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  • Scaling Payment Integrity operations through digital capabilities and automation
  • The impact of Generative AI to Payment Integrity operations

Author:

William O'Neill

Vice President – Product Management, Payment Integrity
EXL

William O'Neill

Vice President – Product Management, Payment Integrity
EXL
  1. Automation frees your Plan’s content from processors, auditors, analysts, and even your vendors. It’s your content.
  2. Query, add exclusions, conduct research, identify new edits and ideas. It’s your content.
  3. Enjoy claim audits that are 26x faster than manual workflows – at less than half the cost – while maintaining > 96% agreement with human review.

Author:

Dutch Noss

Product & Strategy Officer
Alivia Analytics

Dutch Noss is a seasoned leader with over 25 years of expertise in Payment Integrity and Claims Processing, renowned for his pioneering approach to integrating responsible AI and machine learning into operational strategies. As Chief Product & Strategy Officer at Alivia Analytics, he drives innovations that improve accuracy within claims platforms. Dutch has held key leadership roles at various vendors and healthcare plans. A respected speaker at major healthcare conferences, he is recognized for blending deep industry knowledge with cutting-edge technology to shape the future of payment integrity.

Dutch Noss

Product & Strategy Officer
Alivia Analytics

Dutch Noss is a seasoned leader with over 25 years of expertise in Payment Integrity and Claims Processing, renowned for his pioneering approach to integrating responsible AI and machine learning into operational strategies. As Chief Product & Strategy Officer at Alivia Analytics, he drives innovations that improve accuracy within claims platforms. Dutch has held key leadership roles at various vendors and healthcare plans. A respected speaker at major healthcare conferences, he is recognized for blending deep industry knowledge with cutting-edge technology to shape the future of payment integrity.

 

Vladimir-Ducarmel Joseph

CDI Program Manager
Beth Israel Lahey Health Hospital & Medical Center

Vladimir-Ducarmel Joseph is one of the Clinical Documentation Integrity Program Directors at Beth Israel Lahey Health, where he spearheads a dedicated team of CDI professional experts to optimize clinical documentation best practices. With almost a decade in CDI leadership across diverse healthcare environments, Vladimir-Ducarmel holds a Master of Health Administration from George Washington University and his expertise encompasses physician leadership, team dynamics, CDI provider education, and program management.

Vladimir-Ducarmel Joseph

CDI Program Manager
Beth Israel Lahey Health Hospital & Medical Center

Vladimir-Ducarmel Joseph

CDI Program Manager
Beth Israel Lahey Health Hospital & Medical Center

Vladimir-Ducarmel Joseph is one of the Clinical Documentation Integrity Program Directors at Beth Israel Lahey Health, where he spearheads a dedicated team of CDI professional experts to optimize clinical documentation best practices. With almost a decade in CDI leadership across diverse healthcare environments, Vladimir-Ducarmel holds a Master of Health Administration from George Washington University and his expertise encompasses physician leadership, team dynamics, CDI provider education, and program management. A fervent advocate for healthcare excellence, Vladimir-Ducarmel is adept at bridging the gap between clinical and administrative roles. He is proficient in various healthcare-oriented analytical and business tools, leveraging them to drive impactful CDI outcomes.

2023 Showcase Finalists
Interview: Pascal Chapot, Nestlé: Overcoming Training and Onboarding Challenges
 

Kamleh Nicola

Partner
Marks & Clerk

Kamleh Nicola is a partner at Marks & Clerk and Co-Head of the firm’s Litigation practice in Canada. Her intellectual property litigation practice centers around patent, trademark, and copyright disputes. Though her client base is broad in scope, she specializes in Health and Life Sciences, working with domestic and multinational pharmaceutical, biopharma, and MedTech organizations. Kamleh is particularly knowledgeable on matters involving Canada’s patent linkage regimes, health regulatory and related compliance, and trade secrets.

 

Kamleh Nicola

Partner
Marks & Clerk

Kamleh Nicola

Partner
Marks & Clerk

Kamleh Nicola is a partner at Marks & Clerk and Co-Head of the firm’s Litigation practice in Canada. Her intellectual property litigation practice centers around patent, trademark, and copyright disputes. Though her client base is broad in scope, she specializes in Health and Life Sciences, working with domestic and multinational pharmaceutical, biopharma, and MedTech organizations. Kamleh is particularly knowledgeable on matters involving Canada’s patent linkage regimes, health regulatory and related compliance, and trade secrets.

 

 

Mike Gilbert

Partner
Marks & Clerk

Mike Gilbert is a partner at Marks & Clerk in London.  He is an Intellectual Property (IP) lawyer who advises clients in a wide variety of business sectors on issues including litigation and dispute resolution, IP strategy and risk limitation, due diligence projects and commercial and licensing transactions involving IP. His primary focus and expertise, however, lies in life sciences patent litigation where he is considered to be one of the UK’s leading practitioners.

Mike Gilbert

Partner
Marks & Clerk

Mike Gilbert

Partner
Marks & Clerk

Mike Gilbert is a partner at Marks & Clerk in London.  He is an Intellectual Property (IP) lawyer who advises clients in a wide variety of business sectors on issues including litigation and dispute resolution, IP strategy and risk limitation, due diligence projects and commercial and licensing transactions involving IP. His primary focus and expertise, however, lies in life sciences patent litigation where he is considered to be one of the UK’s leading practitioners. He has represented some of the world’s leading biopharmaceutical corporations in complex patent and technical disputes including Genentech, Roche, Chugai, Pfizer, Wyeth, AstraZeneca, MedImmune, Daiichi Sankyo, AbbVie, Amgen and Illumina to name but a few. Mike is well known for his strategic and creative vision and is consistently recommended in various legal directories including the World IP Review, Legal 500, Who's Who Legal and the IAM Patent 1000 guide, which describe him as “always at the top of the pile, especially for pharmaceutical matters”. Mike graduated from Cambridge University in 1989 with a degree in chemical engineering.

 

Homer Najafi

Director, DevOps & MLOps
Levi Strauss & Co.

Homer Najafi

Director, DevOps & MLOps
Levi Strauss & Co.

Homer Najafi

Director, DevOps & MLOps
Levi Strauss & Co.