Advisory Board
CSULB HCA Advisory Board
The HCA Advisory Board consists of leaders in the health and university community, alumni, and/or faculty, that reflect a commitment to add value to the Department and to the professional development of our students. The purpose of the Board shall be to serve in an advisory capacity to support and foster the activities of the Department of Health Care Administration (“Department”) by considering, among other things, the mission, goals, objectives and operations of the Department, discuss current and emerging issues in the health care industry, and to make suggestions regarding course content and curriculum so as to assist the Department in fulfilling its mission and objectives.
Advisory Board Officers |
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Tom Knego WATCH: Tom Knego moderates Health Care Careers Panel with industry leaders Mr. Knego is an Associate General Counsel for Anthem, Inc. supporting healthcare and clinical operations. Previously, Mr. Knego spent 12 years at United Healthcare where he was primarily responsible for management of litigation and related activities. Prior to joining United, Mr. Knego was a partner at K&R Law Group in the firm's litigation practice group where he represented health plans and health care providers in a variety of litigation matters including managed care liability, commercial litigation, employment litigation and medical malpractice. He was awarded the Richard O. Westbrooke award for "Excellence in Trial Advocacy" from the San Diego County Bar Association. Mr. Knego is a member of the American Health Lawyers Association and Orange County Bar Association. He is a frequent speaker on legal issues affecting managed care organizations and health care providers. He is a part-time faculty member at CSULB and teaches Legal Aspects of HealthCare Administration. |
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Alfonso Vega Mr. Vega is responsible for AltaMed’s dental and behavioral health operations in Los Angeles & Orange Counties. These programs currently have an operating budget of approximately $28 million. He joined AltaMed in 2010. Mr. Vega played an instrumental role in the development and successful deployment of an organizational customer service program, a medically integrated behavioral health program and eight urgent care clinics. He has overseen organizational growth acquiring new locations in West Covina and Westlake, and three start-ups in Pico Rivera, Westlake and Huntington Park. Mr. Vega has developed a dynamic team consisting of a Dental Director and a Behavioral Health Manager. In strong collaboration with Clinical Dental, Behavioral Health, Medical and Nursing leadership, we have improved customer service ratings, patient access and clinical quality metrics. He proudly served in the United States Army as a Combat Medic and currently sits on CSULB’s Health Care Administration Advisory Board. Mr. Vega has been managing outpatient medical clinics for the past 33 years. |
Advisory Board Members |
Biography |
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Ardel Guillamas Avelino Dr. Ardel Guillamas Avelino is Senior Director of Operations at St. Mary Medical Center, Dignity Health. A transformational leader, he has extensive experience in various aspects of healthcare operations. He is a proud alumnus of the Long Beach City College registered nursing program and served as an adjunct faculty/clinical instructor. This year, he is being inducted to the prestigious Alumni Hall of Fame for his outstanding contributions to LBCC and the community. Additionally, he holds a bachelors degree in nursing from Holy Names University, a masters in healthcare administration from California State University, Long Beach, and a doctorate in nursing/executive leadership from Baylor University. After graduating from CSULB, he served as President of the HCA Alumni Association. A community leader, he occupies the role of Chairman of the Board for Goodwill Southern Los Angeles County and as a board of governors member with the Long Beach City College Foundation. He also sits as an advisory board member for Terminal Island Federal Bureau of Prisons and Long Beach City College Allied Health and Sciences. Dr. Ardel is a staunch mentor who has guided students in the associate, bachelor, and master's level programs in nursing and healthcare administration fields. He is often invited as a panelist to speak with college students on healthcare trends and careers. His devoted work in mentorship has produced many advanced practice nurses and healthcare leaders. He is also an active mentor for Operations Jump Start, an organization that helps low-resourced, high-potential first-generation students to get in, stay in, and graduate from a four-year college. |
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Robert A. Beltran, M.D., MBA, FACMQ, CHCQM Dr. Beltran is the President of Quality Health Care Management, Inc. a health care management company focusing on care management and health services for diverse ethnic communities, specifically the Latino Population in California and the United States. He has over 20 years experience in senior clinic roles for healthcare companies. His career focus for the past 8 years has been directing utilization managements, credentialing and quality improvement programs for health plans and IPAs in California. They include Care1st, L.A.Care, Universal Care and Monarch Healthcare. |
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Regina Berman, RN, MA, Value Based Care Executive for the Adventist Health System Responsible for successful deployment of a variety of alternate payment models for private, government and commercial lines of business. Adventist Health is a 28-hospital system with more than >400 clinical practice sites. In her previous role, Integrative Care Management and ACO Executive she fostered development and execution of longitudinal care coordination services across the care continuum using a Progression of Care Model and redesign of the inpatient case management services and centralized utilization management and mid-revenue cycle functions. Bringing the clinical voice into the finance and revenue related work has resulted in significant loss prevention and expansion of the program design to address equity and social determinants.
