Vālenz® Health Announces the Acquisition of MCM, Expands Care Management and Population Health Solutions

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PHOENIX, Ariz. (July 27, 2022) — Vālenz® Health announced today it has acquired Medical Cost Management Corporation, d.b.a. MCM Solutions for Better Health and its subsidiary, Med-Care Management, Inc, (MCM), a leading provider of managed care and population health management programs spanning the entire continuum of care for self-funded plans. In May, Valenz announced the acquisition of VerifPoint, a credential verification organization today recognized as VPoint™.

As a Valenz company, the combined MCM and Med-Care subsidiary which have served the multi-employer labor space for more than 35 years, will adopt the trade name Valenz Care. Valenz Care offers member and clinical advocacy through concierge navigation and triple URAC-accredited services for care management, disease management and utilization review. The acquisition accelerates the collective ability to deliver data-driven medical cost management and population health management to labor and public entities, as well as commercial customers.

“Valenz continually explores new ways to deliver on our core promise to engage early and often for smarter, better, faster healthcare, and we are thrilled to now deliver that promise to MCM customers and their members,” said Rob Gelb, Chief Executive Officer of Valenz. “The addition of MCM solutions clearly aligns with the Valenz commitment to deliver care optimized solutions that influence member choices prior to costly healthcare decisions being made. Together, we will prospectively – and continually – address member care needs for improved outcomes and cost containment throughout the member’s healthcare journey.”

The partnership with MCM further fortifies the Valenz Healthcare Ecosystem Optimization Platform, an end-to-end, fully integrated suite of solutions that drives value and assures alignment of the member, payer and provider to enable better decision-making, starting long before care is provided and continuing long after a claim is paid.

“We look forward to introducing our customers to the highly innovative Valenz ecosystem and expanding opportunities to provide cost-efficient and comprehensive care management across the health continuum,” said Thomas J. O’Connor, President of MCM. “Our companies share a dedication to serving the self-insured industry, advocating for plan members, and ensuring high quality, cost-effective care, making our partnership a natural fit.”

MCM, a physician-directed company, is URAC accredited in health utilization management and is licensed in all states with requirements. Its solution portfolio also includes chronic disease management, catastrophic care management, a comprehensive health and wellness program, health risk assessments, predictive modeling, and data reporting.

About Vālenz® Health

Vālenz® Health simplifies the complexities of self-insurance by offering an end-to-end Healthcare Ecosystem Optimization Platform that manages the cost and quality of care for employers and their members. To balance the relationship between healthcare quality, advocacy and cost, the Valenz enterprise-level solution suite aligns the member, provider and payer. Supported by a dynamic, innovation-first culture and a steadfast commitment to data transparency and decision enablement, Valenz leverages its technology infrastructure and enterprise data warehouse to drive value across clinical and member advocacy, network development and the validation, integrity and accuracy (VIA) of claims. Learn more about how Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.

About MCM

A pioneer in medical management, Medical Cost Management Corporation, dba MCM Solutions for Better Health, was founded by Michael O’Connor in 1986 to meet the population health management needs of self-funded plans, Taft-Hartley Trusts, associations and claim payers. MCM and its subsidiary Med-Care Management, Inc., provided services to more than 550 plans representing over 600,000 members nationwide. MCM is now part of the Valenz Health family.

Vālenz® Announces Corporate Sponsorship for HCAA TPA Summit in July

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PHOENIX, Ariz. (July 1, 2022) — As Corporate Sponsors of the HCAA TPA Summit, Vālenz® leaders have announced they will join this year’s key networking event in St. Louis for third-party administrators and the self-funded industry.

The HCAA TPA Summit addresses relevant topics and issues for the self-funded marketplace while providing opportunities to connect with colleagues. The annual conference aims to inform and inspire participants as they break through barriers, differentiate themselves in the market, and transform their thinking while self-funding continues to evolve.

This year’s event, with a forward-facing theme of “Gateway to the Future,” will feature discussion topics including value-based care, mission vs. margin, technology as a key step toward advocacy, improving client service while navigating the legal landscape, and much more.

“As always, we’re looking forward to engaging with new and old friends at the HCAA TPA Summit while sharing the benefits of our comprehensive, data-driven solutions,” said Rob Gelb, Chief Executive Officer of Valenz. “We know Third Party Administrators need a platform that delivers data engagement, decision enablement and true transparency to optimize self-funded plans. That’s where the Valenz Healthcare Ecosystem Optimization Platform supports strong, vigorous and healthy lives – and companies — through its fully integrated solution that improves care quality and health outcomes while minimizing costs. We’re excited about sharing more in St. Louis.”

