Advantek Benefit Administrators

Scott Wells is the Chief Executive Officer for Santé Health System and Advantek Benefit Administrators. Under his direction, Advantek provides quality third party administration services to clients of all industries. In addition, Scott manages and directs management services to the regions largest independent physicians association, and numerous other specialty practice management clients.

Before joining Santé/Advantek in 1995, Scott was Director of Audit and Consulting Services for Community Medical Centers. Prior to his service with Community, Scott was a senior manager with Ernst and Young's accounting, auditing and consulting department.

Chris Cheney is the Chief Financial/Operating Officer for Advantek Benefit Administrators. With a broad range of responsibilities, he directs and oversees Advantek's claims processing, utilization management, customer service, financial operations and decision support.

Chris joined Santé/Advantek in 1998 in his current position. Prior to this Chris was responsible for the Internal Audit Department of Community Medical Centers.

Previously he was a director at Valley Children's Hospital working with physicians and physician practices. Before joining Valley Children's, Chris was an audit manager with Ernst and Young providing audit and consulting services to a varied group of clients and industries.

Dr. Bluestone joined Santé/Advantek as the Vice President of Medical Affairs and Medical Director of Santé/Advantek. Dr. Bluestone's responsibilities include oversight of the utilization management function and staff. Under his direction, medical decisions are reviewed to ensure that Advantek's patients receive the most appropriate, high quality medical care. He also acts as a liaison between Advantek and its provider panel and other hospitals providing care in the Central Valley.

Daniel Bluestone M.D. trained in Pediatrics, Neurology, and Pediatric Neurology at UCSF. He is board certified in Neurology and Pediatrics. From 1989 to 1992, he was Chief of Child Neurology for the US Air Force. Dr. Bluestone opened a private practice in Jacksonville, FL. He served as Director of Clinical Child Neurology and Assistant Professor of Pediatrics and Neurology at UCSF from 1993-1999. In 1997 Dr. Bluestone received an MBA at St. Mary's College, California.

Debbie Nephew is the Vice President of Operations for Advantek Benefits Administrators. She has over 25 years of operations management experience. Her responsibilities include direct management responsibility for the claims department, utilization management, member services unit, technical services, eligibility maintenance, and benefits and cost containment.

Prior to joining Santé Health System, Debbie was employed with CIGNA and most recently was the Regional Director for the Western Region. Her responsibilities included providing day to day operational direction to seven offices, representing over 1,700 employees. One of her major accomplishments was the successful implementation of CIGNA's largest non-standard managed care plan for a premier telecommunication company.

Eileen Kimura began her career in the insurance industry in 1971 with the Equitable Life Assurance which later became CIGNA Healthcare. She processed medical, dental and disability claims and later became a trainer for the office. Eileen relocated to Fresno, CA in 1983 as a supervisor of claims and later returned to training. She traveled to many offices training dental and medical (PPO & HMO) claims processors. Eileen participated in the review and development of New Hire Training curriculum, and was the lead contact for the claim processing systems, system pilots, system issues and policies and procedures. Eileen became a Claim Service Manager responsible for approximately 35 claims examiners for both the PPO and HMO book of business.

Eileen joined Santé Health System and Advantek Benefit Administrators in 2002 as manager of Eligibility, Training and Stop Loss Reinsurance. In 2007, Eileen was promoted to the Director of TPA Claims and Reinsurance.

Kathy Ashlin began her career in the insurance industry in 1996 with Santé Health Systems. Kathy processed medical claims, work in the benefits department and became the eligibility lead. In 2003 Kathy became the TPA claims supervisor. Kathy assisted in managing daily operations of the department, assisted with hiring, supervision and training all TPA claims personnel and worked with our providers to resolve issues or concerns. She also acted as a liaison between health plans and the departments. In 2004 Kathy became the Manager of the TPA claims department. As the Manager she directs all claims to the appropriate claims examiner and reviews policies and procedures and changes as necessary.

Prior to joining Santé Health System, Kathy went to Santa Barbara Business School. She took Medical Office Systems, Computerized Billing, Anatomy and Physiology and Transcription. Prior to the Business College she was in the banking business for 10 years.

Monica Solorio is the Account Manager for Advantek. She has an array of experience working with diverse work environments from fully insured to self-funded. Among her experience, she has dedicated over five years within the health care industry. She graduated with her Bachelor's degree in Business Administration from California State University, Fresno.

Prior to joining Advantek, Monica worked within the health care industry as an Eligibility Auditor for a fully insured company. Her responsibility included providing good member rapport, on-site/client visits, verified employee eligibility for various health plans, ensured compliance of company objectives along with government regulations and provided solutions/recommendations for members and groups.

Jodie Biggs is the Advantek Customer Service and Quality Control Manager. She has more than 20 years experience in the Health Care Industry. Prior to joining Santé/Advantek, Jodie worked for Aetna US HealthCare. She processed Medical and Dental claims, and then became a claims trainer. She has been involved with many implementations of new groups and has been instrumental in various system upgrades and conversions.

