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The CHC Team print this document

Ira N. Gottlieb, President & CEO

As president and founder of The Creative Group, Mr. Gottlieb has focused the company’s mission of providing professional, effective consulting services to insurers and providers in their desire to attain specific business goals and objectives.

Through the combined strengths and talents of the companies under The Creative Group’s umbrella, Mr. Gottlieb has assisted a diverse group of client organizations: hospitals and hospital systems, physicians and physician groups, large national insurers, integrated healthcare systems, specialty/ancillary service providers, niche healthcare companies, HMOs and various other payers and providers. Expertise in assisting clients with developing turn-key networks in addition to service area expansions for national and regional insurers including PPOs, HMOs, Medicare Advantage, Behavioral Health, Workers Compensation and other specialty areas; strategic planning, venture planning, partnering and product introduction.

Harry F. Blair, Vice Chairman

Mr. Blair has managed field operations for network development and contract negotiation projects for the firm over the past 17 years.  These assignments have included developing state-specific PPOs; national specialty networks and HMO network start-ups; Medicare Advantage Plans nationwide and network expansions across all product lines.  As a consultant, Mr. Blair has served as Interim VP, Network Development for Empire Blue Cross Blue Shield and directed strategy and entire staff.

Mr. Blair provides consultative services in managed care including interim management, network contracting, strategy and venture development and implementation, acquisition analysis and negotiations, HMO and PPO development and provider and payer contract negotiations.

Previous positions include Executive Director, Sanus Health plan of Greater New York and New Jersey; Vice President, Metropolitan Life Insurance Company; President, MetLife Healthcare Network of New York/New Jersey; First Assistant New York State Deputy Attorney General of Medicaid Fraud.

Debra E. Bornstein, Chief Operating Officer

Professional experience includes over 20 years in healthcare with a focus on building and maintaining diverse provider networks for some of the largest managed care organizations in the New York tri-state area.  Her expertise lies in provider contracting, strategic planning and medical cost trending with significant operational knowledge of all areas of transaction management.

Prior positions include Market Head, Aetna; Vice President of Medical Delivery Systems, MagnaCare; Vice President of Health Services, United Healthcare; Director, Medical Delivery, Oxford Health Plans.

Sharon S. Adair, Senior Vice President

Ms. Adair has over 20 years of experience in the managed care industry, and is senior consultant for the firm’s physician recruitment initiatives for Medicare Advantage, Medicaid and Commercial HMO and PPO payers nationwide. She led a team that experienced a 92.7% document recovery success rate for EBCBS following 9/11.

Ms. Adair is responsible for customized competitive information, research projects and development and maintenance of the firm’s databases.

Dan Pfeiffer, Senior Vice President

Mr. Pfeiffer brings over 20 years of healthcare management experience to the Creative Health Concepts team. His expertise is focused in network management, contract negotiations, marketing and strategic planning.

Prior to returning to CHC, Mr. Pfeiffer was Regional Vice President at MultiPlan, with oversight of network development and provider relations for the Greater New York area and New England. Previously, Mr. Pfeiffer was a Senior Vice President at CHC, and was with the organization from 1993 to 2002.

Earlier positions include Vice President at Great West/Cigna, and founding member of Vista Chronic Care Solutions, a disease management and specialty pharmacy company affiliated with Trinity Homecare. His early career in managed care was spent with MetLife Healthcare and Sanus NY Life.

Steve Miller, Managing Director

Steve Miller is the Managing Director or the Managed Care division of Creative Health Concepts. HealthCare is at an extraordinary crossroads, experiencing challenges like never before. With over 25 years invested in Hospital and Health Plans C-suite, Steve has an accomplished record of achievement that can address your critical success factors: managing advanced payment models, coordinating and connecting care, brokering partnerships in an effort to reduce cost and increase quality.

Steve is happily married and has two children. Away from business, he enjoys golfing, skiing and spending time with family and friends.