Previously, Principal Strategic Advantage for Health, providing guidance to organizations on effective design and execution for emerging value-based payment models and performance excellence. Skilled in designing whole system change, she excels in program integration and analytic platforms for clinical and claims-based data integration. Other roles include VP Population Health and Accountable Care, COO MemorialCare Regional ACO, LLC, & MemorialCare Health System, VP for Quality and Resource Stewardship for Kaiser Permanente. Population Health, Advanced Senior Care, Transitions of Care and Case Management and Medical Cost Trending, Quality & Regulatory affairs were among her areas of responsibility. She managed a $1.7 billion medical cost budget and achieved a zero % expense trend during her tenure.
While working with Hackensack University Medical Center, Regina was a pioneer in the development of the first Pay for Performance model with the original CMS demonstrations project, and the Robert Wood Johnson/IHI Pursuing Perfection Grant, a 3-year, $25 Million healthcare transformation design to improve clinical outcomes using quality and safety design principles. This work was foundational to what is now known as building high reliability organizations and the Triple Aim for patient centric care. During her tenure Hackensack led the country with the highest quality scores for nine consecutive years. She is committed to continual improvement using value-based, patient centric care models, particularly for the underserved. In 2023 she has been invited to share her insights to national organizations and publications, including the American College of Healthcare Executives, the American Case Management Association, and at the Premier Advanced ACO Collaborative & National Value-Based Payer meeting. On November 1, Becker’s Hospital Review hosted a case study webinar where Regina shared our success in redesigning and automating utilization management. Becker’s is the leading hospital magazine for business news and analysis for hospital and health system executives. This work was also featured in the Fall Healthcare Executive publication. This month, Regina is also sharing our story in an article requested by Simon Beckett, the publisher that produces Management in HealthCare magazine, which has the largest international distribution and readership. |
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Kelly Bruno Ms. Bruno is president and chief executive officer of National Health Foundation, a Los Angeles-based nonprofit organization that works within under-resourced Southern California communities to identify and advance solutions that remove barriers and promote health for all. She joined NHF in 2007, bringing over a decade of executive healthcare leadership and social service administration experience to the organization. Bruno leads a team dedicated to working with local communities to tackle the social determinants of health and right the wrongs of health disparities. One of her most significant contributions was to spearhead a recuperative care program in response to hospitals’ illegal practice of patient dumping. She earned her bachelor’s degree in social work from Azusa Pacific University and a master’s in social work from California State University, Long Beach. She has also completed Stanford University’s Executive Program for Nonprofit Leaders. |
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John A. Calderone, PhD WATCH: Dr. John Calderone answers questions about career paths and advice for students Dr. Calderone was the CEO of Olympia Medical Center from 2006 until his retirement at the end of 2015. He has over 40 years of experience in the healthcare industry. Before assuming his last position, he was the CEO of Corona Regional Medical Center in Corona, California, CEO of College Hospital and Coastal Communities Hospital in Orange County, CA and CO O of Doctors Hospital in Santa Ana and Santa Ana Medical Center in Santa Ana, CA. Previously, Dr. Calderone held positions at a corporate level for over ten years with three different healthcare systems, where he directed the marketing, planning, and business development functions. His last corporate role was with Summit Health, Ltd. Prior to entering the healthcare field, Dr. Calderone was employed at the General Electric Company for over four years in the Transportation Systems Business Operations Division as manager of employee programs. He also was the CEO of Serenity Hall Inc at a not for profit chemical dependency psychiatric network of