Jodie joined Advantek Benefit Administrators in 2002 as the Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) Claims Trainer. In 2007, Jodie was promoted to the Claims Supervisor. In 2008, Jodie was promoted to the Customer Service Supervisor. As of 2010, she is the manager of Customer Service, Benefits and the Quality Department.

Patricia SoRelle is the Manager of the Utilization Management Department. She has over 20 years in operations management. She joined Santé Health Systems and Advantek Benefit Administrators in 2007. Her major responsibility is the supervision of the intake staff, and she works closely with the Medical Director and the Case Manager R.N.'s to insure that requests for utilization review are handled in accordance with Plan provisions and both federally mandated and industry standards.

Prior to joining Santé/Advantek, Patricia worked for several other third party administrators in Fresno, including Western States Administrators, L&H Administrators and Insurance Administrators. She has worked in management positions in marketing, sales, underwriting, customer service, administration, billing, eligibility, and reinsurance.

Erin Ellis is the Manager of Business Development for Advantek. She is a recent addition to the Santé/Advantek team and has 5 years experience in sales/marketing. Erin's responsibilities include developing & maintaining relationships with local and regional insurance brokers specializing in self-insured lines of business, as well as relationships with service partners including PPO networks, reinsurance carriers, pharmacy networks, etc.

Prior to joining Santé/Advantek, she received her Bachelor's degree in Finance from Fresno Pacific University, Fresno.

Jeffrey Gong is the Finance Manager for Advantek. He joined the Santé/Advantek team in 1998 and has more than 16 years experience in health care finance. Jeffrey spends a great deal of time working with clients and vendors to address research and reporting needs.

Prior to joining Santé/Advantek, Jeffrey worked at Community Medical Centers in Accounting and Budget. He received his Bachelor's degree in Business from California State University, Fresno.

Mike Rea is the Director of Data Management for Advantek. He joined the Santé/Advantek team in 1999 and has more than 19 years in the health care industry.

Since joining Advantek, Mike has managed a variety of areas throughout Operation's, such as Eligibility, Configuration, Claim Quality/Training and Client Services. In his current role, his responsibilities include new business development, data integration with business partners and development of business intelligence strategies to better serve internal and external clients.

Mike received his Bachelor's Degree in Business Administration with a minor in Information Technology from National University and his Master of Business Administration Degree from California State University, Fresno.

Marvin Daniels is the Manager of the Data Management and Eligibility departments. He started in the Finance department in 2006 as a Business Analyst. Over time his focus changed to areas of electronic data exchange and eventually to overseeing eligibility. Marvin is also responsible for maintaining the LuminX Information Network, an online set of tools that allow members and clients access to eligibility and claims information.

Lisa Haynes-Scott is a Licensed Vocational Nurse with over 10 years of experience. She received her LVN Education at Clovis Adult School, Bachelor's Degree in Psychology & Organizational Studies at Pitzer College and Master's from National University-Fresno in Public Administration. Lisa has extensive clinical and administrative experience in Psychiatric Nursing.

Becky is a Fresno native. She worked for Fresno Community Hospital for 28 years, before moving to the Utilization Department at Santé in 2005. Her nursing career has included OB nursing, clinical instructor for Fresno City College RN/OB students, Home Health, Hospice, and DRG Assurance. She continued her education to successfully obtain her Case Manager Certification.

Patti joined Advantek Benefit Administrators in November 2010 as a Case Manager in the Utilization Management Department. She comes to Advantek with 3 years of nursing experience which includes working as a Labor and Delivery Nurse at Madera Community Hospital. She has experience in Public Health, Home Health and Case Management. Patti received her Bachelor's of Science degree in Nursing from California State University, Fresno, in 2007 and is one of our newest nurses to join the team. As a Case Manager, Patti's focus is on assisting members in managing their health care needs through outreach and education.

Donna Hummer is a Case Manager in the Utilization Management Department. She began her nursing career with over 12 years experience as a C.N.A in the Skilled Nursing Facility and Psychiatric Unit in Ventura County. She has over 8 years of registered nursing experience which includes working as a nurse in the Pediatric Intensive Care Unit, Acute Care Surgical Unit, as well as teaching various topics in basic and intermediate clinical education at Valley Children's Hospital Central California. Following her Service in the US Army from 1988-1991, Donna received her Associates Degree in Nursing at Ventura College School of Nursing and a Bachelors Degree in Nursing at CSUF.

Pam Brown is a Case Manager in the Advantek Utilization Management Department. She started her career training as a certified OR scrub tech in San Francisco for 4 years. Then, in 1981, she completed her AS degree in nursing at Fresno City College. For the next 34 years, she worked as a Registered Nurse in the operating room. Pam completed her Bachelor of Science degree in Health Care Management from California Coast University, Santa Ana, California. She has 2 years experience working as nurse case manager.