Tag: Medicaid

Kelly Cromer, PharmD, RPh, CPBS: Chief Pharmacy Officer at PCA Rx

Throughout more than 25 years in healthcare and pharmacy, I have had the opportunity to work across clinical practice, pharmacy benefit management, Medicare and Medicaid programs, regulatory affairs, operations, and executive leadership. Each chapter of my career has strengthened my commitment to transparency, informed decision-making, and creating meaningful value for patients and organizations. As I continue expanding my involvement in board and advisory opportunities, I look forward to applying these experiences to help organizations navigate an increasingly complex healthcare landscape. Here is my biography.

Thomas James, MD: Advancing Healthcare Through Clinical Insight, Strategic Leadership, and a Lifetime of Service

I am pleased to share my professional biography, reflecting more than 45 years of experience across clinical medicine, managed care, healthcare leadership, population health, quality improvement, and board service. As I continue this next chapter of my career, I look forward to applying the lessons and perspective gained as a physician executive, Chief Medical Officer, medical director, and nonprofit board leader to organizations seeking experienced and thoughtful governance.

Greg Lipson: Building Stronger Healthcare Systems Through Strategy, Partnership, and Execution

Throughout my career in healthcare, I have had the opportunity to lead provider network strategy, contracting, Medicare Advantage and Medicaid initiatives, value-based programs, market expansion, and operational transformation across a wide range of organizations and communities. Those experiences have reinforced my belief that strong healthcare performance comes from aligning strategy with execution while building trusted relationships with providers, teams, and business partners. I am pleased to share more about the experiences and leadership principles that have shaped my professional journey. Here is my biography.

John T. Wiesler: Executive Leadership Built on Experience, Integrity, and Impact

After more than 40 years in healthcare, employee benefits, insurance distribution, and sales leadership, I am proud to share my professional biography. My career has been built on servant leadership, strategic growth, strong relationships, and a commitment to helping organizations, customers, and teams succeed. I remain passionate about contributing my experience through board service, advisory opportunities, and continued industry engagement. Here is my biography.

Samuel M. DiCapua, MS, DO, CPE, CHIE: Transforming Healthcare Through Experience, Integrity, and Innovation

I am pleased to share my professional biography, which reflects more than 35 years of experience as a physician, healthcare executive, entrepreneur, and board advisor. Throughout my career, I have been fortunate to lead healthcare organizations, improve quality outcomes, drive operational performance, and help navigate the evolving healthcare landscape from both the provider and payer perspectives. I remain passionate about ethical leadership, value-based care, and helping organizations achieve sustainable success while improving the lives of those they serve.

Charles Merz: The Strategic Glue that Provides Financial, Actuarial, and Business Expertise to Help Companies Make Optimal Decisions for Growth and Profitability

After more than 30 years in healthcare, insurance, finance, and actuarial leadership, I've had the opportunity to help organizations navigate growth, profitability, risk management, and strategic transformation. My experience spans executive leadership roles including Chief Actuary, Chief Financial Officer, and Vice President positions with national healthcare and insurance organizations, along with international business experience across Latin America, the Middle East, and Asia. I am passionate about helping companies make better decisions by combining financial, actuarial, and business perspectives. Here is my biography.

Dr. William D. Harvey, PhD, MBA, BSN, RN

After over two decades of service in the healthcare sector—from the bedside to the boardroom—I’ve taken a moment to reflect on the journey, the growth, and the mission that continues to drive me. I’m grateful for the opportunities I’ve had to lead, serve, and advocate for communities and caregivers alike. Here is my biography.

Shana Parker: Leading with Purpose, Impacting with Insight

After years of driving innovation, transformation, and inclusive leadership across the healthcare and insurance industries, I’m proud to share my professional biography. From shaping value-based strategies to mentoring emerging leaders, my journey has been about creating impact with purpose.

Rajesh Adoni | Transformational Healthcare Technology Leader & Strategic Advisor

Rajesh Adoni is a visionary healthcare technology executive with over three decades of experience leading large-scale transformation initiatives across government, health tech, and engineering sectors. Best known for directing California’s Medi-Cal Rx transition impacting over 15 million lives, Rajesh has a proven track record of aligning strategy, compliance, and innovation to drive measurable results. A skilled collaborator and certified Agile leader, he thrives in complex environments and brings a unique ability to unite cross-functional teams around shared goals. His passion for mentorship, systems thinking, and public service makes him a trusted advisor for organizations navigating healthcare modernization.

