Doug Markham is the President for CareWorks Managed Care Services and is responsible for all prospective and retrospective programs and services, including bill review, utilization review, case management, integrated managed care plans, Preferred Provider Organization and diagnostic imaging networks. He has over 15 years of industry experience and previously held leadership positions within the managed care industry including Vice President of Network Development for FOCUS Healthcare Management, a Concentra subsidiary. His background includes an emphasis on strategic planning and implementation, managed care sales and marketing, operations and product development.
Lisa Scaggs-Oskoui, Executive Vice President, has been with CareWorks since January 2011. For more than 20 years Ms. Oskoui has been selling managed care services including Independent Peer Review, Medical Bill Review, Independent Medical Examination, Integrated Services, Investigative Services, Preferred Provider Networks and Pharmacy Benefit Management to regional and national accounts. In addition, Ms. Oskoui has extensive experience in Network Development, Project Management, and Operations.
Mundy Hebert serves as Senior Vice President, Prospective Services for CareWorks and has over 20 years of experience in the insurance industry. Ms. Hebert directs and manages the day-to-day operations of our peer review, case management and utilization review services. She is also responsible for product development and implementation. Previously, she served as Vice President Sales and Marketing for Forté where she directed managed business development and marketing efforts. Ms. Hebert also served as an Account Executive for the company, and focused on account acquisition and management for clients in the workers’ compensation and liability markets.
During her career, she has held several sales management positions including Large Group Sales Manager and Senior Sales Associate for Hillhouse Associates.
J.J. Schmidt serves as Senior Vice President, Managed Care for CareWorks and has over 20 years of managed care experience. Mr. Schmidt oversees CareWorks 's data analytics processes and is responsible for identifying emerging trends and future cost drivers. J.J. earned a Bachelor of Arts degree from The Catholic University of America and a Masters of Business Administration from St. Thomas University. He is currently a Ph.D. candidate at Florida International University.
During his career, Mr. Schmidt has held several high-level positions in managed care and vendor management with several national managed care organizations.
Brenda Calia, Senior Vice President of Integrated Services, has been with CareWorks since 2004. Ms. Calia has more than 25 years of experience in the managed care services industry in various roles including Co-founder of CareSys, Business and Product Development, Program Implementations and Operations Management. In addition, Ms. Calia has extensive experience in working with physicians to develop protocols and databases, as well as experience in Financial Services.
John Paolacci serves as Senior Vice President of Integrated Services for CareWorks and has over 20 years of experience in the claims and managed care industry. Mr. Paolacci leads and directs CareWorks’s national medical bill review operations including best in class network strategy, Medicare secondary payer compliance division, and state certified network operations. In addition, he oversees CareWorks’s pharmacy benefit management program. Mr. Paolacci is responsible for daily operations, product development, and business strategy.
During his career, Mr. Paolacci has served in leadership positions in the claims, managed care, and insurance industries.
B.J. Dougherty, Senior Vice President of Medical Bill Review Services, has been with CareWorks since 2004. Mr. Dougherty manages and oversees CareWorks’ Medical Bill Review Services division.
Mr. Dougherty has more than 20 years’ experience in the managed care services industry in various roles including Co-founder of Solutions4, Management of Bill Processing Operations, and Account Management. In addition, Mr. Dougherty has extensive experience in Sales and Development for a multitude of managed care products within multiple lines of insurance including Group Health, Workers’ Compensation, Auto, Longshore, Liability and Disability.
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