Meet the Board of Directors
Brian Pieninck
President and CEO
CareFirst BlueCross BlueShield
Brian Pieninck
President and CEO
CareFirst BlueCross BlueShield
Brian D. Pieninck is the President and Chief Executive Officer (CEO) of CareFirst BlueCross BlueShield, a leading multi-line, not-for-profit healthcare company offering a comprehensive portfolio of health insurance products through its affiliates and subsidiaries and administrative services to 3.5 million individuals and employers in Maryland, the District of Columbia, and Northern Virginia.
Brian joined CareFirst BlueCross BlueShield in April 2015 as Executive Vice President of the Large Group Strategic Business Unit. He assumed the role of Chief Operating Officer in May 2017 with responsibility for the organization's four Strategic Business Units and Technology & Operational Support Services. In May of 2018, Brian was unanimously selected by the CareFirst Boards to become President and CEO, beginning his leadership of the company on July 1, 2018.
Prior to joining CareFirst, Brian was a member of Aetna Inc.'s executive team, where he held key leadership positions during a 19-year tenure, including Director of Professional Employer Organizations, President of Southeast National Accounts, and President of the Americas for Aetna International.
Brian serves on the Boards of the Blue Cross Blue Shield Association, Federal Employee Program Board of Managers, Greater Baltimore Committee, Baltimore’s Promise, BCS Financial Corporation, Greater Washington Partnership, Synergie Medication Collective, and the Greater Washington Board of Trade. Additionally, Brian is the Chairman of the Board for the Council for Affordable Quality Healthcare (CAQH), and the Board of Trusted Health Plans, Inc., Trusted Health Plan (District of Columbia), Inc., and CareFirst Community Health Plan (Maryland).
Brian holds a Bachelor of Science in Business Studies Business Administration from Southern New Hampshire University, and is a graduate of Leadership Maryland's Class of 2016. A native of Southeastern Pennsylvania, Brian and his family currently reside in Baltimore County, Maryland.
Tim Kaja
President, Optum Health Networks
UnitedHealth Group
Tim Kaja
President, Optum Health Networks
UnitedHealth Group
Tim has been with UnitedHealth Group and/or affiliated companies for 37 years.
As President of Network, Network Support, and EHR Strategy/Operations for Optum Health, Tim is responsible for the development and execution of Optum Health’s national network contracting operations. This includes Payer and Provider contracting to support risk membership growth across all lines of business and products. In addition, Tim is responsible for developing and executing the next generation of Optum Health’s EHR and digital adoption strategy across Optum’s clinics and operations.
Prior to his role at Optum Health, Tim was SVP and Chief Operating Officer of UnitedHealthcare Networks. He was responsible for managing and developing contract management and fee schedule development systems, workflows, interoperability and operations used by network contractors and network care providers when doing business with UHC.
Preceding his role with UHC Networks, Tim developed physician and hospital service operations throughout UnitedHealthcare, including global operations to support provider contract installation, demographic maintenance, and directories across UnitedHealthcare growing the team to over 6,000 employees worldwide. Tim led the charge for both 5010 and ICD10 deployments and other Affordable Care Act Administrative transaction requirements for UnitedHealth Group while promoting the principles of administrative simplification and interoperability that is critical to healthcare reform.
Previous roles include: Development of UHC's national provider portal, the development and build out of the current local provider relations teams across all US markets, the development and build out of the Corporate Network Operations organization within UnitedHealthcare which brought together contract installation, physician demographics, reimbursement policy development/implementation and coding protocols, credentialing, and claim repricing operations. Tim was responsible for the initial development and build of Audit and Recovery Operations, Claim Cost Management, Fraud and Abuse, COB Operations, and other Payment Integrity Operations (that are now part of Optum Insight).
Tim began his career as a Claim Examiner with AARP Operations in Milwaukee, WI in 1985.
He has an MBA and a BS from the University of Wisconsin-Milwaukee.
