Payer-Provider Collaboration: Interoperability for Streamlined Administrative Operations | Kisaco Research

This session will bring together payers and providers to discuss the challenges and opportunities presented by healthcare mandates and electronic medical record systems. Participants will explore strategies for effective collaboration to improve patient care and reduce administrative burdens.

Session Topics: 
Payment Integrity
Sponsor(s): 
AMS Intelligent Analytics
Speaker(s): 

Author:

Novelette Wallace, MPH, PMP, CSSBB

Head of Payment Integrity
Johns Hopkins Healthcare

Novelette Wallace is a distinguished Payment Integrity Leader with a rich background spanning over 30 years in the healthcare industry. Her extensive experience includes leadership roles within payment integrity, where she has played pivotal roles in both payment integrity vendor organizations and health plans. Throughout her career, Novelette has demonstrated a remarkable ability to build and lead Payment Integrity departments from their inception. Her expertise has been instrumental in establishing robust processes and strategies to identify and recover inaccuracies in claims, contributing significantly to cost of care savings for health plans year after year.

Novelette has held key leadership positions with industry-leading organizations, including Performant Corp, United Healthcare, and Aetna (previously Coventry). In each role, she has consistently delivered results by optimizing payment integrity processes and driving operational excellence. Currently serving as the Assistant Vice President (AVP) of Payment Integrity for Johns Hopkins Health Plans, Novelette continues to bring her wealth of knowledge and leadership acumen to the forefront. Her dedication to achieving and surpassing cost of care savings goals exemplifies her commitment to advancing the financial health and efficiency of healthcare organizations.

With a proven track record of success and a comprehensive understanding of payment integrity within the healthcare landscape, Novelette Wallace stands as a respected leader in the industry, contributing significantly to the success of the organizations she serve

Novelette Wallace, MPH, PMP, CSSBB

Head of Payment Integrity
Johns Hopkins Healthcare

Novelette Wallace is a distinguished Payment Integrity Leader with a rich background spanning over 30 years in the healthcare industry. Her extensive experience includes leadership roles within payment integrity, where she has played pivotal roles in both payment integrity vendor organizations and health plans. Throughout her career, Novelette has demonstrated a remarkable ability to build and lead Payment Integrity departments from their inception. Her expertise has been instrumental in establishing robust processes and strategies to identify and recover inaccuracies in claims, contributing significantly to cost of care savings for health plans year after year.

Novelette has held key leadership positions with industry-leading organizations, including Performant Corp, United Healthcare, and Aetna (previously Coventry). In each role, she has consistently delivered results by optimizing payment integrity processes and driving operational excellence. Currently serving as the Assistant Vice President (AVP) of Payment Integrity for Johns Hopkins Health Plans, Novelette continues to bring her wealth of knowledge and leadership acumen to the forefront. Her dedication to achieving and surpassing cost of care savings goals exemplifies her commitment to advancing the financial health and efficiency of healthcare organizations.

With a proven track record of success and a comprehensive understanding of payment integrity within the healthcare landscape, Novelette Wallace stands as a respected leader in the industry, contributing significantly to the success of the organizations she serve

Author:

Dave Cardelle

Chief Strategy Officer
AMS

Dave Cardelle

Chief Strategy Officer
AMS

Author:

Sandy Giangreco Brown

VP, Revenue Integrity & Education
Spire Orthopedic Partners

Sandy Giangreco Brown

VP, Revenue Integrity & Education
Spire Orthopedic Partners

Author:

Donna Malone

Director Risk Capture, Population Health Management
Mass General Brigham

Donna Malone

Director Risk Capture, Population Health Management
Mass General Brigham

Author:

Corella Lumpkins

Manager of Coding, Compliance and Provider Education
Loudoun Medical Group P.C.

Corella Lumpkins is the Manager of Coding, Compliance & Provider Education at Loudoun Medical Group (LMG) - one of the largest and most diverse physician-owned, multi-specialty Accountable Care Organizations in Northern Virginia/DC suburbs. As a subject matter expert, Corella has over 35 years of experience working in every area of the healthcare revenue cycle. Corella holds a bachelor’s degree and eleven certifications with an extensive background in auditing, billing, coding, implementing corporate compliance programs, CDI, education, denial and practice management. Prior to joining LMG, Corella has held leadership roles at Lifebridge, Medstar, Johns Hopkins and the University of Maryland health systems.

Corella is an author, adjunct faculty member and national speaker currently serving on both the AAPC National Advisory Board and Association of Clinical Documentation Integrity Specialists (ACDIS) Leadership Council. Corella works closely with providers in navigating patient-centric value-based care. 

Corella Lumpkins

Manager of Coding, Compliance and Provider Education
Loudoun Medical Group P.C.

Corella Lumpkins is the Manager of Coding, Compliance & Provider Education at Loudoun Medical Group (LMG) - one of the largest and most diverse physician-owned, multi-specialty Accountable Care Organizations in Northern Virginia/DC suburbs. As a subject matter expert, Corella has over 35 years of experience working in every area of the healthcare revenue cycle. Corella holds a bachelor’s degree and eleven certifications with an extensive background in auditing, billing, coding, implementing corporate compliance programs, CDI, education, denial and practice management. Prior to joining LMG, Corella has held leadership roles at Lifebridge, Medstar, Johns Hopkins and the University of Maryland health systems.

Corella is an author, adjunct faculty member and national speaker currently serving on both the AAPC National Advisory Board and Association of Clinical Documentation Integrity Specialists (ACDIS) Leadership Council. Corella works closely with providers in navigating patient-centric value-based care.