Will Kinkead, Senior Director

Mr. Kinkead has extensive experience in the managed care industry specializing in managed care contracting, network development, physician fee negotiation and strategic network management. Mr. Kinkead graduated Monmouth University with a Bachelor of Science degree in Marketing and has since worked for several managed care organizations in the Greater New York City area. His expertise and knowledge of the healthcare industry, in particular the managed care sector, has made him an invaluable asset to the Creative Health Concepts organization.

Mark Hirschhorn, Director

Mark Hirschhorn has over twenty years of experience in the health care field. Mark’s career has included positions in Home Health Care, Workers’ Compensation Managed Care, Hospital Administration as well as the payer and provider side of health care.

Mark’s skills and responsibilities include managed care contracting and negotiation, credentialing, physician practice management, network development and management, provider contracting, provider recruitment, provider relations, new business development, and policy and procedure development and implementation. Additionally, Mark has experience in corporate compliance, malpractice insurance programs, Article 28 Diagnostic and Treatment Centers and Ambulatory Surgical Center Management.

Mark is a member of the National Association Medical Staff Services, New York State Association Medical Staff Services and became certified as a Certified Provider Credentialing Specialist in October 2010.

Mark earned a Bachelor of Science Degree in Health Administration from SUNY Plattsburgh.

John Prufeta, Senior Vice President

John Prufeta is Founder and Chairman of Agilence Health Advisors, LLC, a national health care performance acceleration firm serving Academic Medical Centers, Health Information Technology organizations, Insurers/Consumer-Directed Plans, PBMs, Private Equity and and Venture Firms. Mr. Profetta is also Founder and Chairman of Medical Excellence, an exclusive healthcare concierge membership club.

Mr. Prufeta is former president and CEO of Medix Resources, a publicly-held company (AMEX:MXR) providing technologies that enable secure communication of healthcare data between providers and insurers. Mr. Prufeta was also Founder, Chairman and Chief Executive of OnPoint Partners, Inc., a boutique firm providing a range of healthcare development services including new product development, interim and permanent executive talent, and network contracting. Additionally, Mr. Prufeta co-founded The Creative Group in 1989.

Mr. Prufeta is a member of the Board of Trustees of New York Hospital of Queens, Silvercrest facility, where he serves as Chair of the Finance, Audit and Compliance Committees. Additionally, he is an Adjunct Professor, Consortium on Managed Care at Fordham University School of Business. He is also a founding Committee Member of “America’s Huey” a not for profit organization dedicated to educating Americans about achievements and sacrifices made by our Armed Forces.

Marissa Tempesta, Executive Administrator

Marissa Tempesta joins the CHC team, aiding in the administrative day-to-day of the office and provides crucial support to the entire team. She also assists with network development, recruitment opportunities, and project expansion. Marissa graduated from Boston College in 2011 and looks forward to growth and exciting work within Creative Health.

Kevin Weiner, MD, Vice President/ Medical Officer

Dr. Weiner is a practicing, board certified physiatrist with expertise in practice
management, development of clinical partnerships and staff development. After obtaining his medical degree at The Chicago Medical School, Dr. Weiner trained at the NYU/Rusk Institute of Rehabilitation. Now, over 13 years in practice, Dr. Weiner has established a successful outpatient practice, served as the medical director of several rehabilitation units, served as a PM&R Residency Director and serves as Chairman of PM&R in a NYC hospital.

Richard Beland, Managing Director

Mr. Beland offers over 25 years of executive level sales and marketing experience. In executive management positions for several of the nation’s largest behavioral healthcare organizations including: Merit Behavioral Care, APS and Value Options he was directly responsible for all aspects of sales and marketing. His areas of expertise include: business development, team development, sales and marketing planning, sales strategy (including needs analysis, lead development, customer tracking, pricing (risk based and ASO), RFP response and finalist presentations), account management, product development, cost containment, budgeting and direct sales.

