Executive Summary: Implementing CMS Interoperability & Prior Authorization Rule

Dr. Sand has a proven track record of success as a healthcare executive. From the beginning of his career as a solo private practice ENT surgeon to his experience in the government-sponsored arena, Dr. Sand has been involved in the U.S. healthcare system since 1979. He has led organizations in traditional Medicare and Medicaid, as well as Medicare Advantage and Managed Medicaid programs as the chief medical officer in startups, turnaround situations, and larger, well-established health plans. In his broad experience and tenure in healthcare, Dr. Sand assisted organizations in achieving the Quintuple Aim through innovation, sound business practices, and most of all, teamwork. He served as the chief medical officer for Medicare Advantage at Anthem BCBS, as well as multiple health plans across the country.

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For over 17 years, Tony has led business and technical teams to deploy exchanges in multiple states and championed deep integration of provider data and workflows with payer platforms for improving outcomes and reducing administrative burden. In his current role, Tony is responsible for defining and driving ZeOmega's HealthUnity interoperability platform strategy in collaboration with industry stakeholders and partners. He has extensive experience working with clients on utilization management, case management, and population health systems.

As Associate Vice President of Interoperability Strategy, Mike leads the HealthUnity team in strategic vision for interoperability and executes on market strategies for HealthUnity solutions. Among HealthUnity solutions is the Smart Authorization Gateway, an accredited product to streamline the prior authorization process and reduce burden for providers and payers. Mike has over 20 years’ experience in business and IT roles across the provider and payer landscape, including recognized leadership in the development and implementation of health data standards.