2020 Outcomes Bios

2020 Outcomes Bios

mike-cirillo-outcomes@2x

Host

Mike Cirillo

President, myMatrixx

As President of myMatrixx, an Express Scripts company, Mike Cirillo is responsible for overseeing the workers’ compensation division’s national strategy and corporate operations across the U.S. His responsibilities include developing the company’s growth and productivity initiatives as well as forming new business and industry partnerships.

Mike has proven to be a successful and trusted leader with a strong knowledge of the PBM industry. He joins myMatrixx with more than 25 years of leadership experience in workers’ compensation, claims management, ancillary services and pharmacy. Most recently, Mike served as President of Specialty Solutions Rx, where he helped deliver cost-reduction solutions to national accounts and payers by enabling better patient outcomes.

Through his experience, Mike has led efforts in combatting the high costs of medications and improving patient safety in workers’ compensation. Mike has a strong focus on keeping our clients and their injured workers at the forefront of everything we do.

Mike holds an MBA from Rensselaer Polytechnic Institute and a Bachelor of Science in Business Administration with a concentration in Accounting from Western New England College. He is a Certified Internal Auditor and a Member of the Institute of Managerial Accountants.

He currently resides in Tampa, Florida, and is an avid Boston sports fan.


phil-walls-outcomes@2x

Moderator

Phil Walls, R.Ph.

Chief Clinical Officer, myMatrixx

Phil Walls is the Chief Clinical Officer for myMatrixx. He joined the company in 2006 and oversees all aspects of myMatrixx’s clinical program including drug utilization review, formulary management, drug regimen reviews and targeted intervention with prescribing physicians.

Phil is a clinical pharmacist with over 40 years of experience in pharmacy, healthcare informatics and workers’ compensation. Previously he served in leadership positions within the industry with Health Information Designs, Inc., PMSI and Cigna Healthcare of Florida, Inc. He is a published author and frequent national speaker on clinical issues in workers’ compensation.

Phil is a highly regarded clinical pharmacist who is frequently asked to speak on topics relative to the industry. This is his passion and his priority – educating people and patients on the dangers of opioid abuse and the epidemic that is devastating the lives of so many people across our country.

In recognition of his contributions to the industry, Phil was named CompPharma’s 2015 Person of the Year and received the Dorland Health People Pharmacist Award. He is a member of the AMCP, APhA, APS, ASAP, ASHP, FPA and the International Society for Pharmacoeconomics and Outcomes Research.

Phil received his Bachelor of Science in Pharmacy from Mercer University School of Pharmacy and was awarded Doctoral Candidate status in Pharmacology at Ohio State University.

Phil currently resides in Tampa and enjoys cruising with his family. A notable fact about Phil is that he was the 12th employee hired at myMatrixx.


Teresa Bartlett

Teresa Bartlett, MD

Managing Director and Senior Medical Officer, Sedgwick

Teresa Bartlett is the Senior Vice President and Senior Medical Officer at Sedgwick since January of 2009. Her background in Family Medicine led to a business career with a large automotive manufacturer. She has experience managing large self-insured, multi-state workers’ compensation programs and the Canadian workers’ compensation program. The short term disability (STD) program which Dr. Bartlett managed was union negotiated. She developed an evidence based medical substantiation process which saved millions of dollars and reversed the escalating STD trend. She led the team that won the Corporate Health Achievement Award from ACOEM in 2005 for the Development and Implementation of a Best Practice Clinical Model.

During her career she has had the opportunity to manage and mold wellness and fitness programs which evolved into award winning programs that were integrated into the benefit and claim structure. Dr. Bartlett was the recipient of the Crain’s Detroit Business 2008 Health Care Hero Award for bringing a new and innovative program to address back pain into the workplace. In 2012 she was a Business Insurance recipient of Women to Watch. In 2015 Dr Bartlett was the recipient of the President’s Honor Roll of the Comp Laude award for Work Comp Central for her work with physicians who had aberrant prescribing patterns in California. In 2017 she was appointed to the inaugural Board for the Women to Watch Foundation. Dr. Bartlett volunteers each week as a crisis counsellor for Crisis Text Line providing help for those in the moments of great need. She is a frequently requested national speaker on various health topics in the industry.

As the Senior Medical Officer for Sedgwick, Dr. Bartlett is an advisor in matters affecting the design and delivery of medical management services for the company’s claims clients. She provides strategic counsel and operational support in all areas of medical management including case management, return-to-work, behavioral health interventions, medical outcomes protocols, pharmacy interventions, telemedicine and health and safety matters. Dr. Bartlett also advises on best practices to integrate the delivery of occupational and non-occupational medical services and the matters affecting healthcare as part of the claims services process.


Tamara Evans

Tamara L. Evans, CPCU, AIC, AIM, ACS, AIS, WCLS

Assistant Vice President/Director of Workers’ Comp Claims, EMC Insurance Companies

Tami is Assistant Vice President- Director of Workers’ Compensation Programs and Services for EMC Insurance Companies. She is a graduate of Central College in Pella, Iowa. She has worked in the workers’ comp industry for 34 years, all at EMC. Her responsibilities include the oversight of the workers compensation for all jurisdictions as well as other areas that are directly related to cost management and services for workers compensation claims. Tami is involved in multiple industry activities including the Property Casualty Institute (PCI), IAIABC, Iowa Association of Business and Industry and the Iowa Insurance Institute. She also serves on the Board of the Iowa Workers’ Compensation Advisory Committee, Kids Chance of Minnesota and Iowa and NCCI Medical Data Call Research Committee. She has also completed the following insurance designations: CPCU, AIC, AIM, ACS, AIS, WCLS.


