Rise

Cale Browning Director – CDE Performance Management

Ochsner Health Network

Cale Browning, MBA, CPC, CRC is the Director of Clinical Documentation Excellence & Risk Adjustment for Ochsner Health Network, the Value-Based Care division of Ochsner. Cale has nearly 10 years of experience in Risk Adjustment in various roles such as Risk Adjustment Coder, MRA Frontline Lead, Manager of Risk Adjustment Education, and Director of Revenue Cycle on both the payer and provider side of healthcare. Cale started at Ochsner in October of 2020 as a Risk Adjustment Performance Improvement Manager tasked with building out the necessary Key Performance Indicators (KPIs), dashboards, and educational material for Executive Leadership then absorbed the Clinical Documentation Excellence Team in February of 2022. Since that time, Cale and the CDE Leadership Team have designed and implemented a state-of-the-art Ambulatory / Outpatient CDI Program that supports Primary Care and Specialty service lines with proven success within the first year, subsequently presenting their vision at several conferences and work groups since. 

Jeannine Bumford Director, Risk Adjustment Operations

Christus Health

Jeannine Bumford has worked in the Risk Adjustment industry for over twelve years, beginning her journey in 2012 as a Risk Adjustment Auditor. Experienced, goal-oriented, and innovative leader who has worked with Medicare, Medicare Advantage, and Marketplace business lines. She is the Director of Risk Adjustment Operations for Christus Health. Designed and successfully implemented Provider Education, Coding, and Quality Assurance programs throughout her career. Holds Professional Coder (CPC) and Risk Coder (CRC) certifications. She lives in Waxahachie, Texas, with her husband and three girls. 

Deb Curry Risk Adjustment Programs Director

Medical Mutual

Deb joined Paramount Healthcare/Medical Mutual of Ohio in May 2013 and oversees the Risk Adjustment, Coordination of Benefits, and Subrogation departments.

Prior to her position with Paramount she had 21 years’ experience working with the State of Ohio workers’ compensation program, both for the government and a contracted managed care organizations. She came to Paramount with extensive knowledge in medical coding, provider billing and education, Medicare payment methodologies, quality assurance, and regulatory compliance.

Deb attended The University of Toledo for both her undergraduate and graduate degrees and currently holds a Masters of Business Administration with major in Healthcare Systems Management. She is an active member of the American Health Information Management Association (AHIMA) and is a Registered Health Information Administrator (RHIA) and Certified Coding Specialist, physician based (CCS-P). Deb is also an active member of the America Academy of Professional Coders (AAPC) and is a Certified Risk Adjustment Coder (CRC). Also, Deb is a member of RISE and holds certificates as a Risk Adjustment Practitioner (RAP) and Advanced HCC Auditor (AHCCA). Additionally, Deb is a Board Member of the University of Toledo Health Information Administration Advisory Board, Health and Human Services Alumni Affiliate at The University of Toledo, and Health Information Technology Advisory Committee at Owens Community College.

Dr. Shannon Decker Principal 

VBC One 

Dr. Shannon Decker is principal at VBC One, a consulting firm assisting physician groups, health plans and vendors maximize the performance of their value based contracts and offerings.  Dr. Decker has more than 20 years experience in health care and most recently led teams in risk, quality, data and analytics, telehealth, COVID response and delegation compliance.  Of her more than 20 years of experience in healthcare--15 include working with risk adjustment, quality and Medicare. Dr. Decker has a PhD. in Interdisciplinary Studies, dual MBA degrees--in Finance and in Marketing, as well as an M.Ed. in Secondary Education and a M.Ed. in Administration and Leadership. Dr. Decker is on the faculty at Arizona State University and is also an associate professor of Higher Education & Adult Learning (HEAL) and chief methodologist for Walden and Capella Universities where she chairs and oversees the dissertations of doctoral students. An author of two books and several peer-reviewed articles, and a prolific national public speaker, her interests include the study of human behavior and how theories on motivation and learning may be brought to bear on population health management. 

Erinn Erny VP / Medical Director – Clinical Documentation Excellence

Ochsner Health Network

Dr. Eirinn Erny, M.D. joined Ochsner Health in August 2019 with the Medvantage Clinic in Primary Care and Wellness at Ochsner Jefferson Hwy.  In January 2022, she transitioned to the Ochsner 65+ Clinic while working as a Physician Lead in Population Health. Prior to joining Ochsner Health, she was a Medical Director at a risk-based clinic. As of August 2022, Dr. Erny joined the OHN Clinical Documentation Excellence team as Medical Director while continuing to see patients at the Ochsner 65+ Clinic. She has worked with the CDE team to expand suspecting of HCCs, education of clinicians, and understanding of the BPA and metrics in practice.

Ava Johnson Associate Director, Ambulatory CDQI

Mount Sinai Hospital, NYC

Ava Johnson is the Associate Director of the Outpatient Clinical Documentation Quality Improvement department at Mount Sinai Hospital in NYC. Ava is a seasoned coding instructor, physician educator, multispecialty coder, CDI specialist and public speaker with a focus on executive leadership and career development. 

Donna Malone Director Risk Capture, Population Health Management

Mass General Brigham

Donna Malone, CPC, CRC, AAPC Approved Instructor, AHCCA, RAP, RISE Fellow: Director Risk Adjustment with Mass General Brigham in MA, Adjunct Professor with MassBay Community College, Chair of the RISE Risk Adjustment Academy HCC Coding Faculty Advisory Group as well as content developer RISE designations and workshops, and 2022-2025 AAPC National Advisory Board. Donna has over 28 years’ experience (Payer, Provider System and Vendor) in healthcare with primary focus on Value-Based Care. 

Donna has also served as President of the Watertown AAPC Chapter (2017-2022) and Education officer (2016) 

Donna speaks nationally for RISE, AAPC and AHIMA 

She also received the 2021 MaHIMA Champion Award 

Laura Sheriff

Risk Adjustment Industry Expert

Laura Sheriff is a highly experienced and skilled professional in the healthcare industry, with a wealth of knowledge and expertise in risk adjustment, quality improvement, and population health analytics. With her background in Medicare, Medicaid, and Marketplace Managed Care, as well as her leadership abilities and certifications as a professional coder and risk coder, Laura brings a unique set of skills to her consulting work with physician groups and health plans. 

Susan Waterman Director of Risk Adjustment

Baylor Scott and White Healthcare

As Director of Risk Adjustment, Susan Waterman has been empowered to plan, design and oversee business and strategic objectives in creating and optimizing a Risk Adjustment Department responsible for ensuring the accuracy of risk adjustment payments while successfully managing all activities related to Medicare Advantage, ACA and Exchange Risk Adjusted lines of business. In that capacity Susan directed department changes that resulted in multi-million dollar gains in Risk Adjustment, brought all chart review activity in-house, and partnered with the hospital CDI/Quality Physicians to create an Outpatient CDI Department focused on documentation quality, Risk Adjustment activities and clinic training. 

A proven leader in her field, Susan’s professional experience includes coding and compliance management, auditing and provider training, system management, and consulting services.