Best UPMC Health Plan Podcasts (2025)

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Charting the Path for Electronic Prior Authorization 23:19

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5h ago23:19

23:19

In this episode, Steven Berkow, Senior Advisor for Value-based Care at InterSystems, and Robert Tennant, Executive Director of the Workgroup for Electronic Data Interchange, discuss the evolving landscape of ePrior authorization. They share insights on regulatory changes, industry collaboration, and what healthcare leaders should know as the 2027 c…

1
Zack Myers, National General Manager at SCAN Health Plan 13:23

3h ago13:23

13:23

In this episode, Zack Myers, National General Manager at SCAN Health Plan, discusses the organization’s expansion into new markets, its nonprofit approach to provider partnerships, and how innovative models like iSNPs are improving care and independence for seniors.By Becker's Healthcare

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Driving Community Impact Through Medicaid Innovation at UPMC 18:30

10d ago18:30

18:30

In this episode, Brendan Harris, president of UPMC for You and state programs, shares how initiatives like the Pathways to Work program and Neighborhood Centers are addressing social determinants of health, supporting Medicaid members, and strengthening local communities.By Becker's Healthcare

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Mack McGee, Chief Marketing Officer at CareFirst BlueCross BlueShield 14:11

13d ago14:11

14:11

In this episode, Mack McGee, Chief Marketing Officer at CareFirst BlueCross BlueShield, shares how the organization earned top marks for customer experience in Forrester’s 2025 rankings and discusses the importance of trust, personalization, and simplifying healthcare interactions for members.By Becker's Healthcare

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Navigating Rising Health Costs and Alternative Coverage Models 13:51

10d ago13:51

13:51

In this episode, Scott Burton, Market President at Providence Health Plan, shares insights on the growing interest in ICRAs, strategies to manage rising employer health costs, and how Providence is balancing innovation with long-term sustainability in a shifting insurance landscape.By Becker's Healthcare

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Breaking Down Silos in Health Plan Pricing Operations 17:31

25d ago17:31

17:31

In this episode, Jay Deady, President of Price Optimization at Zelis, discusses why fragmented pricing operations create inefficiencies for health plans and how integrated solutions, advanced technology, and personalization are paving the way for a more connected financial experience across healthcare. This episode is sponsored by Zelis.…

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Navigating Payer Compliance and Regulatory Oversight with Cereasa Horner of CERIS 9:52

26d ago9:52

9:52

This episode features Cereasa Horner, Director of Policy and Payment Integrity at CERIS, who shares insights on the evolving payer oversight landscape. She discusses the challenges of maintaining consistency across state and federal guidelines, the role of AI and predictive compliance modeling, and strategies for payers to stay proactive in a dynam…

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Expanding Behavioral Health Access with Bill Harlan of Point32Health 20:48

22d ago20:48

20:48

In this episode, Bill Harlan, Vice President of Behavioral Health at Point32Health, shares how his team is addressing access challenges, supporting members through navigation services, and building innovative partnerships to improve mental health care delivery.By Becker's Healthcare

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Dan LaVallee and Dr. Brandy Hershberger of UPMC 17:57

26d ago17:57

17:57

In this episode, Dan LaVallee and Dr. Brandy Hershberger of UPMC share how the health system is creating innovative apprenticeship programs to support Medicaid members and employees in pursuing meaningful careers. They discuss workforce development, grant funding, and how these programs are shaping the future of healthcare talent pipelines.…

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Alan Cohen, Co-founder and Chief Product Officer at Centivo 27:11

27d ago27:11

27:11

In this episode, Alan Cohen, Co-founder and Chief Product Officer at Centivo, joins the podcast to share his perspective on escalating healthcare costs, premium increases, and the risks facing the ACA market. He also explains how Centivo partners with high-performing providers to deliver cost-effective, sustainable coverage for employers and their …

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Premera Blue Cross’ In-House AI Chatbot Boosts Customer Service Efficiency 11:54

1M ago11:54

11:54

In this episode, Dr. Nathan Crock of Premera Blue Cross shares how the AI-powered chatbot “Alice” is helping hundreds of customer service representatives quickly find accurate information, reducing call times, improving member satisfaction, and enhancing internal knowledge management.By Becker's Healthcare

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John Byrnes, Chief Operating Officer at Banner|Aetna 18:40

2M ago18:40

18:40

In this episode, John Byrnes, Chief Operating Officer at Banner|Aetna, discusses how the organization is advancing value-based care through integrated technology, strong payer-provider collaboration, and personalized member support. He highlights key strategies driving improved health outcomes and sustainable cost management in Arizona.…

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Leading the Nation’s First Lifestyle Medicine Program for Alzheimer’s at EmblemHealth 23:03