Tim and his wife, Lilly, currently live in Naples, FL. They enjoy traveling, running, and spending time with their four grown children.
Mark Barnard
EVP, Government Programs & Operations
Horizon Blue Cross Blue Shield of New Jersey
Mark Barnard
EVP, Government Programs & Operations
Horizon Blue Cross Blue Shield of New Jersey
In his role as Executive Vice President Government Programs (GP) and Operations, Mr. Barnard is responsible for a wide range of operations across the Company, including Service Operations, and Mandates.
Mr. Barnard also leads the Government Programs business unit, and in that role has end-to-end responsibility and full accountability for P&L (profit and loss) performance related to the Government Programs market segments, including Medicare Advantage, Medicare Supplemental (Medigap), Medicaid, Dual Special Needs Plans (DSNP), and Managed Long-Term Services and Support (MLTSS).
Prior to Mark joining Horizon BCBSNJ in 2006, Mr. Barnard was the President and Chief Executive Officer of the National Account Service Company (NASCO), an Atlanta-based IT infrastructure provider for Blue Cross and Blue Shield Plans nationwide. Mr. Barnard spent six years at NASCO in roles of increasing responsibility, and 16 years with Electronic Data Systems (EDS) where he was ultimately responsible for overseeing all EDS operations for various Blue Cross and Blue Shield Plans across the country. In addition, as Vice President at The MEDSTAT® Group, Mr. Barnard had responsibility for Client Services and Product Development.
Raised in northern Michigan, Mr. Barnard earned a bachelor's degree in Mathematics Education from Michigan State University. Prior to his career in health care, Mr. Barnard taught mathematics at the high school level and coached wrestling. Active in community affairs, Mr. Barnard serves on the board of directors of several non-profit groups and is a volunteer for Habitat for Humanity and the Boy Scouts of America, both nationally and internationally.
Rob J. Alger
SVP, Information Technology Strategy
Kaiser Permanente
Rob J. Alger
SVP, Information Technology Strategy
Kaiser Permanente
Rob Alger is senior vice president, Health Plan Business Technology Solutions and Services for Kaiser Foundation Health Plan, Inc.
In this role, he works closely with Health Plan Marketing, Sales, Service Administration business leaders, project teams and Kaiser Permanente Information Technology (KP IT) to support the Health Plan’s investments in information technology, including ensuring the effective operation of the Health Plan Information Technology Portfolio Approval Council and the continuous revision and relevancy of the Health Plan IT multi-year plan. He leads a team of professionals involved in program and project management, business architecture, governance, and the development and delivery of specific Health Plan capabilities including Kaiser’s implementation of ICD-10. Alger was appointed to this position in 2007.
Before joining Kaiser Permanente, Alger was chief technology officer at Skylight Systems, a start-up providing infrastructure and leading applications to hospitals in support of bedside offerings for hospitality services and administrative applications. From 1995-2001, he served as president, Advanced Health Technologies (AHT), a leading provider of clinical e-commerce solutions for laboratory results and prescription management, and senior vice president, Operations Technology, Cybear, which acquired AHT in 2000. Prior to AHT, Alger was chief information officer, Blue Shield of California, and partner, Scribner, Jackson Assoc., a boutique information technology strategy practice focused on high performance infrastructure and networking. Alger also chaired the National Health Foundation's Health Data Interchange project for its first two years in California.
Marc Barclay
SVP, Provider Network Management
Blue Cross Blue Shield of Tennessee
Marc Barclay
SVP, Provider Network Management
Blue Cross Blue Shield of Tennessee
Marc Barclay is the senior vice president of provider network management at BlueCross BlueShield of Tennessee, which has more than 6,000 employees and serves 3.4 million members in the state and across the country.
Barclay is responsible for all aspects of the company’s provider networks, including contract negotiations with hospitals, facilities, and provider groups. He also oversees ancillary services, provider reimbursement, provider operations, and administrative and support services.
