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Scott Wells, Chief Executive Officer
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.
Daniel Bluestone, M.D., Medical Director
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.
Chris Cheney, Chief Financial Officer
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.
Debbie Nephew, Vice President of Operations
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, TPA Director
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.
Frank Lopez, Director Utilization Management
Frank Lopez is the Director of Utilization Management and Disease Management for Advantek. He joined the Santé/Advantek team in 1999 and has more than 20 years in the health care industry.
With the current focus on improved health behaviors, Frank's attention is on developing an effective partnership between the patient and their health care provider while providing enrollees with knowledge, tools and motivation to assume control of their chronic illness.
Prior to joining Santé/Advantek, Frank was employed with CIGNA Health Care as a claims manager. He received his Bachelor's degree in Business Administration from California State University, Fresno and his Master of Business Administration Degree from National University.
He and his wife Cathy have three children whom enjoy swimming and taking trips to San Francisco.
Jeffrey Gong, Finance Manager
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.
Kathy Bullis, Special Projects Manager for Advantek
Kathy Bullis is the Special Projects Manager for Advantek. She joined Santé Health Systems and Advantek Benefit Administrators in 2007. Her major responsibilities include coordination of special projects, audits and compliance. She works closely with the Medical Director, the Nurse Case Managers and the Utilization Management Department to insure that requests for utilization review and case management are handled in accordance with Plan provisions and both federally mandated and industry standards.
Prior to joining Santé/Advantek, Kathy worked for several other third party administrators in Fresno, including Western States Administrators and ATPA. She has worked in management positions in claims, billing and eligibility, and reinsurance as well as compliance and IT. She has very specific experience in computer software conversions, report development and computer automation.
Erin Ellis, Business Development Manager
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, Erin was previously employed as an Account Executive at The Valley Yellow Pages. She received her Bachelor's degree in Finance from Fresno Pacific University, Fresno.
Monica Romero, Account Manager
Monica Romero is the Account Manager for Advantek and is one of the newest members to join the Santé/Advantek team. She has an array of experience working with diverse work environments. Among her experience, she dedicated four years within health care services. 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. Her responsibility included providing good member rapport, verified employee eligibility for various health plans, ensured compliance of company objectives along with government regulations and provided solutions/recommendations for members and groups.
Patricia Rabanal Manager, Utilization Management
Patricia Rabanal is the Manager of the Utilization Management Department. She has over 20 years in operations management. She joined Sante 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.
Phyllis Jensen, Service Manager
Phyllis Jensen is a Fresno native. Phyllis has over 30 years of experience in the health insurance field. Phyllis came from Cigna HealthCare where she has held the positions of Customer Service Manager, Benefits Co-ordinator, where she set the benefits for medical, dental and vision for 4 different claims payment systems, Claims Manager for both HMO and PPO products. Phyllis was a customer service Manager for Blue Shield of California for 2 years prior to Cigna HealthCare. Phyllis came to Advantek in 2002 as member of the benefits department. Shortley after her starting she demonstrated her leadership in the role as Claims Manager for Advantek, managing both the Customer Service and Claims Departments. In her current role as Service Manager she assist both internal and external customers with identifying issues and finding resolutions.
Kathy Ashlin, TPA Manager
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. 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. Reviews policies and procedures and changes as necessary. Schedules and holds regular staff meetings. Identifies software issues for the claims department.
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.
Mike Rea, Director of Data Management
Mike Rea is the Director of Data Management for Advantek. He joined the Sante/Advantek team in 1999 and has more than 19 years in the health care industry.
Since joining Sante/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.
Lisa Haynes-Scott, L.V.N. Utilization/Case Manager
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 Wells, RN CCM
Becky is a Fresno native. She worked for Fresno Community Hospital for 28 years, before moving to the Utilization Department at Sante 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. Becky Wells, RN CCM.
Her love is her family and her Corgis. She is at home in the garden. Growing sweet peas and roses are her specialty.
Sylvia Metzler, RN
Sylvia Metzler, R.N., is a Case Manager for Santé and Advantek in the Utilization Management Department. She has over 23 years of registered nursing experience which includes working as a registered nurse at Saint Agnes Medical Center, Children's Hospitals of Central California, and Community Regional Medical Center. She has had extensive experience in medical surgical nursing, physical rehabilitation nursing at Leon S. Peters Rehabilitation Unit, as a dialysis nurse at Community Regional Medical Center and over 10 years experience as a nurse case manager for Community Home Health prior to coming to Santé and Advantek. She is honored to be the first case manager at Advantek and continues to enjoy her work at Santé and Advantek. Sylvia received her Associate Degree in Nursing from Fresno City College in 1986 and joined Santé in 2002 in her current case management position. She is also responsible for utilization review for inpatients well as outpatient care and reviews prior authorization requests for her department. Her varied working experiences have enabled her to assist patients with their case management needs to improve their health and quality of life.
Sylvia is a Fresno native and is married with 2 children and 3 grandchildren. She enjoys spending time with family and friends as well as traveling, cooking, photography, scrapbooking and reading.
Margie Hill, RN
Margie Hill is the Health and Condition Management Specialist for Advantek. Her role in the Disease Management Program is to improve the quality of life for enrollees by preventing or minimizing the effects of disease through early intervention, education and integrative care.
Margie received her Bachelor's in Nursing from Eastern Washington University in 1982 and her Master's in Leadership and Organizational Studies from Fresno Pacific University in 2007. She began her nursing career in cardiac care, transitioned to the neonatal intensive care for many years, and most recently gained experience in utilization review with case management. Margie has worked at Community Regional Medical Center for the past 24years providing direct patient care, education, case management, and nursing leadership.
Margie and her husband have raised their family in Clovis and now enjoy traveling and spending time at the beach with their yorkies.
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