The HCAA TPA Summit will be held July 18-20 at the Hyatt Regency St. Louis at the Arch downtown. Attendees are encouraged to connect with Valenz to explore the benefits to their business and plan members provided by full data transparency, robust analytics, and a unique integration of services across the care and claim continuum that drives smarter, better, faster healthcare.

About Valenz

Vālenz® simplifies the complexities of self-insurance by offering an end-to-end Healthcare Ecosystem Optimization Platform that manages the cost and quality of care for employers and their members. To balance the relationship between healthcare quality, advocacy and cost, the Valenz enterprise-level solution suite aligns the member, provider and payer. Supported by a dynamic, innovation-first culture and a steadfast commitment to data transparency and decision enablement, Valenz leverages its technology infrastructure and enterprise data warehouse to drive value across clinical and member advocacy, network development and the validation, integrity and accuracy (VIA) of claims. Learn more about how Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.

Vālenz® Partners with GenRocket to Produce Test Data Fifty Times Faster

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PHOENIX, Ariz. (June 30, 2022) — Vālenz®, a tech-enabled healthcare ecosystem optimization platform for the self-insured industry, recently partnered with GenRocket, a synthetic test data automation company, to leverage synthetic test data in its quality assurance process for the company’s next-generation claims processing platform.

According to Garth Rose, CEO and Co-founder of GenRocket, software testing requirements for healthcare industry applications are particularly complex, with strict data privacy regulations along with complex data sets to manage. “Valenz, like most companies, realized using real data posed unacceptable privacy and security risks, and the option to manually create the necessary test data posed undesirable time constraints,” explained Rose.

GenRocket’s synthetic test data automation platform replicated the data model from the Valenz claims application to generate realistic and accurate synthetic data without the use of any PHI during testing and development. “Using GenRocket’s synthetic test data automation platform, we were able to produce 300,000 claim records approximately 50 times faster than a manual method of scrubbing data to produce the required test data for building and testing the next generation of our platform,” said Edward Zwicker, Chief Information Officer for Valenz.

“With GenRocket, we accelerated our time to market significantly, allowing Valenz to re-direct staff to other time-sensitive tasks required for us to deliver a more automated and scalable claims processing platform to better support our customer needs,” added Zwicker.

For more details, read the case study: https://www.genrocket.com/newsletter/private-secure-healthcare-test-data-produced-50x-faster-with-genrocket/

About Valenz

Vālenz® simplifies the complexities of self-insurance by offering an end-to-end Healthcare Ecosystem Optimization Platform that manages the cost and quality of care for employers and their members. To balance the relationship between healthcare quality, advocacy and cost, the Valenz enterprise-level solution suite aligns the member, provider and payer. Supported by a dynamic, innovation-first culture and a steadfast commitment to data transparency and decision enablement, Valenz leverages its technology infrastructure and enterprise data warehouse to drive value across clinical and member advocacy, network development and the validation, integrity and accuracy (VIA) of claims. Learn more about how Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.

About GenRocket
GenRocket is the leader in real-time synthetic Test Data Automation (TDA), high-performance technology for provisioning test data for Agile and DevOps environments. GenRocket’s patented, groundbreaking platform accelerates test data provisioning by more than 1,000% as it improves data quality and test coverage while reducing cost and ensuring data privacy. Headquartered in Ojai, California, GenRocket operates in global markets through a network of systems integration partners and has customers in more than 14 vertical markets including financial services, insurance, and healthcare. For more information, visit www.genrocket.com.

Vālenz® is Proud Title Sponsor of SIIA 2022 National Conference in Phoenix

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PHOENIX, Ariz. (June 3, 2022) — Vālenz® announced today it is the Title Sponsor of the 42nd annual Self-Insurance Institute of America (SIIA) National Conference & Expo this fall – an event that will be even more special because the conference will be held in the Valenz hometown of Phoenix and is fully in-person for the first time in three years.

Scheduled for Oct. 9-11 at the JW Marriott Phoenix Desert Ridge Resort & Spa, the SIIA National Conference & Expo is the world’s largest self-insurance event, offering educational programs, meaningful insights and game-changing solutions on the latest industry topics.

