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Paula R. Dillon Managed-care-1Ask-the-Experts

Paula R. Dillon is the director of managed care for Rockford Health System, an integrated hospital system located in Rockford, Ill., and the largest health system serving northern Illinois and southern Wisconsin.

Paula has responsibility for leading systemwide managed care strategy development and managing all facets of system contract administration, including negotiation, analysis, and implementation and enhancement of managed care initiatives with Rockford Health System market brokers and employees.

Paula has more than 16 years of experience in the managed care industry. Prior to joining Rockford Health System, she worked for HFMA’s national office as a technical manager, providing advisory services on managed care industry trends and issues and educational product recommendations.

Paula has a bachelor’s degree from Grinnell College and an MBA from Benedictine University. She is currently the secretary for the First Illinois HFMA Chapter. Her areas of expertise include:

  • Reimbursement negotiation and strategies
  • Employer contracting solutions
  • Medicare Advantage contracting approaches
  • Payer performance metrics
  • Insurance exchanges

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Craig Ganger   Craig Granger

Craig Ganger is the director of managed care and decision support for Premier Health in Dayton, Ohio. Responsibilities include managed care negotiations and contracting for Premier’s four hospitals and over 400 employed physicians, financial analysis for facilities (including pro formas for business expansion and product line P&Ls), and contractual budgeting and analysis. 

Prior to his current role, Craig served as director of patient financial services for Premier Health from 2007-2010, at which time he oversaw the creation of the central business office and the implementation of the billing and collection modules. 

His areas of expertise include: 

  • Managed care negotiation and strategy
  • Health insurance exchanges
  • Financial analysis for decision making
  • Contract reimbursement strategy and analysis

Craig is a life-long resident of Ohio. He holds a MBA degree from The Ohio State University and a bachelor’s in finance from the University of Dayton. Craig resides in Tipp City with his wife Miranda and their three children.

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Matt Levsen

Matt Levsen, CPA, FHFMA, is associate CFO of University of Missouri Health Care, Columbia, Mo.

He has more than 30 years of healthcare finance experience in varying roles at healthcare organizations. Matt is a member of HFMA’s Board of Examiners and has been actively involved with his local HFMA chapter for many years, serving as chapter program chair, chapter president, and regional executive. His areas of expertise include:

  • Medicare and Medicaid reimbursement
  • Chargemaster
  • Managed care contracting

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Michele Marcum Michele Marcum_2

Michele Marcum, CHFP, is hospital contract executive, Idaho and Montana, for Humana, Inc. Michele holds a bachelor's degree in business administration/accounting from Central Missouri State University.

She has served on the board of HFMA’s Idaho Chapter and currently serves on HFMA’s Board of Examiners. She is a frequent presenter on managed care and reimbursement topics. Her areas of expertise include:

  • Contract language
  • Negotiation
  • Payer performance evaluation
  • Medicare Advantage plans
  • Commercial ACO development

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Dan McAfee /uploadedImages/Communities/Forums/Managed_Care/DanMcAfee (2).jpg

Dan McAfee is senior managing director of payer contracting and reimbursement strategy for The Godbey Group, Irving, Texas, a leader in provider contracting and reimbursement strategy. He is responsible for client negotiations, including benchmarking, modeling, market analysis with the payer, and client communications.

Dan has more than 20 years of experience in the managed care industry. Previous experience includes vice president of Texas Health Harris Methodist Hospital and director of planning and finance for Aetna. His areas of expertise include:

  • Managed care contracting
  • Managed care strategies
  • Managed care operations
  • Managed care reimbursement and pricing strategies and analysis
  • Incentive and quality-based contracting for solo providers, provider systems, and PHOs, including ACOs

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Chad Mulvany Chad Mulvany_2

Chad Mulvany is a technical director for HFMA and is based out of the association’s Washington, D.C., office. Chad is responsible for creating content covering reimbursement issues and healthcare reform. He also is a regular contributor to hfm magazine and speaks frequently to local chapters. 

Chad has more than 10 years of revenue cycle and reimbursement experience, working as both an internal and external consultant to large healthcare systems. Prior to joining HFMA, he helped Fortune 500 companies re-engineer their innovation and marketing processes as a consultant at the Corporate Executive Board. 

Chad has an MBA from the University of Maryland. He is active with the Virginia Chapter of HFMA where he has served as a past board member.

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Katie Niesen

Katie Niesen has worked in the healthcare field for 16 years and currently holds the position of manager of managed Care for Swedish Covenant Hospital, a 323-bed independent hospital serving the north and northwest sides of Chicago.  She has previously held positions at other hospitals, insurance companies and PPO networks in various parts of the country.  

Katie received her MBA from North Park University in Chicago.  Her areas of expertise include:

  • Managed care contracting (ambulatory surgery centers, hospital, and physician)
  • Medicare and Medicaid HMO
  • Reimbursement
  • PHO 
  • Denials management
  • PFS billing and collections
  • Capitation agreements

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Caswell Samms, III Caswell Samms_2

Caswell Samms, III, is vice president of revenue cycle at St. Barnabas Hospital, a not-for-profit acute care community hospital and Level I trauma center based in the Bronx, NY.

Prior to joining St. Barnabas, Caswell was part of the executive team at East Orange General Hospital in East Orange, NJ, where he served as the assistant vice president of planning and business development, as well as the vice president of finance and planning.

Caswell holds a bachelor’s degree in accounting from Virginia State University and an MBA in finance and accounting from Regis University. He is also an expert for HFMA’s Revenue Cycle Forum. His areas of expertise include:

  • Managed care
  • Reimbursement
  • Budgeting
  • Planning
  • Business development

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David A. Williams David Williams_2

David A. Williams, CPA, FHFMA, is a partner and leader of healthcare reimbursement and advisory services at HORNE, LLP, Ridgeland, Miss. He is also chairman of the company’s technology committee and a member of the firm’s IT project review committee.

With more than 25 years of experience, David’s practice is concentrated in the healthcare industry providing assurance, reimbursement, and advisory services for a wide range of organizations, including hospitals, outpatient centers, home healthcare agencies, skilled nursing facilities, assisted living centers, rural health clinics, and mental rehabilitation centers.

David earned a bachelor of business administration degree from the University of Southern Mississippi. He serves on HFMA’s Board of Examiners and is also an expert for HFMA’s CFO Forum. His areas of expertise include:

  • Cost reporting
  • DRG post-acute transfer
  • Medicare and Medicaid appeal assistance
  • Disproportionate share hospital payments
  • Rural health clinic and federally qualified health center designation and qualification

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