inpatient and outpatient facilities in Pennsylvania. Throughout his career, he has been an adjunct professor teaching at several different universities. He served on the Board of Directors of several community organizations such as the YMCA, American Cancer Society and Inland Empire Health Plan. Dr. Calderone was named the 2013 recipient of the 4th Annual Healthcare Administrator Award, presented by the Association for Professionals in Infection Control and Epidemiology (APIC). He served on the Board of Directors for the Hospital Association of Southern California (HASC) for over fifteen years, its Executive Committee for seven years. He was the 2014 Chairman of the Hospital Association of Southern California. Additionally, he served on the Board of Trustees and its Executive Committee for the California Hospital Association (CHA). He also was appointed and served on the Board of Directors for the California Hospital Quality Institute. Dr. Calderone holds a Ph.D. in Counseling Psychology from the University of Pittsburgh, and a postdoctoral degree in Psychology from Edinboro University. Currently, he is serving on the Board of Directors of the National Health Foundation, Los Angeles, the Convalescent Aid Society, Pasadena, and Gateways Hospital and Mental Health Centers, Los Angeles. He is also Chair of Communities Lifting Communities, LLC, Los Angeles. |
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Amy Canter Ms. Canter has over 25 years of experience in Healthcare Operations. Highlights of her diverse career includes administrative process development in numerous hospital departments, overseeing multi-million-dollar construction projects, expansion of healthcare systems for HIV/AIDS programs, and experience with quality improvement preparations for hospital accreditation. Ms. Canter is proud to be affiliated with CSULB where she received her Masters Degree in Health Care Administration. |
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Terence T. Cunningham, MHA, FACHE Mr. Cunningham had a faculty appointment as a Full Time Lecturer in the CSULB, Department of HCA, and taught graduate and undergraduate classes from 2011 to 2019. These classes included Organizational Theory and Behavior, Health Care Finance, Strategic Planning and Marketing, and HCA Internship classes. He was the Coordinator of the graduate and undergraduate HCA Internship programs. His previous experience included working for over 44 years in short term, acute care hospitals (11) and multi-specialty ambulatory care centers (2). He served in senior executive positions (CEO, COO, CFO and VP). For the 2014 to 2015 Academic Year, he was selected by the CHHS as the Most Valuable Professor. He has served on the CSULB HCA Advisory Board since 2010. Mr. Cunningham received a Bachelor’s degree in Microbiology, with minors in Economics and Business Administration from CSULB. He received a Master’s in Healthcare Administration from The George Washington University. He is a Fellow in the American College of Health Care Administration and is a Board Certified Specialist in Health Care Administration. He served for over 20 years as a Hospital Preceptor for students performing internships, residencies or fellowships in HCA. He is presently on the Advisory Board of Los Alamitos Medical Center and remains current with HCA Academic publications. |
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Rick Desai Watch Health Care Leadership Speaker Series Video featuring Rick Desai Mr. Desai is the President\COO of Artifex Strategies, a nationally known healthcare operations and strategy consultant organization. He has over 20 years experience on both the payer and provider side of the healthcare delivery model including executive management positions at Promises Behavioral Health, Magellan Health, MedXM, Wellcare Health Plans, Kindred Healthcare and USC Health System. He has extensive knowledge across the continuum of care in the healthcare industry including development and implementation of network management strategies, operations, population health management, analytics, finance, product development and strategies as well as other areas focused around organizational growth and performance. Mr. Desai is a part-time faculty member at CSULB and teaches managed care in the accelerated program graduate program. |
