The Mission of the Managed Care Academy is to create an educational experience in which healthcare professionals gain expertise in quality managed care and regulatory compliance, enabling them to become noted experts and effective leaders in the field.
The Purpose of the Managed Care Academy is to produce stellar experts in managed care operations who can assess their organizations’ needs, effect operational change, improve regulatory compliance, and influence marketplace decisions and choices.
Goals
- Teach the operational principles and practices of managed care
- Review the basis and functionality of regulatory requirements governing managed care
- Present and resolve common problems in managed care operations and regulation
- Construct data requirements that protect and define managed care
- Show how well-drawn policies and procedures align with good managed care and help organizations meet regulatory requirements
Core Values
- Leadership
- Ethical Choices
- Social Consciousness
- Quality of Care
- Innovation and Change
ROSE LEIDL, RN, BSN – Founder and President, Managed Healthcare Unlimited, Inc.
Ms. Leidl has over 28 years of broad-based experience working with major health insurers and regulators. She actively participates in audits and investigations that reshape policies regulating managed care and has co-authored definitive technical assistance guides, which have become standard references for industry reviews. Prior to founding her firm, Ms. Leidl served as a critical care nurse, consulted for HCFA (now CMS), served as a NCQA-certified HEDIS compliance auditor, and worked for major health plans.
PATRICIA SCHANO, MEd – Vice President, Managed Healthcare Unlimited, Inc.
Ms. Schano has over 30 years of executive-level experience in the assessment of quality and compliance within health care delivery systems. Prior to joining the firm, she led health care analysts, statisticians, and programmers in research projects and served as an NCQA-certified HEDIS compliance auditor.
CHRISSY HSIEH, MD, JD – Medical Director, Managed Healthcare Unlimited, Inc.
Dr. Hsieh has a strong managed care background and offers a legal perspective on compliance issues. Prior to joining the firm, she worked for the California Department of Health Care Services for 11 years as a consultant and expert witness. She also served as a family practice physician in a managed care environment.
ANNALISA A. ALMENDRAS, PsyD – Director of Behavioral Health Operations, Managed Healthcare Unlimited, Inc.
Dr. Almendras has a rich background in behavioral health with over 13 years of experience as a practicing psychologist, consultant, and instructor. Her comprehensive scope of practice includes adults with complex mental health histories and at-risk youth. She currently serves as project lead for the firm’s California Mental Health Parity & Addiction Equity Act (MHPAEA) review project.
BRUCE HOFFMAN, MBA, PhD – Director of Survey Operations, Managed Healthcare Unlimited, Inc.
Dr. Hoffman’s decades-long experience in managed care includes senior level regulatory oversight positions for both state and health plan operations with an emphasis on auditing and monitoring, respectively. His subject matter expertise emphasizes grievances and appeals and compliance management.
ROGER K. DIEMERT, MD – Senior Consultant, Managed Healthcare Unlimited, Inc
Dr. Diemert is an internal medicine specialist with extensive leadership experience in various managed care environments. He participates in routine and focused audits, serving as an onsite medical authority in the areas of quality management, medical management and continuity/coordination of care.
- Teach the operational principles and practices of managed care
- Review the basis and functionality of regulatory requirements governing managed care
- Present and resolve common problems in managed care operations and regulation
- Construct data requirements that protect and define managed care
- Show how well-drawn policies and procedures align with good managed care and help organizations meet regulatory requirements
Who Should Attend
Health care professionals who want to advance their careers and increase their knowledge and skills in the areas of regulatory compliance, deficiency management, and quality improvement will benefit from the Academy. In particular, mid-level health plan staff, both clinical and non-clinical, and practicing clinicians who wish to transition to executive managed care positions are encouraged to apply.
Profile of an Academy Applicant
Applicants typically include the following healthcare professionals:
- IPA and medical group members
- Health plan employees
- Physicians and dentists
- Healthcare executives
- Nurses, behavioral healthcare providers, and other clinical professionals
Organizations that Benefit from Employing Academy Graduates
Organizations in the fields of healthcare, law, and government benefit from the services of an Academy graduate:
- Health plans requiring increased skill level and competency in regulatory compliance within their departments
- Healthcare firms and agencies recruiting managed care experts in the areas of utilization management, grievances and appeals, member services, and quality management
- Legal firms and organizations needing expanded expertise and understanding of managed care operations, standards, and regulations
- Regulatory and accreditation agencies overseeing or participating in managed care processes