The management of Medical Advantage is a diverse team of industry professionals. Each is dedicated to developing strategies as healthcare consultants that are quality-focused as well as value-driven to achieve client healthcare goals.
The management of Medical Advantage is a diverse team of industry professionals. Each is dedicated to developing strategies as healthcare consultants that are quality-focused as well as value-driven to achieve client healthcare goals.
Paul MacLellan is an industry leader in health care quality improvement, value-based contracting, and population health management. He has a deep understanding of how to successfully integrate technology with process improvement methodology to drive positive health care delivery system outcomes, helping solve the many health care business challenges health plans and delivery systems face today.
As president of Medical Advantage, Mr. MacLellan expanded the company into new markets and doubled revenue while generating millions in value-based care incentives for physicians. Through his leadership, Medical Advantage is now a nationally recognized health care solutions company serving health plans, health systems, physician groups and practices.
Before joining Medical Advantage, Mr. MacLellan was a director at Blue Cross Blue Shield of Michigan (BCBSM) where he was responsible for leading IT and analytics for the Value Partnerships and the Chief Medical Officer. In this role, he was a key architect in the development of the first fully integrated data solution to support clinical analytics and reporting at BCBSM and provided the platform for its nationally acclaimed Physician Group Incentive Program and Patient-Centered Medical Home initiative. He also created a process for the National Committee for Quality Assurance HEDIS accreditation of a 2.2 million-member PPO health plan.
Mr. MacLellan’s experience also includes the launch of two start-up companies, Route One LLC, where he managed an indirect lending product for automotive finance, and RealAge, Inc., where he developed a web-based health risk appraisal system.
Mr. MacLellan holds a Bachelor of Mathematics degree from the University of Waterloo, Ontario Canada.
A board-certified family physician with a proven medical management track-record, Robert J. Jackson, MD, MMM, medical director, is a leader in the development of physician organizations that achieve high-quality, cost-effective health care. With more than 30 years of experience in successful practice expansion, technology adaptation and quality improvement, Dr. Jackson has provided essential clinical insights for Medical Advantage physician organization management services as well as mentorship to physician leaders. His broad organizational knowledge and communication skills have helped Medical Advantage become one of the largest managers of physician organizations participating in Blue Cross Blue Shield of Michigan (BCBSM) incentive programs.
Earlier in his career, Dr. Jackson was pivotal in the creation of the Accountable Healthcare Alliance (AHA), resulting in high levels of care quality and patient satisfaction, as well as benchmark levels for cost and utilization. He currently serves as AHA’s president and medical director. Dr. Jackson also helped organize the Wyandotte Hospital Physicians Independent Physician Association (IPA) and the Oakwood Primary Care Physicians IPA. As chairman of the Southeastern Michigan Health Information Exchange, he also has been instrumental in securing two federal grants totaling more than $18 million. While working in his own primary care practice, he led the group through BCBSM Patient-Centered Medical Home certification, Michigan Primary Care Transformation project, Comprehensive Primary Care Plus Track 2 initiative, implementation of electronic health records, and numerous other quality improvements resulting in maximum health plan quality bonuses.
Dr. Jackson is currently chairman of the Michigan Academy of Family Practice and served as President in 2017. He is also a frequent speaker at state and national conferences. He received a medical degree from Wayne State University School of Medicine and completed his family practice residency at Oakwood Hospital. He also holds a Master of Medical Management degree from the H. John Heinz School of Public Policy and Management from Carnegie Mellon University.
Vice President, In-Practice Technology Services
Chad Anguilm has over a decade of experience developing and implementing innovative and sustainable health care technology solutions for health care providers. As vice president of In-Practice Technology Services at Medical Advantage, Mr. Anguilm leads strategic partnerships with national technology firms, plans and executes large, multi-faceted migration projects, and ensures delivery of proactive and meticulous professional consulting services. An accomplished strategic advisor, he partners with health system and medical practice clients to design technology solutions that maximize clinical and financial outcomes in value-based care contracting (federal, state, and commercial) and expertly gains stakeholder acceptance throughout the organization. Mr. Anguilm brings deep expertise in practice operations, EHRs, clinical workflow redesign, value-based care programs, HIPAA, and interoperability to every client engagement.
Mr. Anguilm also leads Medical Advantage’s electronic health record (EHR) implementation team, MACRA consulting services, and provides vital practice consultation to optimize systems. With a unique combination of technical and interpersonal skills, Mr. Anguilm effectively leads his team to analyze practice processes from the inside out to provide the most optimized technology solutions that enhance practice operations, reimbursement, and patient care.