“Our sponsorship of the SIIA National Conference this year will bring Valenz full circle,” said Rob Gelb, Chief Executive Officer of Valenz. “We launched the Valenz ecosystem at the national conference in October 2019, which was the last time it was held in person before the pandemic. Three years later, we are celebrating being together again and unveiling the fully integrated Healthcare Ecosystem Optimization Platform. It is a tremendous honor to now say thank you to the SIIA community through the Title Sponsorship in our hometown. We can’t wait for October.”

Valenz has been a Diamond Member of SIIA since 2020, which signifies the highest level of support for SIIA’s mission and demonstrates a leadership position in serving the needs of the self-insurance community.

“We were very excited to announce Valenz as the Title Sponsor for this year’s conference,” said SIIA President & CEO Mike Ferguson. “Not only have they been a great supporter of the organization, but they also are an industry innovator in healthcare cost containment solutions for so many of our members involved with self-insured health plans and captives. With Valenz’s support, we expect Phoenix to be a wonderful host city for our biggest event of the year.”

Gelb will facilitate an “Engagement Accelerator” session at the conference called “Selling in the Self-Insurance Market,” which will address the acceleration of change, the challenges of staffing and other industry developments that may shift the mind of the buyer in the self-insurance value chain. Participants will share their experiences and strategies on how to work most effectively to support the self-insurance industry buyers while achieving corporate growth objectives.

Registration for the conference – along with links to the daily schedule, session topics, speakers, FAQs and more – is available at https://www.siiaconferences.org/2022/register_now.cfm.

About Valenz

Vālenz® simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. To balance the relationship between healthcare quality, advocacy and cost, the Valenz approach aligns the member, provider and payer. We deliver this synergy through a strong foundation with deep roots in clinical and member advocacy, alongside decades-long expertise in claim reimbursement and payment validity, integrity and accuracy. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for you and your members, Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners. More information is available at valenzhealth.com.

Vālenz®, VerifPoint Announce Integration and Launch of Comprehensive Provider Credentialing Solution

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PHOENIX, Ariz. (May 24, 2022) — Vālenz® announced today it has integrated with VerifPoint, an industry-leading Credentialing Verification Organization for health systems, hospitals, providers and health plans. 

The integration of the two companies creates a new solution called Valenz VPoint™, a provider credentialing and continuous monitoring solution that offers effective, diligent credential verification to ensure quality of care for patients and members. As a critical component of the Valenz strategy to assure Validation, Integrity and Accuracy (VIA) for providers, VPoint offers NCQA-certified and URAC-compliant credentialing and re-credentialing solutions. 

In addition, VPoint and Valenz Assurance will combine to enhance VIA Provider Solutions, a comprehensive compliance management solution to improve medical coding efficiency, reimbursement assurance, auditing toolsets, claims accuracy, credentialing, medical staff licensing and exclusion monitoring. 

“We are thrilled to partner with VerifPoint in accelerating our collective ability to deliver data-driven, analytical solutions for credentialing and continuous monitoring,” said Rob Gelb, Chief Executive Officer of Valenz. “With the launch of VPoint, we are poised to support our clients with reduced exposure and facilitate higher-quality care. This is a clear example of how Valenz continually delivers on our promise to engage early and often for smarter, better, faster healthcare.” 

The integration of VerifPoint further fortifies the Valenz Healthcare Ecosystem Optimization Platform, a fully integrated suite of solutions that drives value and assures alignment of the member, payer and provider across all phases of the claim life continuum. While minimizing the opportunity for fraud, waste and abuse, VPoint’s credentialing and monitoring services protect clients from denials, appeals, unpaid claims and penalties associated with employing or paying providers with improper licenses or disciplinary issues. 

“As we join the highly innovative Valenz ecosystem, we are well positioned to accelerate growth and value for clients together,” said Asim Ashary, CEO and President of VerifPoint. “The two companies share a deep commitment to meeting client-specific needs while proactively anticipating the constant changes in technology and the healthcare industry. We look forward to the next steps toward an exciting future as one united company.” 

About Valenz 

Vālenz® simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. To balance the relationship between healthcare quality, advocacy and cost, the Valenz approach aligns the member, provider and payer. We deliver this synergy through a strong foundation with deep roots in clinical and member advocacy, alongside decades-long expertise in claim reimbursement and payment validity, integrity and accuracy. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for you and your members, Valenz engages early and often for smarter, better, faster healthcare. Valenz, ranked two years in a row on Inc. 5000, is backed by Great Point Partners.