2M ago23:03

23:03

In this episode, Karen Ignagni, Executive Chair, and Dr. Dan Knecht, Chief Medical Officer at EmblemHealth, discuss the launch of the first health plan covered lifestyle medicine program for early-stage Alzheimer’s. They explore how evidence-based interventions, community support, and integrated care are reshaping brain health and advancing equity …

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Jeff Yuan, Co-founder of Mending 18:43

2M ago18:43

18:43

In this episode, Jeff Yuan, Co-founder of Mending, discusses how his company is building an AI-native health insurer focused on reducing provider burden and improving patient access through direct primary care partnerships. He also shares insights on rebranding, early success in Maine and Oklahoma, and plans for thoughtful national expansion.…

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Advocating for Medicare Advantage with Dawn Maroney of Alignment Health Plan 12:02

2M ago12:02

12:02

In this episode, Dawn Maroney, President of Alignment Health and CEO of Alignment Health Plan, shares her experience testifying before Congress on the future of Medicare Advantage and highlights key policy changes needed to protect access, expand rural care, and ensure member choice in a rapidly evolving healthcare landscape.…

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Navigating Medicaid Reform and Community Care with CalOptima CEO Michael Hunn 28:34

2M ago28:34

28:34

In this episode, Michael Hunn, CEO of CalOptima Health, joins Jakob Emerson to discuss how the organization is preparing for sweeping changes under the Federal Reconciliation Bill. He shares insights on preserving access to care, the importance of managed care partnerships, and how collaboration, communication, and innovation will be essential to m…

1
Virtual Care Innovation and What’s Next with MD Live by Evernorth 11:10

2M ago11:10

11:10

This episode features Anthony J. Colistra, President of MD Live by Evernorth, discussing how virtual care has evolved, where consumer demand is headed, and how MD Live is using AI to personalize the patient experience, improve patient-provider communication, and streamline provider administrative tasks to give them more time to spend with patients.…

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The Future of Non-Emergency Medical Transportation with Alan Murray, CEO of MediDrive 17:39

2M ago17:39

17:39

In this episode, Alan Murray, President and CEO of MediDrive, shares how innovative, tech-enabled approaches to non-emergency medical transportation are closing care gaps, reducing no-show rates, and supporting more coordinated, patient-centered care—while also improving administrative efficiency and helping to lower system-wide costs. This episode…

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Driving Innovation in Medicare Advantage with Dr. Joe Kimura of SCAN Health Plan 20:33

2M ago20:33

20:33

In this episode, Dr. Joe Kimura, Chief Medical Officer at SCAN Health Plan, discusses how SCAN is leading innovation in Medicare Advantage through personalized care, data analytics, and strategic partnerships. He also explores the critical role of technology and member engagement in improving outcomes for a growing senior population.…

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Amy Jordan, Vice President of Consumer Digital Engagement at UnitedHealthcare 12:03

2M ago12:03

12:03

This episode features Amy Jordan, Vice President of Consumer Digital Engagement at UnitedHealthcare, discussing the launch of Smart Choice, a data-driven provider search tool designed to simplify healthcare navigation. Amy shares how the platform uses personalization and quality metrics to improve member experience and how it fits into UnitedHealth…

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Dr. Tom Allen, Executive Medical Director, Behavioral Health, Blue Cross and Blue Shield 9:39

2M ago9:39

9:39

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Dr. Tom Allen, Executive Medical Director, Behavioral Health, Blue Cross and Blue Shield. Dr. Allen shares how his team is advancing behavioral health outcomes through telehealth, data-driven insights, and deeper integration with primary care while address…

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Chris Wasel, President, Strategic Partnerships, Vantage Healthcare 4:52

2M ago4:52

4:52

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Chris Wasel, President, Strategic Partnerships, Vantage Healthcare. He shares how Vantage is aligning value-based care, patient satisfaction, and care accessibility through innovative on-site services in skilled nursing and assisted living facilities acros…

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From Reactive to Proactive: How AI Is Transforming Care Management 20:25

2M ago20:25

20:25

In this episode, Michelle Fullerton of Blue Cross Blue Shield of Michigan and Connie S. Ducaine of MyndYou, explore how AI is streamlining workflows, improving patient engagement, and helping care teams operate at the top of their licensure. They share real-world use cases, tips for integration, and insights on measuring value across efficiency, qu…

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Saria Saccocio, Chief Medical Officer, Essence Health 6:43

2M ago6:43

6:43

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Saria Saccocio, Chief Medical Officer, Essence Health. Saria shares how Essence Health is enhancing outcomes through physician-led value-based care, leveraging technology like AI and wearable health devices, and advancing health equity through deep communi…

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Shawn Shuman, Director, Medical Management, Peak Health 5:31