Prior to joining Medical Advantage, Mr. Anguilm was instrumental in launching Health Care Management, a EMR professional services company, where he served as vice president of Professional Services. He also served as a workflow consultant at Kraft Business Systems. Mr. Anguilm currently participates on the physician burnout committee and the Medicare Access and CHIP Reauthorization Act (MACRA) task force for The Doctors Company. He is a frequent speaker at state conferences on MACRA and EHR optimization and holds multiple advanced EMR certifications. Mr. Anguilm is an emerging influencer in AI and is an expert in voice-recognition software implementation. Mr. Anguilm holds a Master of Business Administration – Strategic Management degree from Davenport University, Grand Rapids, Michigan.
Vice President, Population Health, Strategy and Solutions
Dr. Darline El Reda is a public health epidemiologist with 20 years of experience in a variety of public health settings, academia, and the health insurance industry. She is an expert in administrative claims data analysis, working with information technology partners to build data marts for use by health care analysts, and development of strategies and solutions to advance population health and value-based care solutions.
As vice president of Population Health, Strategy and Solutions at Medical Advantage, Dr. El Reda leads a team of data scientists, health informaticists, and health care consultants in the analysis of clinical, payer, and contract data to advise clients on strategies aimed at maximizing provider performance in value-based care arrangements. Once client-specific solutions are designed, she leads a team of multi-disciplinary practice transformation specialists who work directly with payers and providers, inside physician practices, to help them achieving quality and efficiency targets.
Before joining Medical Advantage, Dr. El Reda held a variety of roles in public health, including at the Centers for Disease Control, the Michigan Department of Community Health, Michigan State University, and Blue Cross Blue Shield of Michigan (BCBSM). At BCBSM, Dr. El Reda served as the lead data scientist providing oversight to a multidisciplinary team of 70 epidemiologists, biostatisticians, and medical informatics analysts for approximately eight years. These teams were responsible for the development, implementation, and support of the health plan’s analytic offerings for the nationally recognized Value Partnerships Physician Group Incentive Program and the nation’s largest Patient-Centered Medical Home (PCMH) program.
Dr. El Reda is published in peer-reviewed literature on many topics, such as obesity, PCMH, disease management, preventive care, and infectious diseases.
Dr. El Reda holds a Doctorate in Public Health with a focus on epidemiology, biostatistics, and program evaluation from the University of Texas Health Science Center at Houston, Houston, Texas.
Vice President, Operations
Mr. Laidlaw’s business expertise is the foundation of Medical Advantage’s high-quality client services as well as company growth. He understands the critical role of informational technology in achieving cost-effective processes and services. An expert in technology implementation, Mr. Laidlaw is adept at managing cross-functional teams that develop and use software to achieve challenging market and organizational goals. Prior to joining Medical Advantage, Mr. Laidlaw was a senior manager at Blue Cross Blue Shield of Michigan (BSBSM). At BCBSM he managed a $12 million annual budget and the design, development and implementation of analytical and reporting platforms for a large-scale, pay-for-performance program and statewide patient-centered medical home project which included a data center for member and patient populations that processed millions of member records and claims per month.
Director, Information Technology
A proven technology leader with more than 15 years of experience in developing innovative infrastructure and application designs, effective system implementation, and support of technology and process-related solutions, Ben Bawcum serves as the director of IT at Medical Advantage. Using his extensive background in building new products and solutions as well as optimizing and strengthening existing processes and systems, he provides unsurpassed IT support to Medical Advantage and its clients.
Since joining Medical Advantage, Mr. Bawcum has transformed the company’s IT offerings by adopting highly secure and scalable cloud technologies and creating a highly mobile workforce. This includes creation of a health management technology platform used by Medical Advantage data scientists in support of client needs.
Mr. Bawcum’s areas of expertise include system architecture, optimization, integration, monitoring and analysis, infrastructure design, product management, system integration, performance metrics, engineering, administration, and project management.
Throughout his career, Mr. Bawcum has helped organizations and clients maximize their operational efficiency and performance through implementation of strategic technological solutions and support. Before joining Medical Advantage, he worked as a technology consultant for Blue Cross Blue Shield of Michigan where he helped design the architecture and technology needs of the organization and established strategies consistent with business goals and economic viability. He also has provided technical guidance to clients and internal IT staff in the design and development of fully integrated technology solutions. In addition to this role, he has served as a contracting product development manager, project manager and configuration engineer for RouteOne LLC, an international automotive financing company.
