Each project is completed smoothly and economically when the right consultant
comes to the table.
Ashley Reynolds, PhD, RN, ACSM-HFM
Ashley Reynolds, PhD, RN, ACSM-HFM, has 20 years of healthcare experience with a dozen years of professional nursing experience. This seasoned healthcare executive has led large regional territories and multiple departments within health plan, disease management, health technology and wellness companies.
Ashley’s in-depth knowledge of NCQA accreditation standards and FDA medical device standards includes disease management, health plan, HEDIS and wellness and health promotion. He provides expert services to organizations seeking NCQA Wellness or URAC disease management accreditation or developing a comprehensive well-being strategy. He has been responsible for all quality improvement activities for operations in a Medicare Advantage Special Needs plan, disease management program, private disease management company and in healthcare centers. This include establishing and maintaining quality indicators in accordance with standards of care and industry benchmarks.
His business development skills include project management, policy and procedure development, quality improvement, team building, operations management, wellness program planning, implementation and program evaluation. He also provides specialized program development for research study design, data management and health intelligence.
Ashley holds a doctorate in nursing science, with a minor in health behavior, from the University of Florida and a bachelor and master’s degree in nursing from Jacksonville University.
Lynne Pennypacker provides research and development services, including Internet research, software development/design/testing/implementation, data analysis and reporting, data maps, system documentation, procedure development, and proofreading.
She has more than 25 years, beginning as a computer programmer. She worked for national companies such as Automated Financial Systems, a software company that provides banking systems to the top banks in the United States, and U.S. Preventive Medicine, where she performed competitive research and helped develop support tasks its innovative online preventive health product.
Lynne holds a bachelor’s degree from The Pennsylvania State University with an English minor, and a Certificate in Computer Systems from The State University of New York - Purchase.
Carmen Winters has more than two decades of experience in the areas of Medicare, Medicaid and CMS compliance, which has enabled her to assist organizations from start up through implementation of new regulatory requirements. This experience includes compliance activities related to Medicare Advantage and Prescription Drug plans, with targeted focus on both Chronic and Dual Eligible Special Needs plans. She has provided oversight of all functional areas within health plan systems – including plans with more than 500,000 covered lives — to ensure that they are accurate, compliant and efficient. Recently she has stepped into acting Chief Compliance Officer roles and various leadership roles in the operational functional areas to assist organizations in transition.
Her expertise includes compliance effectiveness audits, remediation and training; data validation; policies and procedures; corporate liaison with government agencies; grievances and appeals; Enrollment, Low Income Subsidy and Late Enrollment Penalty reconciliations; Sales and Marketing compliance; HIPAA privacy and security; and NCQA accreditation.
Carmen earned a master’s degree in organizational management from the University of Phoenix and a bachelor’s in communication/public relations from the University of Tennessee at Chattanooga.
She has numerous certifications, which include AHIP Health Care Anti-Fraud Associate certification; Professional, Health Insurance Advanced Studies (PHIAS) certification; and AHLA/HCCA Fraud and Compliance certification.
Shannon Paulin and Julie Esbjorn
Shannon Paulin and Julie Esbjorn have work closely together for more than 15 years to create highly polished graphic design solutions that not only are compelling, but also meet their clients’ branding and business goals. Their partnership allows them to offer client services that are timely and cost-efficient, from concept to completion. Shannon and Julie’s client base includes large and small businesses, universities and government agencies, with a special focus on health care design.
For more than a decade, Jeff has led a team of experienced technology professionals who partner with Star Health Management to create digital marketing programs, websites and an online presence that help our clients meet their strategic business goals. Optimal results are always the end goal when Jeff and his team begin the process to understand which technology, media channels and creative strategies will work best for each client. Jeff and his team have honed their specialties to include:
He holds a degree in computer science engineering from the University of North Florida.
Leah Nelms, MBA
Health care executive Leah Nelms has an in-depth understanding of the health care arena due to 25 years of experience in hospital administration, commercial insurance, Medicaid, Medicare, practice management, and academic medicine. She has played an integral role in six startup companies and new product line implementations as well as spent a decade in managed care. Her primary expertise includes contracting with payers and large health systems to increase the scope of services as well as increasing revenue based upon best practices in managed care and health care administration techniques.
Leah has help lead several regional and national organizations, including serving as the Administrator for the surgical business unit University of Florida Health ($450 million annually), Executive Vice President of Operations at HealthScreen America, Senior Director of Family First Health Care for the University of Chicago Health System, and Regional Manager for HealthCare USA.
Leah holds an MBA with a concentration in health care and is a certified online health care administration faculty member. In addition, she is a published author in academic journals, an inventor and an invited speaker.
From ANOC and open enrollment to ongoing strategic planning, the Command Direct team is plugged in to the challenging deadlines that health plans face. Sensitive healthcare communication requires careful management and execution. Command’s technology, equipment and personnel are completely dedicated to solving problems and streamlining processes. Just as important, their team understands HIPAA compliance and follows strict guidelines to ensure that PHI is always kept secure. Their services include:
A privately held company, Command has 45 employees, located in Hauppauge, NY and Charlotte, NC. The complete focus of their business is on providing unique printing, mailing and dedicated solutions to the managed care industry. Command has extensive equipment to efficiently handle both on-demand (digital) and long run (offset) requirements.
For nearly three decades, Gayle Gallagher has developed and overseen advertising and marketing campaigns for internal and external audiences. She is keenly attuned to both the marketer’s mission and the end user’s experience, which results in sturdier bridges between company and customer. Her clients include universities, financial institutions, data infrastructure firms, government agencies, and the automotive industry.
Gayle holds a bachelor’s degree in literature from the University of North Florida, and has been accredited since 1995 through the International Association of Business Communicators.