Once your strategies are in place and best practices established, our people lead the entire implementation and optimization of your systems. And, where needed, we can provide interim leadership to ensure technological and procedural transitions complete smoothly and effectively.
Change is the only constant in today’s regulatory environment. With increasing pressure to meet compliance requirements within government-specific timeframes, payers are seeing operations and infrastructure placed under unprecedented strain.
HighPoint helps government program payers understand and adapt to regulatory complexities. We guide the
development and implementation of strategies to accomplish complex goals. We identify the technologies and organizational processes necessary to meet compliance standards. We work to rationalize systems and business structures so our clients can reach aligned payment models, manage the costs of care, and effectively transition to population health.
GOVERNMENT PROGRAM SERVICES
Tackle compliance at every step of your project, and every point of your processes with the full support of an expert HighPoint team.
Our healthcare leaders provide up-front management consulting and advisory services that prime your organization for regulatory success from the top down:
LEADING GOVERNMENT PROGRAMS
Pam RuebelmannVice President, Government Programs
With over 25 years of technology and healthcare consulting experience, Pam is an expert in healthcare management, claim cycle management, and revenue cycle management. She is a member of the Managed Care Executive board with extensive subject matter experts in the commercial payer and provider markets. Prior to joining HighPoint, Pam held senior management roles at leading IT consulting firms and was the CIO at Mid-America HealthNet. Her academic credentials include an MBA from the University of Kansas and a BA in Computer Information Systems, graduating cum laude from Ottawa University. She is also a Project Management Professional (PMP), certified by the Project Management Institute (PMI).
Ann GainesDirector, Payer Technology
Ann Gaines is a Director at HighPoint. She has over 25 years of experience in the healthcare industry. She has extensive program and project management experience, while assisting in staff development in project management, configuration, and business processing skills.
Ann’s experience includes HealthEdge HealthRules Payor and Care Manager, and Cognizant QNXT. Throughout her career, she has focused on using established programs and project management methods, processes and practices for implementing core processing systems with multi-system enterprise ecosystems. She also has experience in core claim administration system conversions, claims management, testing, auditing, workflow analysis, re-engineering, implementation management and systems configuration.
Joni WagnerSenior Manager, Government Programs
Joni has over 25 years of experience working in the Healthcare industry. Her experience includes a variety of leadership roles in Health Plan Operations, prior to moving to into a consulting career with HighPoint Solutions. Throughout her career, she has had responsibility to ensure that core systems support accurate and efficient administration of the Health Plan core operational functions (configuration, claim adjudication – benefits and pricing, customer service, medical management, billing, enrollment and fulfillment). Her experience also includes core system selection, implementation and upgrades.
Joni has experience with a variety of product lines, including Commercial (fully and self insured), Individual, and Government Programs (Medicare MAPD, Medicare Dual Eligible, Medicare Supplement, Medicaid and Medicaid Managed Long Term Care). Joni holds a BA in Business Administration from Michigan State University.
Tommaso DiGiovanniSenior Consultant, Government Programs
Tommaso DiGiovanni is a Senior Consultant for HighPoint Solutions. He has spent the last two decades working to analyze and develop solutions for health plans in the commercial, self-insured, Medicare, and Medicaid lines of business. Much of his work has centered on initiatives to improve operational efficiencies, upgrade technologies, and to ensure continuous compliance with state and federal regulations. He holds a Master’s degree in Management, Strategy, and Leadership from Michigan State University and a Bachelor’s of Business Administration from the University of Miami.