2M ago5:31

5:31

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Shawn Shuman, Director, Medical Management, Peak Health. Shawn discusses how Peak Health is tackling healthcare access barriers, boosting member satisfaction, and addressing health equity through innovative care management strategies.…

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Harlon Pickett, President, Eagle Care Health Solutions 8:03

2M ago8:03

8:03

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Harlon Pickett, President, Eagle Care Health Solutions. He shares how his organization is improving healthcare access, affordability, and quality through customized, membership-based models, while expanding care equity in rural and underserved communities.…

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How University Health Is Tackling Payer Pressure and Driving Mission-Driven Revenue Cycle Innovation with Kevin Barron 29:27

3M ago29:27

29:27

In this episode, Kevin Barron, Deputy VP of Payer Relations at University Health, shares how his team is navigating increasingly aggressive payer tactics, implementing smarter contract oversight, and championing a mission-first approach to revenue cycle operations. He also explains why aligning contracting within RevCycle has delivered measurable r…

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Capitalizing on Momentum: Payer Perspectives on Value-Based Care in 2025 15:18

3M ago15:18

15:18

In this episode, Carey Ketelsen, President of Virtix Health, joins Becker’s Healthcare to discuss how payers are navigating and accelerating value-based care (VBC) strategies in 2025. From increasing revenue projections to the role of AI and data analytics, Carey shares insights into the opportunities and challenges shaping payer-provider collabora…

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Chris Gay, CEO of Evry Health 18:31

3M ago18:31

18:31

Chris Gay, CEO of Evry Health, joins the podcast to discuss how his organization is enhancing the patient experience and advancing population health. He explores how innovative technology is being used to address persistent challenges in the payer space and improve health outcomes. Gay also shares insights into building a more efficient, patient-ce…

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Doug Henry, Enterprise Medical Director of Behavioral Health, Highmark Health 13:44

3M ago13:44

13:44

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Doug Henry, Enterprise Medical Director of Behavioral Health, Highmark Health. Dr. Henry shares how Highmark is improving access, outcomes, and satisfaction through strategic partnerships, data-driven innovation, and value-based care models that prioritize…

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Illan Shapiro Strygler, Chief Health Correspondent and Medical Affairs Officer and Senior Vice President, AltaMed Health Services 5:17

3M ago5:17

5:17

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Illan Shapiro Strygler, Chief Health Correspondent and Medical Affairs Officer and Senior Vice President, AltaMed Health Services. Dr. Shapiro shares how AltaMed leverages data, cultural understanding, and community connection to improve care quality, redu…

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Kourtney Witten, Area Vice President Network Managing Partner Wisconsin, Advocate Health 6:40

3M ago6:40

6:40

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Kourtney Witten, Area Vice President Network Managing Partner Wisconsin, Advocate Health. Witten discusses how her organization is leveraging data, technology, and relationship-based care to reduce costs, close care gaps, and deliver high-quality, patient-…

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Integrating Specialty Pharmacy into Electronic Health Record Workflows: Unlocking Enhanced Value 11:22

3M ago11:22

11:22

In this episode, Becker's Healthcare speaks with Jim Blondin, Senior Director of Digital Product Strategy at Accredo Specialty Pharmacy, about the strategic benefits of integrating specialty pharmacy into EHR workflows. The discussion explores how this integration can reduce workflow friction, improve care coordination, and enhance both patient and…

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How Accurate Provider Data Drives Better Care Access and AI Innovation 17:14

3M ago17:14

17:14

In this episode, Joey Seliski of Allegheny Health Network and Pritee Subramany of Highmark Health discuss how consistent, accurate provider data is essential for improving care coordination, patient trust, and enabling AI-driven tools like virtual assistants and personalized provider recommendations. This episode is sponsored by Kyruus Health.…

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Dr. Brian Smolich, Vice President, Health Alliance Quality and Managed Care Operations, Carle Health 7:35

3M ago7:35

7:35

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Dr. Brian Smolich, Vice President, Health Alliance Quality and Managed Care Operations, Carle Health. Dr. Smolich shares how his organization is balancing cost and quality, leveraging biosimilars, digital engagement tools, and provider collaboration to imp…

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Brad Riley, Vice President, Analytics and Reporting, Longevity Health 10:56

3M ago10:56

10:56

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Brad Riley, Vice President, Analytics and Reporting, Longevity Health. Brad discusses how Longevity Health is leveraging predictive analytics, machine learning, and innovative provider partnerships to balance cost containment with high-quality care, while …

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Paul Christopher Hiltz, President and CEO, NCH Healthcare System 2:55

3M ago2:55

2:55

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Paul Christopher Hiltz, President and CEO, NCH Healthcare System. Paul shares how a metrics-driven culture, strategic partnerships, and clinical excellence are guiding NCH’s efforts to improve care quality, reduce costs, and expand access through major ini…