Barclay has more than 25 years of experience in the health care industry and has been involved in network management for a variety of employers since 1995. Before joining BlueCross, he served as senior director of regional network management at CENTENE Corporation where he was responsible for building provider networks in new expansion markets and negotiating complex provider contracts nationally. Barclay also served as director of network management for United Healthcare of Tennessee and director of provider contracting at Humana.
An active member of his community, Barclay currently serves on the board of trustees at Skyuka Hall, which serves the needs of Chattanooga area K-12 students with learning disabilities. He also recently served on the board of Signal Centers, a community non-profit whose mission is to strengthen children, adults, and families through services focusing on disabilities and early childhood education. Barclay previously served on boards for Tennessee Charitable Care Network in Chattanooga, TN., Mending Hearts in Nashville, TN., and Institute of Family Medicine in St. Louis, MO.
Barclay earned a Bachelor of Business Administration from Belmont University and a Master of Health Services Administration from the University of Saint Francis.
Kristen Bolam
Director, IT Operations & EDI Support
Aultcare
Kristen Bolam
Director, IT Operations & EDI Support
Aultcare
Kristen Bolam has worked for AultCare for 24 years in various roles. Currently, she oversees several departments within AultCare such as EDI, IT Development, and Operations. Kristen’s background is in Customer Service and Claims for self-funded and fully insured plans. She is currently working on her bachelor’s degree in healthcare management.
Jessica Conley
Vice President, Provider Experience
Aetna
Jessica Conley
Vice President, Provider Experience
Aetna
Jessica Conley serves as the Vice President of Provider Experience, Interoperability, Digital Solutions, and Operations at Aetna, a CVS Health company. Her responsibilities include setting the vision, strategy, and culture to evolve the enterprise focus on Provider Experience, Provider Data Governance, and Interoperability in addition to delivering operational performance across digital assets and provider operations, including credentialing, provider data loading, provider portal, electronic data interchange, and fraud, waste and abuse for all lines of business.
Jessica has a longstanding career in various health care leadership roles in provider, consumer, and client experience, network management, product strategy, and data analytics. Her experience spans Commercial, Medicare, Medicaid, and Individual and Family lines of business, with deep expertise in behavioral health.
Paul Eisenstat
Chief Network Officer
Elevance
Paul Eisenstat
Chief Network Officer
Elevance
Paul Eisenstat is the Chief Network Officer for Elevance Health, where he is accountable for overall network and care transformation strategy with a strong focus on enabling and engaging providers in value-based outcomes, optimizing the company’s high-performing provider approach, reinventing payment models, and advancing high-quality, affordable care. Previously, Paul served as the Vice President of Network for Elevance Health’s East Region where he was responsible for developing, leading, and overseeing the implementation of provider solutions strategies in the East Region markets.
Before joining Elevance Health, Paul was the Senior Vice President, Health Care and Network Management, for Excellus Blue Cross Blue Shield, where he led efforts to achieve cost control and quality improvement, collaborating on the development of more sustainable, patient-centered health care delivery. Prior to this role, Paul served as the Chief Operating Officer of PersonalCare Insurance of Illinois at Coventry Health Care, Inc.; Vice President, Network Management at United Healthcare; Director, Eastern Massachusetts Provider Contracting at Blue Cross Blue Shield of Massachusetts; and Senior Policy Analyst at the Massachusetts Division of Health Care Finance and Policy.
Paul holds a baccalaureate degree from Tufts University in Biology and English, and a master's degree from Harvard University in Health Care Policy and Management.
James Grant
SVP and Chief Medical Officer
Blue Cross Blue Shield of Michigan
James Grant
SVP and Chief Medical Officer
Blue Cross Blue Shield of Michigan
James D. Grant, M.D., M.B.A., FASA, is the Senior Vice President and Chief Medical Officer of Blue Cross Blue Shield of Michigan.