Mr. Bawcum holds a Bachelor of Information Technology degree from Lawrence Technological University, Southfield, Michigan.
Dan Crowley is a proven financial management leader with over 30 years of experience working in multiple healthcare settings, representing both providers and payers. He brings expertise in financial reporting and analysis, budgeting, provider contracting, network development, and value-based reimbursement. He currently serves as the Director of Finance for Medical Advantage, responsible for driving the organization’s financial management strategies and optimizing overall financial performance. He also manages all accounting and financial functions for the organization.
Mr. Crowley joined Medical Advantage in 2008 as a Senior Consultant. In that role, he was responsible for management and oversight of Beaumont PO, a multi-specialty physician organization representing over 2,000 physicians. He worked directly with the Beaumont PO’s Board of Directors on issues related to financial and strategic planning, health plan contracting, and operational activities. He also served as the Manager of Finance for Medical Advantage from 2012 to 2018.
Prior to joining Medical Advantage, Mr. Crowley held management positions with several local health care organizations, including Trinity Health, the University of Michigan Health Systems/M-CARE HMO, United Healthcare, and Botsford Hospital (now Beaumont Health).
He holds a master’s degree in business administration from the University of Detroit-Mercy and a bachelor’s degree in accounting from Madonna University. He also has a certification in Lean Healthcare from the University of Michigan College of Engineering./
Director, Healthcare Transformation
A highly effective health care manager with more than 25 years of experience working with providers and insurers, Michael Grodus, director of health care transformation at Medical Advantage, provides management services and performance improvement guidance for its client, Professional Medical Corporation. Under Mr. Grodus’s leadership, Professional Medical Corporation has earned tens of millions in value-based reimbursement for providers and the ACO is among the top in the nation for quality and cost savings. An expert in provider network development, reimbursement methods and contracting, as well as financial administration of physician organizations, hospitals and managed care entities, Mr. Grodus skillfully guides physician organizations toward more cost-effective care and reimbursement strategies that lead to value-based health care delivery.
Prior to joining Medical Advantage, he was vice president of health care network strategy for the Capital District Physician Health Plan in Albany, New York, where he was responsible for provider network strategy and development, service area expansion, reimbursement and cost savings, as well as negotiating and contracting with a provider network of more than 70 hospitals, 14,000 physicians and ancillary providers. Mr. Grodus has also served as director of network development and contracting for Priority Health and previously held a similar position with M-Care. He also was controller and subsequently chief financial officer of Oakland Physician Network Services, where he established and maintained the financial services department. He also held management positions at the Detroit Medical Center for seven years, serving as director of finance for Children’s Hospital of Michigan and as manager of finance for DMC Coordinated Health Care, the DMC’s managed care contracting entity, and three affiliated independent physician associations.
Mr. Grodus received a bachelor of science degree in administration from the University of Michigan-Dearborn and a master’s in business administration from Wayne State University.
Director, EHR Optimization
With more than 25 years of healthcare experience, Angie Howard, Medical Advantage’s Director of EHR Implementation and Optimization, brings an extensive understanding what it takes to successfully install, enhance, and continually refine EHRs and their related in-practice workflows.
Since joining Medical Advantage in 2015, Howard has led and grown an EHR implementation and optimization team responsible for the installation of hundreds of EHR systems in all 50 states as well as Puerto Rico. Underneath her leadership, this team established an optimization program to help reduce provider burnout, created multiple quality consulting service lines, and successfully transitioned several large EHR systems from one software platform to another. Howard has been an integral part of expanding Medical Advantage’s EHR service offerings to include not only implementation, but also revenue cycle management optimization, the addition of payer-incentive programs, and overall workflow redesign.
Howard’s career has spanned a variety of roles within healthcare, including project management, medical practice development, marketing, and her current role as Director of EHR Implementation and Optimization. Her background includes management and analyst positions at Beaumont Health, Ascension Health, and Henry Ford Health System. Howard is a graduate of Wayne State University and holds a Bachelor of Science degree, as well as several EHR & Practice Management certifications.
Director, Healthcare Transformation and CIPA
Linda Mackensen is a registered nurse with more than 37 years’ experience working in the health care industry in both administrative and clinical settings. As the director of the Consortium of Independent Physician Association (CIPA) Healthcare Transformation, she leads statewide efforts to strengthen more than 1,000 physicians’ overall performance in quality, cost of care and utilization management. A respected leader, Ms. Mackensen works to enhance physician pay-for-performance outcomes through her extensive knowledge of the Patient-Centered Medical Home (PCMH) and the PCMH-Neighbor (PCMH-N) models of care. From 2006 – 2011, she was responsible for the implementation of one of the largest PCMH programs in the country with the Blue Cross Blue Shield of Michigan (BCBSM) PCMH designation program.