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Louis DeStefano, Senior Vice President of Growth at Oscar Health 6:16

3M ago6:16

6:16

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Louis DeStefano, Senior Vice President of Growth at Oscar Health. He shares how Oscar is leveraging personalized plan designs, technology-driven engagement, and the growing potential of ICHRAs to improve affordability, satisfaction, and outcomes in the ind…

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Dr. Alex Ding, Deputy Chief Medical Officer, Humana 8:40

3M ago8:40

8:40

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Dr. Alex Ding, Deputy Chief Medical Officer, Humana. Dr. Ding shares how Humana is bridging its payer and provider roles to advance health equity, enable clinicians, and drive value-based care transformation at scale, all while putting whole-person care an…

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Rebuilding NEMT: Creating a Modern, Scalable Transportation Model for Health Plans with Kinetik 9:47

3M ago9:47

9:47

This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Sufian Chowdhury, Chief Executive Officer of Kinetik. Sufian discusses how Kinetik is transforming non-emergency medical transportation (NEMT) through real-time data, interoperability, and plan-owned infrastructure to improve compliance, reduce fraud, an…

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Lila Benayoun, Chief Operating Officer, MetroPlusHealth 5:53

3M ago5:53

5:53

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Lila Benayoun, Chief Operating Officer, MetroPlusHealth. She shares how the organization is combining predictive analytics, personalized outreach, and community-based services to proactively manage care, improve member satisfaction, and address social dete…

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Mark Rich, Former President and current Board Member of Steward Health Care System LLC 8:08

3M ago8:08

8:08

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Mark Rich, Former President and current Board Member of Steward Health Care System LLC. Mark shares insights from the provider and ACO perspective on accelerating value-based care, aligning payer-provider collaboration, and leveraging actionable data to dr…

1
Lawrence Hamilton, Executive Vice President, The Permanente Medical Group 9:37

3M ago9:37

9:37

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Lawrence Hamilton, Executive Vice President, The Permanente Medical Group. Lawrence discusses the power of payer-provider alignment in delivering population health, advancing health equity across service lines, and using real-time patient feedback to enhan…

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Dr. Aisha Rahim, Medical Director and Co-Lead, AI Governance Council, Johns Hopkins Health Plans (JHHP) 13:43

3M ago13:43

13:43

This episode, recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable, features Dr. Aisha Rahim, Medical Director and Co-Lead, AI Governance Council, Johns Hopkins Health Plans (JHHP). Dr. Rahim discusses how JHHP is leveraging artificial intelligence to manage costs, close care gaps, advance health equity, and enhance member engage…

1
Improving Access to Preventive Care and Whole Person Health with Dr. Jennifer Nuovo 21:39

3M ago21:39

21:39

In this episode, Dr. Jennifer Nuovo, Chief Medical Officer of Blue Shield of California’s Promise Health Plan, joins Jakob Emerson to discuss how her team is increasing access to preventive care, addressing health disparities, and building community trust through targeted outreach, innovative programs, and a focus on whole person care.…

1
Stacy Edgar, Co-Founder and CEO at Venteur 12:17

4M ago12:17

12:17

Stacy Edgar, Co-Founder and CEO at Venteur, joins the podcast to discuss how her organization is working to strike the right balance between affordability and quality in healthcare. She highlights initiatives that support new mothers in navigating their healthcare journey and emphasizes the importance of understanding and aligning with partners to …

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Dawn Maroney, Chief Executive Officer of Alignment Health Plan and President of Alignment Health 10:40

4M ago10:40

10:40

This episode recorded live at the Becker's 3rd Annual Spring Payer Issues Roundtable features Dawn Maroney, Chief Executive Officer of Alignment Health Plan and President of Alignment Health. She shares how Alignment uses AI-assisted care, culturally aware outreach, and a deep commitment to equity to deliver affordable, personalized care for senior…

1
Redefining Payer Strategy: From Benefit Design to Intelligent Care Delivery 17:04

4M ago17:04

17:04

This episode, recorded live at the Becker’s Hospital Review 15th Annual Meeting, features Nirnay Patel, EVP and GM of Benefits1™ and Chief Digital Officer at Simplify Healthcare. He shares how integrated benefits data, AI, and platform thinking are transforming payer operations and personalizing the member journey across Medicare, Medicaid, and com…

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Utilization Management That Works: Strategies, Stories & What’s Next 17:00

4M ago17:00

17:00

In this episode of the Becker’s Healthcare Podcast, Lukas Voss is joined by Chad Kersting, Business Development Director, and Dr. Eric Gratias, National Physician Executive of Medical Benefit Services, both from EviCore by Evernorth. Together, they explore the evolving landscape of utilization management (UM) beyond prior authorization—highlighting…