About VerifPoint 

A Credentials Verification Organization based in Lake Forest, Calif., VerifPoint offers easy and customizable medical credentialing solutions and provides highly affordable, timely and accurate healthcare practitioner information. Our vision is to be the leading service provider for medical credentialing by providing optimum and best system solutions that are fully adaptable to meet the special needs of clients while keeping pace with the ever-changing needs of technology and the healthcare industry. Fully certified by NCQA, VerifPoint provides primary source verification that meets industry and regulatory standards such as NCQA, TJC, URAC, CMS and AAAHC. 

Vālenz® Hires John Paolacci as Chief Claims Officer

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PHOENIX, Ariz. (May 13, 2022) — Vālenz® is pleased to announce John Paolacci, MBA, has joined the company as Chief Claims Officer. With more than 20 years’ experience in managed care and claims, Paolacci has served in leadership roles in client services, operations, strategic planning, managed care product design, pricing, strategic partner contracting, business development strategy and M&A integrations. At Valenz, he will lead the Validation, Integrity and Accuracy (VIA) of claims and payments, implementing tech-enabled solutions that support a robust claim infrastructure for accelerated and streamlined claim operations.

As Chief Claims Officer, Paolacci will partner with Amy Gasbarro, Chief Operations Officer, who ensures early engagement and continuous clinical, member and provider advocacy across the entire healthcare ecosystem. Together, Gasbarro and Paolacci will facilitate a seamless entry for self-insured employers and members into the Valenz Healthcare Ecosystem Optimization Platform, a fully integrated suite of solutions that drives value and assures alignment of the member, payer and provider across the Claim Cost ArcSM.

“John is widely recognized as a results-driven, solutions-oriented leader with deep expertise in claim management and cost containment,” said Rob Gelb, Chief Executive Officer of Valenz. “His superior capabilities position us well to continue building a strong foundation in claim operations as our member base grows, and his philosophy of servant leadership aligns perfectly with the collaborative Valenz culture. We are thrilled he is joining the team.”

Most recently, Paolacci was Senior Vice President, Managed Care for Sedgwick, with responsibility for standalone managed care cost containment divisions including medical bill review, provider networks and client services. He also has held senior leadership positions with York Risk, Avizent Risk, and the Frank Gates Service Company.

Paolacci earned his master’s degree in Business Administration at Franklin University in Columbus, Ohio, He lives in Granville, Ohio.

“I’m honored to have the opportunity to be part of such an energetic, collaborative company that is driving true innovation in the market,” Paolacci said. “As we anticipate the needs of our self-funded customers and continue building the next generation claim organization to serve an ever-evolving healthcare industry, I look forward to advancing the business operations and Valenz vision for smarter, better, faster healthcare.”

About Valenz

Vālenz® simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement. To balance the relationship between healthcare quality, advocacy and cost, the Valenz approach aligns the member, provider and payer. We deliver this synergy through a strong foundation with deep roots in clinical and member advocacy, alongside decades-long expertise in claim reimbursement and payment validity, integrity and accuracy. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for you and your members, Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.

Vālenz® Hires Kevin O’Donnell as Vice President, Enterprise Solutions

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PHOENIX, Ariz. (March 25, 2022) — Vālenz® is pleased to announce Kevin O’Donnell, MPA, has joined the company as Vice President, Enterprise Solutions.

O’Donnell brings extensive experience in providing advisory and strategic services, project management and implementation support to healthcare organizations. He will be highly involved in expanding and integrating how Valenz delivers solutions for providers and payers that assure the validation, integrity and accuracy of reimbursement and claims, as well as care and member advocacy program enhancements. Other key responsibilities include driving product growth, supporting client-facing sales function, and fulfilling roles within operations and technology.

“We are thrilled to have Kevin’s entrepreneurial spirit and proven success in operations, consulting and change management on the Valenz leadership team,” said Maurice Steenland, Senior Vice President, Product & Delivery. “His superior skills in implementation of care management and value-based care, as well as operational assessments and restructuring, has delivered significant results in improved care, streamlined operations and increased revenues.”

Most recently, O’Donnell was Managing Director of Operations for Evolent Health and held several other leadership positions there in operations, claims quality and payment integrity. He also served as managing consultant for Navigant.

O’Donnell earned a master’s degree in Public Administration with an emphasis in health and human services from the University of Arizona’s Eller College of Management, He lives in Newark, Del.