Known for her ability to develop highly-effective clinical teams to maximize practice transformation activities, Ms. Mackensen’s career has encompassed leadership roles in utilization management, provider relations, hospital and physician contracting, quality improvement, and physician incentive programs. She previously worked with various hospital systems in New York, California, Chicago, and Michigan. She also has worked with a variety of health plans including Humana Health Care Chicago, Blue Care Network, and BCBSM. She was also director of practice transformation for PCMH and PCMH-N programs at The Physician Alliance, a 2,200 member physician organization.
Ms. Mackensen holds associate’s degrees in liberal arts and nursing from Tompkins Cortland Community College in Dryden, New York, and a bachelor’s degree in health care administration from Concordia University in Ann Arbor, Michigan.
Director, Sales & Marketing
Bill Riley, Medical Advantage’s Director of Sales & Marketing, brings over three decades of experience in sales, revenue growth, and go-to-market strategy to his current role, where he spearheads Medical Advantage’s dynamic and ever-evolving sales and marketing efforts. His leadership in the growth and administration of service portfolios, as well as the inclusion and engagement of distribution channel management, has been instrumental in driving Medical Advantage’s geographic expansion within and beyond Michigan’s borders.
Since joining Medical Advantage, Riley has overseen the creation and expansion of the marketing team. Alongside his strengths of lead generation, team building, product marketing and communication, Riley has extensive career experience in IT and telecommunications, and excels at marketing high technology products.
Prior to joining Medical Advantage, Riley held positions at AT&T, Stefanini, and TechTeam Global, where he served in roles spanning marketing, sales and leadership capacities. Riley holds a bachelor's degree in Mathematics from Michigan State University.
Director, Care Management
Meghan Sheridan is a registered dietician and expert in population health management, evidence-based guidelines, and value-based care. She currently serves as the Care Management Director at Medical Advantage, where she oversees the development, implementation, and evaluation of care management programs. She is responsible for building high-performing care management teams to work collaboratively with providers. She also lends her analytic expertise to design interventions that drive success in value-based arrangements.
Ms. Sheridan joined Medical Advantage in 2015 as a MiPCT Project Manager/Consultant where she worked directly with physician organizations to implement the Michigan Primary Care Transformation Project, the nation's largest multi-payer Patient Centered Medical Home demonstration. Her efforts helped position Michigan as the most successful state in the program, achieving the greatest reduction in Medicare expenditures, improved care coordination, team communication, attention to mental health, self-management support, and medication reconciliation. She also worked as a Population Health Manager, developing and overseeing population health programs using evidenced-based guidelines and best practices. Her programs have proven to consistency drive reductions in utilization and cost while improving the quality of care.
Prior to joining Medical Advantage, she worked as a registered dietician in the Women, Infants, and Children program at Jackson County Health Department, where she counseled high-risk clients. She also worked as a dietician for the Kulana Hawaii Weight Management Program, a free weight management program offered to native Hawaiians.
Ms. Sheridan holds a bachelor’s degree in dietetics from Michigan State University in East Lansing, Michigan.
James Stephens brings 20 years of experience in information technology including 10 years in health care IT focusing on population health to his role as director of Informatics for Medical Advantage. In this position, he facilitates the development of tools and processes to enable communication of information and publication of analytic insights. He leads a team responsible for development and maintenance of a data warehouse, including developing functional requirements, testing implementations and managing the intake of data.
As a strategic analytical thinker with strong communication skills, Mr. Stephens’ expertise includes database and applied theory in a variety of systems and businesses, project design and development, SQL Server and Oracle databases, among other systems.
Before joining Medical Advantage, Mr. Stephens led the development and maintenance of a 20+ TB data mart for Blue Cross Blue Shield of Michigan (BCBSM), which supported population health analytics and reporting, including claims, provider, membership, and clinically derived data for more than 4 million members.
While at BCBSM, he reduced monthly efforts 60 percent by developing improved reporting processes for a variety of pay-for-performance programs. His department also produced provider, member and customer-facing analytics and reporting for a variety of population health and value-based reimbursement programs. His strategic planning, data management and reporting supported company trend analyses, predictive model development and other advanced analytics including HEDIS and CMS STAR ratings.
Mr. Stephens holds a Bachelor of Science degree in chemistry from the University of Michigan, Dearborn, Michigan.
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