Eric Lloyd: Visionary Healthcare Leader Driving Innovation, Strategy, and Impact Across Systems

Eric Lloyd is a visionary healthcare executive with over two decades of experience leading strategic transformation across public, private, and digital health sectors. Renowned for his ability to build high-performing teams and forge impactful provider partnerships, Eric has consistently delivered operational excellence and financial growth in roles ranging from CEO of multibillion-dollar health plans to strategic advisor for emerging, venture-backed companies. His leadership has shaped value-based care models, reduced healthcare costs, and advanced innovations in maternal health, behavioral health, and primary care. With a strong foundation in health administration and a passion for improving community outcomes, Eric continues to redefine how healthcare organizations deliver meaningful, measurable results.

Mary Cantu: Global Leader in Market Access, Reimbursement Strategy & Health Policy

Mary Cantu is a seasoned healthcare executive with over two decades of experience leading global market access, reimbursement strategy, and health policy across the medical device and pharmaceutical industries. Renowned for her ability to navigate complex regulatory and payer landscapes, she has successfully developed and executed comprehensive access strategies that drive product adoption, secure favorable coverage and coding, and expand patient access across domestic and international markets. With a proven track record of aligning cross-functional teams around clear, value-based goals, Mary brings strategic vision, operational excellence, and a deep commitment to healthcare innovation to every stage of the product lifecycle.

Sejal Jonas, PharmD, RPh | Strategic Healthcare Leader | Market Access Expert

Sejal Jonas, PharmD, RPh, is a visionary healthcare executive with over three decades of experience shaping payer strategy, formulary management, and market access for some of the nation’s leading pharmaceutical and healthcare organizations. Known for her deep clinical knowledge, strategic acumen, and commitment to improving health outcomes, Sejal brings a rare ability to bridge the gap between innovation and execution. Her work has empowered brands to thrive in complex regulatory and reimbursement environments, while her leadership continues to influence how healthcare systems deliver value to patients and providers alike.

Laura Freedy | Transformational Healthcare Executive | Strategic Innovator in Clinical Operations and Compliance

Laura Freedy is a visionary healthcare executive with more than three decades of experience leading innovation at the intersection of clinical operations, regulatory compliance, and payer-provider collaboration. Known for her integrity, strategic foresight, and commitment to driving meaningful change, Laura has held senior leadership roles across major healthcare organizations, including UnitedHealth Group, Optum, and HTC Global Services. Her ability to align business objectives with clinical and technological solutions has consistently delivered improved health outcomes and operational performance. Passionate about service and mentorship, Laura is now focused on board service where she can share her expertise and guide organizations toward impactful, sustainable growth.

Matthew C. Hedberg | State Government Affairs & Health Policy Executive | Corporate Advocacy Leader

Matthew C. Hedberg is a seasoned State Government Affairs and Health Policy Executive with 27 years of experience shaping legislative and regulatory landscapes across consumer brands, healthcare, pharmaceuticals, manufacturing, and technology. A trusted strategist and corporate advocate, he has successfully led high-stakes negotiations, influenced critical policy decisions, and built lasting relationships with policymakers, executives, and industry leaders. His expertise spans state and federal healthcare policies, market access, economic development, and corporate governance, making him a vital asset for organizations navigating complex regulatory environments. Known for his integrity, strategic foresight, and ability to drive consensus, Matthew leverages his deep knowledge and communication skills to align business objectives with policy initiatives, ensuring sustainable growth and industry leadership.

Rudy Pearce: Strategic Leader in Pharmaceutical Market Access and Managed Care

Rudy Pearce is a seasoned pharmaceutical executive with a proven track record in managed markets, government accounts, and sales leadership. With over three decades of experience, he has successfully led teams, negotiated high-impact contracts, and expanded market access for critical therapies. His expertise spans commercial and government healthcare sectors, where he has driven formulary wins, launched new products, and strengthened partnerships across PBMs, Medicare, Medicaid, and the Department of Defense. Recognized nationally for his leadership and strategic vision, Rudy is a results-driven professional dedicated to enhancing healthcare access and driving organizational success.

Nancy Hess: Transformative Healthcare Executive and Strategic Consultant

Nancy Hess is a highly accomplished senior healthcare executive and strategic consultant with over 25 years of experience driving innovation and growth across the healthcare sector. As Chief Commercial Officer at Spiras Health, she leads transformative strategies for Medicare Advantage plans, Medicaid, ACOs, and value-based care organizations, fostering market leadership through innovative solutions and C-Suite engagement. Known for her expertise in value-based care, consumer engagement, and provider optimization, Nancy has consistently delivered exceptional results, including managing portfolios exceeding $1.5 billion and achieving 40% annual revenue growth at Optum. A dedicated leader and community advocate, she also serves as Vice President of Membership for the Chicago Symphony Orchestra Women’s Board, championing arts and education initiatives.