clinical guidelines and has extensive hands-on experience training and supervising physician reviewers and medical directors in guideline implementation. She has worked in a number of different regional and national managed care settings as medical director, with full responsibility for utilization management, case management, disease management, and quality improvement programs. Dorothy Correa, RN, CS, FNP, MSN Workshop: Wednesday 10:45 AM Dorothy is Editor for Recovery Facility Care and Home Care. Her responsibilities include management of the development of new guidelines and the revision of existing guidelines based on published evidence. Dorothy has over 15 years of clinical and advanced practice nursing experience in emergency department, hospital, ICU, and primary care clinic settings. She practiced primary care in Sacramento, California and has experience in a variety of clinic settings that served commercially insured, uniformly government insured (Medicaid), and uniformly uninsured (safety net clinic) populations. She has extensive experience as a nurse research coordinator of clinical research projects in a hospital setting. She has done work on original research projects regarding nursing care practices and is a published author in the peer reviewed medical literature. She has prior experience as a reviewer of guidelines on patient triage and telephonic advice. Her past work with the Care Guidelines includes the translation of a compendium of guidelines into a lay-language patient education document format. Debbie Jepson, RN, CCP Workshop: Wednesday 10:45 AM Debbie has over 20 years experience in the healthcare Profession. Prior to joining Milliman Care Guidelines, Debbie held clinical training and management positions in the acute care setting and in the integrated health management field. Debbie directed the internal training development and delivery for 400 clinical employees in the areas of Demand, Disease, Case and Utilization Management. Her instructional design skills supported the creation of curriculum that consistently focused on the needs of the adult learner, and addressed clinical, technological and delivery process learning requirements. Julie Arotin, RN, MS, CCP Workshop: Wednesday 10:45 AM Julie has 20 years of clinical nursing and management experience in a variety of settings, including inpatient, long-term care, private practice, military medicine and utilization review. Before joining Milliman Care Guidelines, Julie used her clinical knowledge and expertise to provide consulting and client education services for clinical software applications. She also helped clients develop policies and procedures to apply clinical software to questions of case management, risk management, quality/performance improvement and infection control. Sandy Tuzzolo, RN, CCM, CCP Workshop: Wednesday 10:45 AM Sandy has over 20 years experience in a variety of healthcare settings, which includes a combination of clinical and management positions. Prior to joining Milliman, Sandy held leadership and clinical positions in the acute short- and long-term care setting, disease management field, and in managed care organizations. Sandy has developed and led case management programs in the insurance industry and the long-term acute care setting. She has been responsible for developing patient education, including curricula and educational materials development. In addition to developing and implementing educational programs for patients and health care professionals, Sandy has directed the activities of health plans and hospital services in preparation for external accreditation by both JCAHO and NCQA. Carol Johnson, RN, CCM, CCP, CTT+ Workshop: Wednesday 10:45 AM Carol has more than 25 years of experience in inpatient medical surgical nursing and management in clinical settings, including as a medical practice manager for multi-physician specialists. As business administrator for home health and hospice, she had direct oversight of pre-certification, case management and contract negotiations. She is a Certified Case Manager with extensive managed care and health plan leadership experience, including inpatient and ambulatory case-management programs, disease management, catastrophic case management, and specialty case-management programs including high-risk maternity, transplant, NNICU and oncology. Her managed-care career experience includes work as case manager specialist, telephonic and onsite review nurse, prior authorization, clinical trainer, and national clinical project manager. As a Certified Technical Trainer, Carol has trained clinical and non-clinical staff, including physician medical directors. Dawn Vande Moortel, RN, MS Workshop: Wednesday 10:45 AM Dawn has over 30 years of clinical nursing and management experience in a variety of health care settings, including inpatient, outpatient/emergency room, home care and mental health/substance abuse. Before joining Milliman, Dawn held the position of Director of Case Management for a three hospital health system, where she was instrumental in developing a clinical progression tool designed to facilitate multidisciplinary dialogue and patient progression at the point of care. She has served as Executive Director of a substance abuse agency and understands the unique needs of both the mental health and substance abuse populations. Her work experience also includes health plans and the private consulting arena. As a seasoned veteran of case management and its processes, Dawn brings solid knowledge of utilization review and hospital based case management practices to her role as Clinical Trainer for Milliman Care Guidelines. Mindy Lazor, RN, BSN, CCM, RN-BC, CCP Workshop: Wednesday 10:45 AM Mindy has more than 30 years of clinical nursing and leadership experience in a variety of healthcare settings. She has worked in all areas of acute care nursing practice, and has extensive experience in both Case Management and Utilization Management. She has managed staff and developed training materials for Managed Care and Disease Management employers. Some of her other responsibilities also included oversight of pre-certification, medical necessity, outpatient treatment, technology, and utilization reviews for commercial, indemnity, and self-insured plans. Mindy has developed, trained and managed a national Post-Discharge Services department. Mindy holds Case Manager Certifications from both the American Nurses Credentialing Center and the Commission for Case Management Certification. She received her Chronic Care Professional certification this year. Jeff Frater, RN, BSN, CCM Workshop: Wednesday 10:45 AM Jeff has over 10 years experience in a variety of healthcare settings, which includes a combination of clinical nursing and case management positions. Prior to joining Milliman, Jeff held leadership and staff level positions in primary care, acute hospital, and post-acute inpatient and managed care settings. Jeff has developed and presented education for case managers on clinical topics such as diabetes, renal failure, anemia and neutropenia; and has developed and presented case management content such as observation care strategies and primary care case management. Jeff has also written and presented health care reimbursement education for clinical staff (physicians, nurses, pharmacists, and physical therapists). Jeff is active in the Case Management Society of America. Previously he was on the National Board of Directors for CMSA and is currently the President-elect. Jill Hastings, RN, PAHM Workshop: Wednesday 10:45 AM Jill has 19 years clinical nursing and clinical systems experience in a variety of settings, including inpatient, outpatient, occupational, long-term, private practice, home care, utilization management, case management, and disease management. Before joining Milliman Care Guidelines, Jill served as consultant and clinical technical specialist for the development, testing, and implementation of clinical software applications. She also has experience in workflow analysis, process engineering, regulatory and accreditation standards and compliance. Louise Bower, RN Product Overview: Sunday 2:00 PM Louise is a product consultant for the Milliman Care Guidelines. She joined the firm in 2004. In this position, she assists current and potential customers in gaining a better understanding of the guidelines and learning how their use can assist in achieving organizational goals. In addition to her clinical nursing experience, Ms. Bower has more than 17 years of Medical Management experience, including leadership positions, on both the payor and provider sides, in which she designed and implemented patient care management systems. Her consulting experience extends internationally to the United Kingdom, where she introduced level-of-care concepts and implemented care management programs to improve patient access for National Health Service (NHS) Healthcare Trusts.
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