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Mark Gamble Watch Health Care Leadership Speaker Series Video featuring Mark Gamble Mr. Gamble is the Chief of Advocacy and Operations with the Hospital Association of Southern California. HASC is a reginal advocacy organization that represents 182 member hospitals in Los Angeles, Orange County, San Bernardino, Riverside, Ventura, and Santa Barbara counties. HASC works closely with the California Hospital Association to improve the quality and accessibility of health care services in Southern California. Mr. Gamble has been with HASC for more than 26 years, has a background in public policy and advocacy, and is responsible for the division that provides hospitals with programs and services in the areas of community health improvement, human resource management, and patient access services. |
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Carissa Green is a Principal with the National Accounts division at Blue Shield of California, holding primary responsibilities for strategy, enterprise level support, and overall client relationship for customers with 3,000 employees and above. Ms. Green brings a rich and diverse background in healthcare, with experience working with insurance carriers and benefits consulting. Prior to joining Blue Shield, she was an Area Vice President at Gallagher focusing her efforts on driving growth for Gallagher’s public sector business in Southern California. Prior to Gallagher, Ms. Green spent 16 years with UnitedHealthcare, progressing rapidly through the organization. Her experience at UnitedHealthcare included sales, operations, marketing, product development, and health services. She spent most of her time in client management and sales, working with large, complex, multi-site clients. During her tenure, Ms. Green was responsible for considerable growth in the education sector of the business and built solid relationships with her clients. Ms. Green holds a BS in Health Care Administration with a minor in Human Resource Management from CSULB. She holds life and health agent licenses in California and has a background in Six Sigma project management. |
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Mr. Goode provides leadership, direction and support to the company’s information technology (IT) areas including Digital Strategy, Business Intelligence, Consumer Experience, IT Infrastructure, Project Management, Electronic Data Interchange (EDI) and Application Development. Under his guidance, SCAN is leveraging its technology investments to meet the individual needs of seniors now and in the future. Prior to joining SCAN in 2013, Mr. Goode worked for Accenture, a multinational technology and management consulting firm. During his 15 years at Accenture, he worked with several health plans throughout the United States, including PacifiCare, CIGNA, Express Scripts and UnitedHealth Group. Mr. Goode’s experience includes analyzing, planning and implementing a variety of technological improvements and leading large technology programs, such as systems implementations and IT transformations. |
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Stephanie Guastella, FACHE Ms. Guastella is responsible for increasing volume and revenue of assigned service lines across the PIH Health Integrated Delivery System. Previously, she was the Executive Director of Program Development for children’s and women’s services at Miller Children’s and Women’s Hospital. Her responsibilities included the development, management, measurement and implementation of new program initiatives for the pediatric and women’s service lines. She also held the role of Executive Director for Business Development and Physician Relations with Long Beach Memorial, Miller Children’s and Women’s Hospital and Community Hospital of Long Beach. She was responsible for developing and managing the implementation of growth strategies to support key service lines. Past experience includes leading the program development initiatives for Center of Excellence service lines for a regional healthcare system and managing the development and implementation of Institute service lines for CHOC Children’s. She led the business development functions for USC University Hospital and USC Norris Cancer Hospital. |
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Kathy Hegstorm Kathy holds a Masters in Health Care Administration Management and is one of the two original founders of Advanced Medical Management (AMM) which was established in 1981. Kathy has 39 years of leadership experience in the administration of managed care programs for government clients, medical groups and other risk-bearing entities. Kathy’s new role is that of AMM’s Executive Advisor where she advises AMM on its general business operations.
