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This session explores how health plans are tackling one of the biggest challenges in payment integrity today: fragmented, inconsistent pricing and reimbursement data. Through real-world case studies, we’ll examine how leading organizations have approached this issue with scalable strategies that reduce errors, improve transparency, and drive operational efficiency.

Key Takeaways:
Understand how fragmented pricing data leads to leakage and mistrust
Learn practical steps to centralize and maintain consistent reimbursement logic
See how other plans have successfully implemented scalable solutions

This session takes a critical look at standout innovations currently shaping healthcare—from tech solutions to care models—and invites discussion on where leaders see the greatest need for further advancement. Gain real-time insight into what’s delivering value now, and what’s still missing from the innovation landscape.

Author:

Novelette Wallace, MPH, PMP, CSSBB

Head of Payment Integrity
Johns Hopkins Healthcare

Novelette Wallace is a distinguished Payment Integrity Leader with a rich background spanning over 30 years in the healthcare industry. Her extensive experience includes leadership roles within payment integrity, where she has played pivotal roles in both payment integrity vendor organizations and health plans. Throughout her career, Novelette has demonstrated a remarkable ability to build and lead Payment Integrity departments from their inception. Her expertise has been instrumental in establishing robust processes and strategies to identify and recover inaccuracies in claims, contributing significantly to cost of care savings for health plans year after year.

Novelette has held key leadership positions with industry-leading organizations, including Performant Corp, United Healthcare, and Aetna (previously Coventry). In each role, she has consistently delivered results by optimizing payment integrity processes and driving operational excellence. Currently serving as the Assistant Vice President (AVP) of Payment Integrity for Johns Hopkins Health Plans, Novelette continues to bring her wealth of knowledge and leadership acumen to the forefront. Her dedication to achieving and surpassing cost of care savings goals exemplifies her commitment to advancing the financial health and efficiency of healthcare organizations.

With a proven track record of success and a comprehensive understanding of payment integrity within the healthcare landscape, Novelette Wallace stands as a respected leader in the industry, contributing significantly to the success of the organizations she serve

Novelette Wallace, MPH, PMP, CSSBB

Head of Payment Integrity
Johns Hopkins Healthcare

Novelette Wallace is a distinguished Payment Integrity Leader with a rich background spanning over 30 years in the healthcare industry. Her extensive experience includes leadership roles within payment integrity, where she has played pivotal roles in both payment integrity vendor organizations and health plans. Throughout her career, Novelette has demonstrated a remarkable ability to build and lead Payment Integrity departments from their inception. Her expertise has been instrumental in establishing robust processes and strategies to identify and recover inaccuracies in claims, contributing significantly to cost of care savings for health plans year after year.

Novelette has held key leadership positions with industry-leading organizations, including Performant Corp, United Healthcare, and Aetna (previously Coventry). In each role, she has consistently delivered results by optimizing payment integrity processes and driving operational excellence. Currently serving as the Assistant Vice President (AVP) of Payment Integrity for Johns Hopkins Health Plans, Novelette continues to bring her wealth of knowledge and leadership acumen to the forefront. Her dedication to achieving and surpassing cost of care savings goals exemplifies her commitment to advancing the financial health and efficiency of healthcare organizations.

With a proven track record of success and a comprehensive understanding of payment integrity within the healthcare landscape, Novelette Wallace stands as a respected leader in the industry, contributing significantly to the success of the organizations she serve

Author:

Christopher Draven

Senior Director of Payment Integrity Analytics & AI
HCSC

Christopher Draven is Senior Director of Payment Integrity Analytics & AI at HCSC where he leads a cross-functional team focused on delivering actionable insights and savings. He has over 25 years experience in healthcare, starting in direct patient care.

Christopher Draven

Senior Director of Payment Integrity Analytics & AI
HCSC

Christopher Draven is Senior Director of Payment Integrity Analytics & AI at HCSC where he leads a cross-functional team focused on delivering actionable insights and savings. He has over 25 years experience in healthcare, starting in direct patient care.

Staffing shortages in Revenue Cycle Management are placing intense strain on back-end operations—slowing claims processing, increasing denials, and delaying collections. This session explores how health systems and plans are responding with targeted strategies to stabilize their RCM workforce, automate high-burden tasks, and reduce dependency on hard-to-fill roles. Attendees will learn how addressing these gaps is critical to accelerating reimbursement, reducing administrative waste, and protecting the financial foundation of care delivery.

This session explores practical models and proven strategies for making remote work effective in health plans and hospital systems. From fostering connection to reinforcing a shared sense of purpose, we’ll discuss how to keep remote employees engaged, aligned with patient-centred values, and committed to driving impact, even from a distance.

 

Kimberly D Conner

Subject Matter Expert

Kimberly D Conner

Subject Matter Expert

Kimberly D Conner

Subject Matter Expert

RCM leaders are increasingly challenged by manual processes, fragmented systems, and staffing shortages that hinder efficiency and financial performance. This session delves into how healthcare organizations are leveraging automation and intelligent workflows to address these issues. By examining real-world scenarios, we'll explore strategies to reduce administrative burdens, enhance data accuracy, and improve overall revenue cycle operations.

As the healthcare landscape evolves, the future of payment integrity depends on stronger, more transparent relationships between payers and providers. This session will explore how shifting from adversarial audits to aligned, data-driven collaboration can lead to more sustainable results. Using real case examples, we’ll discuss how leaders are redesigning their PI strategies to prioritize trust, accuracy, and efficiency.

 

Sharada Devarasetty

Senior Director IP
GH Research

Sharada Devarasetty

Senior Director IP
GH Research

Sharada Devarasetty

Senior Director IP
GH Research
 

Nicolas Ruiz

Head of IP
Esteve

Nicolas Ruiz

Head of IP
Esteve

Nicolas Ruiz

Head of IP
Esteve