Alice Lihou

Alice Lihou

President and CEO, Qual-Lynx Inc.

Alice Herron Lihou is the President and Chief Executive Officer of Qual-Lynx, a regional claims and managed care services organization that provides property and casualty claims administration to large self-insured employers, insurance carriers, and pooled association risks. Alice is also Vice President of QualCare, Inc., which offers provider network access for Workers’ Compensation.

Qual-Lynx is owned by QualCare Alliance Networks Inc. (QANI), which is a wholly-owned subsidiary of Cigna Health and Life Insurance Company. QANI is also the parent company of QualCare Inc. (QualCare), a managed care organization headquartered in Piscataway, New Jersey. Qual-Lynx/QualCare employ nearly 250 claim professionals, medical case managers, medical bill repricers and support staff personnel. This affiliation provides Qual-Lynx and QualCare the ability to bring their respective strengths together to offer clients an enhanced workers’ compensation product and a seamless, collaborative approach to managing workers’ compensation injuries and their underlying costs.

Alice is a seasoned executive with over 30 years of experience in the property and casualty insurance business. She is responsible for business development for all property and casualty products and services, including managed care services for Workers’ Compensation programs, as well as running the day-to-day operations of Qual-Lynx which maintains offices in New Jersey, Pennsylvania, New York and Florida. Qual-Lynx offers professional management of claims arising from all lines, including but not limited to Workers’ Compensation, General Liability, Automobile Liability, Property, Employment Practices Liability, Educators Legal Liability and Public Officials Liability exposures.

Ms. Lihou has been employed by Qual-Lynx since 1989. She has an industry wide reputation for her knowledge, attention to detail and providing outstanding service to clients. Throughout her distinguished career at Qual-Lynx, she has held a variety of assignments of increasing responsibility.

Ms. Lihou has also been an integral part of Qual-Lynx’s ongoing marketing and public relations efforts. In this role, she is the face of Qual-Lynx at local and national meetings and conventions, speaking at seminars, and providing information and instilling confidence to prospective clients.

Ms. Lihou is a graduate of St. Joseph’s University in Philadelphia, Pennsylvania, and has also earned her degree as a Paralegal from the Sutton School of Paralegal Studies. Alice has achieved a WCCC designation and her Associate in Claims from the Insurance Society of Philadelphia and continues to pursue continuing education as a lifelong learner.


John Ruser

John W. Ruser, PhD

President and CEO, WCRI

John W. Ruser, Ph.D. has 35 years of professional experience in conducting and managing economic research projects in labor and health economics, and in managing and interpreting economic surveys pertaining to employee pay, benefits and working conditions. He is currently President and CEO of the Workers Compensation Research Institute (WCRI) in Cambridge, Massachusetts, an independent, not-for-profit research organization. Dr. Ruser is responsible for executive leadership and strategic planning for the Institute, as well as oversight of the Institute’s economic and statistical research program. Dr. Ruser previously held three executive positions in the Federal statistical system, serving as Associate Commissioner for Productivity and Technology and Assistant Commissioner for Safety, Health and Working Conditions, both at the US Bureau of Labor Statistics (BLS), and Associate Director for Regional Economics at the US Department of Commerce, Bureau of Economic Analysis. In these three positions, he managed statistical programs that produced data on productivity, worker safety and health, and regional income, price and product accounts. Previously, Dr. Ruser was a researcher and Chief of the BLS office that conducted research on and improved measures of employee pay, benefits and working conditions in the US. Dr. Ruser has written many academic peer-reviewed and non-technical articles and book chapters on employee compensation and occupational safety and health. He holds Ph.D. and M.A. degrees in economics from the University of Chicago and a B.A. in economics from Princeton University.


David Wehner

David Wehner

Managing Director, Ostroff Associates, former CEO of the New York State Insurance Fund and former Chairman of the New York State Workers Compensation Board

David joined Ostroff Associates Inc, in January of 2011 and brings over 25 years of federal and state government experience to the firm. David specializes in the areas of insurance, labor, workers' compensation and business development. He is a frequent speaker on workers' compensation and regulatory issues.

David most served as CEO of the New York State Insurance Fund and Chairman of the New York State Workers' Compensation Board. Prior to that he served as Executive Deputy Commissioner of the New York State Department of Labor. He also served as Media Director to United States Senator Alfonse M. D’Amato.

David has had leadership roles with numerous labor and workers' compensation associations including President of the National Association of Government Labor officials. He is a former member of the Board of Governors of the NYS Compensation Insurance Rating Board, and former board member of the Special Funds Committee. He has also honored by the NY Claims Association, the Workers' Compensation Bar Association and the State University of New York. David is also President of Kid’s Chance of New York, an organization that provides scholarships to children of workers who have suffered catastrophic workplace injuries.

David holds a Bachelors and Masters Degree in Communications from the State University of New York at Albany.