Mr. Beland is one of the nation’s leading behavioral healthcare sales producers, having personally sold 100’s of millions of dollars in EAP and behavioral healthcare services to various customers including Medicaid, Medicare and commercial HMO’s, insurance companies, Fortune 500 companies, state and local government entities as well as unions. Mr. Beland holds a Bachelor of Business Arts from The University of Pennsylvania’s Wharton School as well as a Master of Science from their Dynamics of Organization program. Responsible for managed care credentialing for individual physicians, large group practices and ancillary providers for one of the firm’s major hospital clients.

Claudia Beland, RN, Managing Director

Ms. Beland has over 25 years of executive level health care management experience. In executive leadership positions for several large behavioral health and medical managed care companies and a specialized health care informatics company she was directly responsible for all aspects of strategic business development and operations. Her areas of expertise include: implementation, account management, clinical operations, program design, customer retention, data analytics, report development, quality improvement, sales and marketing and product development.

Ms. Beland has an extensive background in quality management program design and evaluation. She and her team of independent clinical consultants supported quality of care reviews and audits for several State agencies to assess compliance with federal and state standards related to quality of care in acute care psychiatric facilities and residential care settings.

Ms. Beland has held executive management positions in Value Options, Merit Behavioral Care, WellCare, Empire Blue Cross Blue Shield and ActiveHealth Management.

Ms. Beland is a New York State Registered Nurse.

Michael P. Frampton, Vice President

Mr. Frampton has 30 years experience in the healthcare industry including positions of executive leadership and currently provides healthcare consultation as Frampton Associates, LLC. He has consulted for the past 15 years to the senior sales/marketing and provider network executives of virtually all Blue Cross Blue Shield Plans on design and development of provider networks and health management, provider transparency and consumer-directed programs to meet national employer expectations for quality and cost trend management. He has served as Senior Vice President at Consortium Health Plans and Vice President for Provider Network Management at Empire Blue Cross and Blue Shield and Empire Mental Health Choice.

Mr. Frampton is versed in strategic planning to win and retain national employer health benefits business and structuring inter-health plan fee arrangements to combine local health plans into seamless national networks for self-funded employers. He is the principal architect of ClaimsQuest™, the industry-leading approach to measuring the value of healthcare provider discounts.

Mr. Frampton holds degrees in Human Behavior (B.A.) and Social Service Administration (M.A.) from the University of Chicago.

Victoria Lukas, Consultant

Ms. Lukas has over 30 years experience in health care on a national level which includes hospital, home care, and managed care experience. She is commended for her ability to spearhead network development projects; lead negotiations; and strongly analyze and manage strategic business plans. Her ability to identify and capitalize on contracting, marketing and strategic opportunities that support project delivery makes Ms. Lukas a critical member of the CHC staff.

Prior career includes Universal American, Houston, TX; Integrated Health Plans, St. Petersburg, FL; Cigna Health Plan of NY. Held Management Positions: Select Providers, Lake Success, NY; Executive Nurses Home Care, Inc., Port Washington, NY; American Management Services, Denver, CO; Better Health Plan/Coastal Physician Group, Durham, NC.

Mary Kay McHale, Consultant

As a consultant for CHC, Ms. McHale has recruited targeted physicians to participate in a capitated managed care plan; created and organized a client’s computer database to include it affiliated physicians with participating managed care plans.

Her 17 years experience has been as Manager of Credentialing/Provider Services/Customer Services for MagnaCare and Manager of Provider Services; Manager of Provider Services form MetLife Network.

Nancy Sullivan, Consultant

Ms. Sullivan is an experienced health care executive, with over 20 years in hospitals, home health care, managed long term care and marketing. She has an extensive background in all aspects of health care within a local and regional marketplace. Ms Sullivan has significant experience in operations, strategic planning and high level negotiations. She is the in-house specialist for all areas of Home Health Care.

Ms. Sullivan’s prior positions include: COO at Family Aides, Inc., VP Marketing at Family Care Certified Services, VP Marketing/Managed Care at Good Samaritan Hospital and President at Samaritan-At-Home Services.

 

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