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David Keele, CPA Chief Financial Officer, Tibor Rubin VA Medical Center Mr. David Keele is the Deputy Chief Financial Officer of the Veterans Administration’s Desert Pacific Healthcare Network which is comprised of eight health care systems and 65 community clinics serving 1.5 million veterans in Arizona, New Mexico and Southern California. David recently served as the Chief Financial Officer of the Long Beach Veterans Hospital. Prior to that, David served twenty years on active duty as a Marine Corps Officer. David is also a Lecturer in the Department of Health Care Administration at Long Beach State University. He has a B.S. from Iowa State University and an MS in Management from the Naval Postgraduate School in Monterey, CA. VA Desert Pacific Healthcare Network is one of 21 Healthcare Networks operated nationwide by the United States Department of Veterans Affairs (VA). We are comprised of eight health care system and 65 community clinics serving 1.5 million veterans in Arizona, New Mexico, and Southern California. |
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Denise Likar is the Vice President for Independence at Home (IAH), a SCAN community service, where she has responsibility for all non-health plan home and community-based programs. Ms. Likar joined IAH in 2002 as an MSSP Care Planner. She has also held the positions of MSSP Supervisor and MSSP Site Director/Director of Programs. Over her 19-year tenure with SCAN, Ms. Likar has led her management team and staff in providing quality care management and supportive services, including the largest Multipurpose Senior Services Program (MSSP) in California, as well as other county contract programs. In her time at IAH, Ms. Likar has overseen the growth of the organization’s resource and referral line, providing support for seniors and their caregivers. In addition, she oversees the organization’s health and wellness education efforts, Volunteer Action for Aging and Community Giving. In 2019, Ms. Likar led the establishment of the first SCAN Health Plan Scholarships for Senior Health and Independence in conjunction with CSULB. Denise continues to work with LBSU’s Center for Successful Aging within the College of Health and Human Services on the selection of students to receive the scholarships. Prior to SCAN, Ms. Likar worked in substance abuse treatment as Deputy Director of Outpatient Services and Supervisor of Case Management for Prototypes Women’s Center, Staff Development Specialist for McKesson Water Products and Director of Social Services for Driftwood Health Care Center. Ms. Likar spent four years as the President of the MSSP Site Association, where she provided leadership and coordination of legislative and policy efforts. Ms. Likar is Legislative Chair of the MSSP Site Association, where she manages education and advocacy around policies that impact the clients served by MSSP and all seniors. Ms. Likar received her MS in Social Work from the USC and her BA in Psychology from Loyola Marymount University. |
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James Lott, PsyD, MBA James (Jim) Lott is an accomplished senior executive (retired), board member, and thought leader with more than 25 years of success in the healthcare industry. Leveraging his extensive experience with crisis communications, government, and public relations, Jim consults for companies seeking guidance on media and stakeholder communications management. His broad areas of expertise include healthcare policy development, strategic planning, marketing, collaboration, government advocacy programs, executive, and management coaching. Throughout his executive career, Jim held leadership positions with Martin Luther King, Jr. Community Hospital, COPE Health Solutions, the Hospital Association of Southern California, the Hospital Council of San Diego & Imperial Counties, and the California State Senate. Jim holds a Doctor of Psychology degree from Phillips Graduate University; a Master of Business Administration from the University of Redlands, and a Bachelor of Arts in Sociology from California State University, Los Angeles. He has served on the Board of Governors for the L.A. Care Health Plan; Board of the Los Angeles Area Economic Development Corporation; Board of Overseers, Claremont University Consortium; and he has served on the boards of the American Lung Association, the American Heart Association, the Greater San Diego Chamber of Commerce, the San Diego County Regional Task Force on AIDS, the San Diego Hospice Foundation. Jim currently serves on the Citizens Financial Accountability and Oversight Committee of California’s stem cell research grant program (California State Senate Appointee), the Los Angeles County Emergency Medical Services Commission, and the National Health Foundation. As a lecturer, Jim teaches public health and healthcare administration courses at both Cal State Los Angeles and Long Beach. |
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Josh Luke Dr. Luke is an award winning speaker, philanthropist, author, educator, and consultant on a variety of healthcare issues. As a former Hospital CEO he provides executive coaching, strategy and mentoring to hospital CEOs and healthcare executives nationwide. He currently serves as Founder & CEO of AnyFans, a social media app that partners with organizations to improve young adult mental health. Dr. Luke founded the not for profit National Readmission Prevention Collaborative, has taught at USC, CSULB, CSUF and Hope International University. His non-profit foundation teaches healthcare providers how to transform to value based care and Americans how to engage in the healthcare process to eliminate wasteful healthcare spending. His expertise includes sharing simple tactics on how to make healthcare more affordable for families, employees and business, as well as how to get access to the best doctors and hospitals. Dr. Luke is an Amazon Best Selling author of the following titles: Health-Wealth for You (2019), Health-Wealth: Is healthcare bankrupting your business? (2018) and Ex-Acute: A former hospital CEO tells all on what’s wrong with American healthcare (2017). He hosts the award winning YouTube Show & podcast Spend Less, Live Well with Dr. Josh Luke. |