Prior to his arrival, Dr. Grant was the chair of the department of anesthesiology and physician executive of perioperative services at Cedars-Sinai Medical Center in Los Angeles. Before moving to California, Dr. Grant was professor and chair of anesthesiology at Oakland University William Beaumont School of Medicine, chair of the department of anesthesiology at Beaumont Health – Royal Oak Campus.
Dr. Grant was elected the 2018 president of the American Society of Anesthesiologists (ASA). Prior to his elevation to the presidency, he served as first vice-president, and treasurer and had been on the ASA Administrative Council from 2006-2019. Additionally, he chaired both ASA’s Section on Fiscal Affairs, Committee on Executive Compensation and served as the ASA Advisor to the ASA Relative Value Update Committee (RUC) in addition to countless committees and taskforces at ASA. Dr. Grant has been on the ASA Board of Directors since 1999. He also serves on the Board of Directors of The Anesthesia Foundation and the Foundation for Anesthesia Education and Research and is a senior examiner for the American Board of Anesthesiology.
Dr. Grant currently serves as the chair of the anesthesiology section council to the American Medical Association. Prior to that role, he chaired the Michigan delegation to the AMA.
A past president of both the Michigan State Medical Society (MSMS) and the Michigan Society of Anesthesiologists (MSA), Dr. Grant received the MSA’s President’s Award in 2012 and the MSMS Presidential Citation in 2014. In addition, he served on the Michigan Board of Medicine for seven years, under two different governors, and was elected chair from 2003-2006.
Dr. Grant received his Bachelor of Science degree from Michigan State University in East Lansing, his Doctor of Medicine from Wayne State University in Detroit and his Master of Business Administration from the Indiana University Kelley School of Business in Bloomington, Indiana. He completed his anesthesiology residency at Northwestern University Medical Center in Chicago, where he was chosen as chief resident.
Dr. Grant and his wife, Lisa, a physical medicine and rehabilitation physician, reside in Bloomfield Hills and have two children, Brendan and Alexandra.
James D. Grant, M.D., M.B.A., FASA, is the Senior Vice President and Chief Medical Officer of Blue Cross Blue Shield of Michigan.
Prior to his arrival, Dr. Grant was the chair of the department of anesthesiology and physician executive of perioperative services at Cedars-Sinai Medical Center in Los Angeles. Before moving to California, Dr. Grant was professor and chair of anesthesiology at Oakland University William Beaumont School of Medicine, chair of the department of anesthesiology at Beaumont Health – Royal Oak Campus.
Dr. Grant was elected the 2018 president of the American Society of Anesthesiologists. Prior to his elevation to the presidency, he served as first vice-president, and treasurer and had been on the ASA Administrative Council from 2006-2019. Additionally, he chaired both ASA’s Section on Fiscal Affairs, Committee on Executive Compensation and served as the ASA Advisor to the ASA Relative Value Update Committee (RUC) in addition to countless committees and taskforces at ASA. Dr. Grant has been on the ASA Board of Directors since 1999. He also serves on the Board of Directors of The Anesthesia Foundation and the Foundation for Anesthesia Education and Research and is a senior examiner for the American Board of Anesthesiology.
Dr. Grant currently services as the chair of the anesthesiology section council to the American Medical Association. Prior to that role, he chaired the Michigan delegation to the AMA.
A past president of both the Michigan State Medical Society (MSMS) and the Michigan Society of Anesthesiologists (MSA), Dr. Grant received the MSA’s President’s Award in 2012 and the MSMS Presidential Citation in 2014. In addition, he served on the Michigan Board of Medicine for seven years, under two different Governors, and was elected chair from 2003-2006.
Dr. Grant received his Bachelor of Science degree from Michigan State University in East Lansing, his Doctor of Medicine from Wayne State University in Detroit and his Master of Business Administration from the Indiana University Kelley School of Business in Bloomington, Indiana. He completed his anesthesiology residency at Northwestern University Medical Center in Chicago, where he was chosen as chief resident.
