Rae A. McIntee, DDS, MD, MBA, FACS, CPE
Medical Director Clinical Solutions (Supporting Payment Integrity & SIU)
Louisiana Blue
Understand the strategic considerations behind deciding whether to insource or outsource key operational functions, such as billing and pre-certification, and how to assess both financial and operational impacts.
Learn how to evaluate vendor relationships effectively, including identifying the true costs of outsourcing, recognizing areas for potential in-house solutions, and assessing when to pivot away from third-party vendors for long-term sustainability.
Matt Perryman
Chief Analytics & Insight Officer
Alivia Analytics
Matt leads Alivia’s advanced analytics, data science, and platform development for fraud, waste, and abuse (FWA) detection—validated through payment integrity edits, audits, and data mining. With expertise in healthcare analytics and risk modeling, he oversees AI-powered solutions that help Medicaid, Medicare, and commercial payers prevent improper payments and uncover emerging fraud schemes.
Before assuming this role, Matt built a strong reputation at Alivia as a customer-facing data scientist, helping technical and non-technical users alike apply analytics to drive measurable results. He is a regular speaker at healthcare FWA conferences, including NHCAA and NAMPI, where he presents pre- and post-payment analytic strategies alongside health plan leaders. He was valedictorian of his graduating class from Boston College with degrees in biochemistry and philosophy.
The healthcare industry is at a turning point: payers and providers alike are demanding more from payment integrity than opaque rules engines and audit surprises. While black-box vendors have long promised value, their lack of transparency can lead to costly misalignment, internal dependency, and missed opportunities for learning and waste prevention.
This session will explore the hidden costs of opacity in traditional payment integrity models and offer a modern alternative. We’ll examine how health plans can reclaim ownership of their payment integrity strategy by shifting to AI-powered platforms to empower internal audit teams (0-pass) phase, promote internal learning, reduce overdependence on black-box vendors, and align audit logic with clinical evidence.
Attendees will learn how connecting prior authorization and claims data earlier in the care lifecycle can help identify root issues before they become payment errors. Beyond preventing waste, this approach can strengthen provider relationships, improve internal capabilities, and ultimately drive more proactive, accurate decision-making.
Using real-world insights, we’ll show how a collaborative, clinical intelligence-driven model can give payers a sustainable edge in accuracy, agility, and provider trust.
Monique Pierce
Payment Solutions & Operations
Cohere Health
Monique started her Payment Integrity career in COB at Oxford HealthPlans. After the merger with UnitedHealthcare, she led multiple teams and was responsible for creating innovative programs. Monique joined SCIO Health Analytics in 2014 and was responsible for system and process improvements before being promoted to VP of client engagement and business optimization In 2020, Monique joined start-up Devoted Health and created a full suite of programs from the ground up. Based on a passion for metrics and measuring performance, she centralized and standardized all programs reducing implementation time and maximizing savings. Today, Monique is driving opportunities to improve claim payment by designing and developing new prior auth and claim reconciliation products at Cohere Health.
Lalithya Yerramilli
SVP, Payment Solutions
Cohere Health
Katch
Website: https://katchiq.com/
Katch is the industry leader in payment coordination, offering end-to-end solutions from Proactive Injury Coverage Coordination (PICC) to subrogation.
Katch gives you more from every claim: more value, more savings, and more confidence in the process.
By combining human insight with data and technology, we deliver smarter outcomes—before and after claims are paid. We tailor our strategies to each client’s unique needs, building partnerships that create real impact.
Katch finds what others miss—earlier, faster, and easier.
- 35+ years of subrogation experience
- Supporting 100+ clients across all 50 states
- Scaled solutions for PICC and subrogation
Proactive By Design
Raffaello d'Amor
Head of Product
Magical
Not all automation is created equal. This session helps healthcare leaders cut through the noise and get real about what “agentic” means in practice. If you’ve been burned by bots that couldn’t scale—or are evaluating solutions now—this talk will help you make smarter choices.
Learning Objectives:
Distinguish between RPA, chatbots, and agentic AI
Learn how agentic systems adapt, escalate, and self-manage
Discover where agentic AI delivers outsized value in RCM
Get a checklist for evaluating automation depth and risk
Vanessa Moldovan, CRCR, CPC, CPB, CPMA, CPPM, CPC-I
Head of RCM Strategy
Magical
Raffaello d'Amor
Head of Product
Magical
Magical
Website: https://www.getmagical.com/
Magical helps to securely transfer patient data between systems. Autofill forms and databases in your EHR system or on insurance portals without expensive integrations or APIs. Magical’s no-code solution allows teams to connect and move information between different systems and apps—instantly.
Laika Kayani
Vice President, Product Management, Payment Integrity
Optum
Payment integrity is at a critical inflection point—facing unprecedented challenges, but also extraordinary opportunity. This session will explore the move from traditional payment integrity to payment precision, focusing on how increased transparency between health plans and providers can enable real-time interactions at claim submission. AI is bringing a new paradigm of payment integrity interventions, and when done right and paired with deep healthcare expertise, it can unlock unprecedented value.
Jeremy Hill
VP, Payer Solutions
Optum
Optum
Website: https://business.optum.com/en/operations-technology/payment-integrity.html
Optum is a leading information and technology-enabled health services business dedicated to helping health plans achieve payment accuracy and improve cost savings across the claim lifecycle.
Peter Monson
Sr. Manager, Special Investigations Unit
UCare HP
Peter Monson is the Sr. Manager of the Special Investigations Unit at UCare, where he leads a team dedicated to preventing, detecting, and correcting fraud, waste, and abuse in health care claims. With more than a decade of investigative and leadership experience across health plans and state government, he has overseen some of the most significant Medicaid fraud cases in Minnesota’s history and has redesigned investigative practices to maximize efficiency and impact.
In addition to his role at UCare, Peter previously served as President of the Midwest Insurance Fraud Prevention Association, fostering collaboration between private insurers and government agencies to strengthen fraud prevention efforts. He holds a Bachelor of Science in Criminal Justice and minor in Psychology from North Dakota State University.