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Carrie Mclain CEO Helton Law Group APC Carrie McLain is the Managing Partner of the Helton Law Group, APC, a well-known law firm in Southern California specializing in healthcare issues of all types. Ms. Mclain oversees a legal team fully trained to handle all aspects of complex managed care reimbursement matters from claim investigation and review through and including trial. In addition, Ms. McLain provides transactional support to various healthcare providers including contract language for hospital negotiators (especially on dispute resolution and key reimbursement terms), participates as part of the legal team on large dispute “pre-litigation” meetings with payors, and provides assistance on HIPAA and revenue cycle issues unique to disputed claims. |
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Susie Mix Ms. Mix brings over 20 years of versatile experience in Contract Management, Business Consulting, and Healthcare Administration. Susie brings a unique and extensive knowledge to the Skilled Nursing and Managed Care industry. Susie’s company, Mix Solutions Inc., specializes in Managed Care Contracting, Consulting, Case Management system development, best practices, and Managed Care Billing/Collections currently servicing over 600 healthcare providers in 45 states. Susie speaks at state and national conferences and conducts regular webinars for skilled nursing facilities and ancillary providers educating them on our transforming healthcare world. She began her career in healthcare in 1998 and has worked in various areas within the industry, including long-term care administrator, case manager, marketing director, contract negotiator, consultant, and professor. |
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Theresa Murphy With over 25 years of experience in the healthcare industry, Ms. Murphy has led complex operational processes, facilitated change initiatives, and developed functional teams. Her areas of interest include advancing professional nursing practice through the understanding of the California Nurse Practice Act, the development and coaching of emerging leaders, and the development of organizational structures that support the unique acute hospital environment. She has served on several hospital organizations in managerial and executive levels; the Board of Directors of the Chin Family Institute for Nursing at CSULA; the Hospital Association of Southern California Nurse Advisory Council including serving as Chair; HASC Board of Directors; the California Hospital Association (CHA) CNO Advisory Committee; the Advisory Board of the O’Rourke Institute for Advancement of Professional Practice and the advisory board of Healthcare Administration at CSULB. Ms. Murphy served as an evaluator for the BETA HEART Event Review Panel. She occasionally lectures at Mount St. Mary’s University and volunteers with the Executive Service Corps providing executive coaching to leaders serving community non-profit organizations. |
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Adela Redzic Adela Redzic currently oversees Dental operations as well as strategic initiatives for the Behavioral Health, Radiology, and HIV services divisions. She is passionate about engaging her team and focuses on implementing effective strategies to drive outcomes for patients in quality, service, access, as well as overall operations. Ms. Redzic holds an MBA from CSULB and is certified as a Lean Six Sigma Green Belt. |
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Mark Rivera Mr. Rivera is President of Managed Care Consulting, Inc., a specialty managed care consulting firm serving governmental, nonprofit and for profit healthcare entities nationally. He has been employed with a variety of local and national companies including executive positions with such organizations as CalOPTIMA, Adventist Health/Pacific Integrated Health, Hoag Hospital, and Capp Care. He is a proven healthcare leader with a track record for achievement in developing and executing financial strategies that positively impact organizations and drive operational excellence in areas such as contracting, auditing, and regulatory compliance. Mr. Rivera specializes in maximizing reimbursement and costs containment while ensuring excellence in patient outcomes. In addition, Mr. Rivera brings technical competencies and security clearances to engage in the areas of FQHC compliance, Federal Tort Claims Act, Uniform Data Systems, advanced analytics, and managed care. |