Dr. Grant and his wife, Lisa, a physical medicine and rehabilitation physician, reside in Bloomfield Hills and have two children, Brendan and Alexandra.
Sachin Joshi
Chief Data Analytics & Engineering Officer
CIO US
The Cigna Group
Sachin Joshi
Chief Data Analytics & Engineering Officer
CIO US
The Cigna Group
Sachin has a dual role serving as both the Chief Data Analytics Engineering Officer and Chief Information Officer of U.S. Commercial. As the leader of the Data Analytics Engineering teams, Sachin is responsible for the engineering and governance of Cigna's enterprise data assets, advanced analytics platforms, and reporting solutions. This team has been a catalyst for the use of Big Data, Machine Learning, Generative AI, and Open Source technologies in support of Cigna's Personalization and Affordability strategies.
Sachin recently assumed oversight of U.S. Commercial and is identifying and implementing new innovations and practices into the organization, much like he has already done within Data Analytics Engineering. Sachin is now responsible f0r delivering the capabilities for our growth platforms and products that will make it easy for our clients to manage costs and improve the health and vitality of their employees via a streamlined, integrated technology ecosystem in support of Cigna's growth within the medical, dental, vision stop loss and supplemental business lines. Most recently, Sachin and his teams have been working to establish better engineering excellence standards across organizations, as well as execute an Al enablement strategy to drive a culture of innovation, adaptability, and continuous learning.
Previously as VP of Health Services Technology Solutions, Sachin led the product, planning, and engineering delivery for key business partners representing Evernorth's Health Services for Pharmacy+, PBM, Digital, Client Coverage Benefits Set-up, Enterprise Systems, and Core Platforms Architecture. The team partnered across Health Services and Cigna's enterprise to bring innovative solutions to the marketplace to better service clients, providers, and customers.
Prior to joining Cigna, Sachin was at American Express for 10 years in a variety of roles including Engineering, Solutions Architecture and Corporate Strategy.
Sachin holds a Bachelor of Science in commerce from the University of Virginia and a Master of Business Administration from the University of Michigan.
Oraida Roman
SVP, Value Based Strategies
Humana, Inc.
Oraida Roman
SVP, Value Based Strategies
Humana, Inc.
Oraida Roman, MHA, is the Senior Vice President of Provider Experience at Humana. In this position she is responsible for building, enhancing, and maintaining strategic partnerships with large regional and nationwide healthcare systems and other large value-based provider groups.
The Provider Experience organization develops, supports, and deploys the best programs, practices and capabilities that assist Humana’s provider partners and internal customers to successfully achieve enterprise goals. The Provider team supports the growth of members in value-based arrangements and helps providers progress successfully on this path. This includes the organizational advancement of innovative payment models that enable Humana to support providers as population health managers in value-based care relationships.
Roman’s career with Humana spans more than 23 years, during which time she has held various management roles, including Vice President, Regional President, Director of Operations, and Director of Provider Contracting. Prior to being Vice President for Humana, Roman worked for several years with DaVita Medical Group as the Chief Operating Officer of Florida and Market President of Colorado.
Roman holds a master’s in health administration from the University of South Florida and an undergraduate degree in Biology from Florida State University.
Susan Smith
Chief Operating Officer
Centene Corporation
Susan Smith
Chief Operating Officer
Centene Corporation
Susan serves as Centene’s Chief Operating Officer with responsibility for core business operations, clinical and specialty services, enterprise transformation office, provider experience, and quality.
She brings nearly two decades of expertise in the payer space, having spent 19 years at Humana. Susan most recently served as SVP of Clinical, Quality and Enterprise Solutions President, where she had oversight of quality, clinical strategy, analytics and product development, clinical operations, risk adjustment, and experience transformation.
She is credited for leading Humana's efforts to improve its STAR ratings and member quality, and for her experienced leadership creating sustainable organizations.
Susan started her career at Colgate-Palmolive as an engineer.