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Karen Sielbeck Karen Sielbeck, RN, MSN, Chief Operating Officer at Kaiser Permanente, South Bay Medical Center. Highly knowledgeable, broadly skilled, and extensively experienced in health care delivery, management, and administration. Thirty-eight years in healthcare and over 28 years of successful performance in a variety of roles at Kaiser Permanente (KP) South Bay Medical Center, the Southern California Region, and the Enterprise. Previously served as a Chief Nurse Executive, Assistant Medical Center Administrator for Quality, Safety and Accreditation & Licensing, as well as leading in the Southern California Permanente Medical Group as Director of Population Care Management and Oncology. Current portfolio includes leading key strategic priorities for growth and retention, hospital throughput and care without delay across the continuum, exceptional experience, and safe, secure, and respectful environments of care. Karen was trained as a Registered Nurse and holds a Master of Science Degree as a Clinical Nurse Specialist from California State University at Los Angeles. |
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Dirk Thornley Mr. Thornley has more than 30 years of experience in health care administration in a wide range of positions including medical group associations, medical device companies and hospitals. Dirk is currently serving as a health economics and reimbursement expert in the area of structural heart disease. Dirk is focused on consulting with hospitals and physicians in California, Nevada, Idaho, Oregon and Alaska. He was formerly Associate Director, U.S. Field Services at Zimmer Biomet, working on the Market Access team consulting with hospitals, orthopedic surgeons, and neurosurgeons to assist in making technology available to patients. Prior to the positions above, Mr. Thornley’s prior positions included Vice President of the California Association of Physician Groups (CAPG); Sr. Corporate Accounts Manager at Medtronic Diabetes, and Director of Business Development at PIH Health, where he led a team that managed physician relationships and drove growth in the health system. |
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Jose Valenzuela Jose Valenzuela is currently a Compliance Director accountable for Clinical and Network Programs at UnitedHealthcare. Jose has been in healthcare in various operational areas since 1993, including experience in health plan operations, governance, compliance, and regulatory affairs. He prides himself on excellent presentation skills and diligent research habits that result in clear and concise verbal and written communications to all audiences. Prior to holding this role, Jose was leading a team of staff accountable for legislative implementation and product, network, and compliance related filings for 13 West Region States. He has also demonstrated great success implementing and maintaining a compliance program within complex and diverse business models within UnitedHealth Group’s OptumCare businesses throughout Southern California who contract with multiple Payers offering Commercial, Medicare, and Medi-Cal products. Mr. Valenzuela has extensive knowledge of business governance, compliance, and regulatory affairs, including: Effective support of all aspects of the seven elements of an effective compliance program with focus on business operational compliance in provider and clinical businesses models. Leading ethics and compliance plans, overseeing accreditation activities, monitoring fraud, waste, and abuse (FWA), privacy & security activities, and ensuring organizations respond effectively to unacceptable financial and legal risks. |
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Gordana Vukotich Dr. Vukotich has over 20 years’ experience in the health system space. She began her career in the industry, group up as a marketing rep for CareMore Medical Group, a start-up IPA, which evolved into a health system as they obtained a Knox- Keene license. Her experience includes progressive leadership roles, successfully leading Medicare health plan sales and teams, Medicare Health plan sales expansion, provider services and network development working for both payers and providers. As she grew within the industry, Dr. Vukotich went back to school to support her career growth and obtained her Master of Science degree in Health Care Administration, from Cal State Long Beach. Concurrently, her focus shifted and she became focused on operational roles and executing strategic initiatives. As a result her overall experience includes comprehensive managed care, Medicare and Medicaid experience, with a focus on membership growth, network development and IPA operations. To support her commitment to learning and professional growth in a complex, healthcare delivery system, most recently Dr. Vukotich completed doctoral studies at USC’s Rossier school of education,in Organizational Change and Leadership. During this time she was consulting and working on an interim contracting project for the state of California. She is presently working as a consulting, offering services to payers and providers: health plans, provider groups, management services organizations (MSO’s) and health systems. Her passion is developing strategy, leading execution and driving corporate vision to improve the overall improvement of healthcare delivery. Upon completion of recent research focused on the significance of leadership during health system mergers, Dr. Vukotich is transitioning back to an organizational role. Her focus is to identify a long-term leadership role with a health plan and provider where she will add value to a team as they collectively make a dent in the industry. She would also like to teach a university course as adjunct faculty while working full-time. Her past and present affiliations include vice president and member at large - CSULB Health Care Admin Alum Association, CSULB Department of Health Care Administration advisory board, board member of the Manhattan Beach Emergency Response Team, Women in Health Administration, the SoCal Chapter of the American College of HealthCare Executives (ACHE), and treasure of St. Stevens Womans’ Auxiliary. |