“I’m a firm believer in living out the culture of strong, vigorous and healthy, which Valenz has fully incorporated into the way it serves its employees, its partners, and their members,” O’Donnell said. “I’m looking forward to building upon that foundation through the proactive, sustainable solutions and customer love that have set Valenz apart as healthcare continues to evolve.”

About Valenz

Vālenz® simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement. To balance the relationship between healthcare quality, advocacy and cost, the Valenz approach aligns the member, provider and payer. We deliver this synergy through a strong foundation with deep roots in clinical and member advocacy, alongside decades-long expertise in claim reimbursement and payment validity, integrity and accuracy. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for you and your members, Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.

Vālenz® CEO Shares Power of Positive Culture in Podcast for Self-funded Employers

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Rob Gelb, Chief Executive Officer of Vālenz®, is spotlighted in a new podcast and video from host Spencer Smith, CSFS®, as he shares how the company’s collaborative culture forges a path to creative solutions for self-insured employers.

In Smith’s video from the recent True Captive “Future of Benefits and Business” conference in Oklahoma City, Gelb discusses how the “Yes, and …” mentality fosters a positive connection among teammates, partners and leaders, facilitating meaningful solutions to industry challenges through the power of the Valenz ecosystem.

Valenz has long been a champion of inclusivity and agility to support its partners in making better decisions as they navigate the complicated nature of health insurance. Replacing an initial negative response with a respectful, team-oriented answer of “Yes, and …” positions all parties to capitalize on shared resources and data to uncover new solutions together.

“When we listen without judgment, build upon each other’s expertise, redirect when necessary and get it right together, that’s how we create healthier plans and strong, vigorous and healthy members,” Gelb said. You can watch the full video below.

The weekly “Self-Funded with Spencer” podcast focuses on healthcare and health insurance in the United States, with a special emphasis on the value of self-funded plans.

Vālenz® Hires Suzann Chesek as Vice President of Care

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PHOENIX, Ariz. (Feb. 25, 2022) — Vālenz® announced today that Suzann Chesek, BSN, RN, MBA, CCM, joined the team as Vice President of Care on February 21.

Chesek, who has more than 20 years’ experience with managed care and healthcare organizations, will lead care management operations for Valenz following the retirement of Janet Koch. Over the next three months, Chesek and Koch will work closely to assure a seamless transition before Koch’s retirement begins on June 1.

Most recently, Chesek was Director of Clinical Operations, Healthcare Management for Trustmark Health Benefits. She also served as Clinical Operations Manager with Holy Spirit Health System and as Hospital Administrator and Clinical Manager Employee Health & Safety with Wellspan Health.

Chesek’s background in clinical operations for managed care is fortified by her strong foundation as an ICU nurse, including roles such as ICU Bedside & Charge Nurse, House Supervisor & ICU Flex Nurse, and PRN ICU RN. With a bachelor’s degree in Nursing from Eastern Mennonite University and an MBA in Healthcare Management from Western Governors University, Suzann is working toward a second master’s degree in Management & Leadership from WGU.

“By leveraging a rich blend of leadership skills and technical expertise throughout her impressive career, Suzann has established herself as a proven leader who thrives in a fast-paced, complex environment,” said Rob Gelb, Chief Executive Officer of Valenz. “She welcomes a challenge and is highly recognized for her superior planning, decision-making and change management capabilities.”

Chesek pointed to her experience in managed care organizations as well as her studies in healthcare management and leadership as great preparation for her new role with Valenz.

“The teamwork, collaboration and leadership model at Valenz clearly align with my vision for the continuous growth and innovation of care management operations,” Chesek said. “As a strong believer in asking “why” to discover what is best for patients, clients and the company, I look forward to further enhancing our culture of partnership and accelerating our ability to deliver smarter, better, faster healthcare for the people we serve.”

Learn more about the Valenz leadership team.

About Valenz

Vālenz® simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement. To balance the relationship between healthcare quality, advocacy and cost, the Valenz approach aligns the patient, payer and provider. We deliver this synergy through a strong foundation with deep roots in clinical and member advocacy, alongside decades-long expertise in claim reimbursement and payment validity, integrity and accuracy. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for you and your members, Valenz engages early and often for smarter, better, faster healthcare. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners. 

Portrait of Jordan Hersch, SVP of Channel Distribution at Valenz

Vālenz® Promotes Jordan Hersh, MBA, to Senior Vice President, Channel Distribution

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Hersh brings 15+ years’ experience solving cost-related healthcare challenges for employers and companies of all sizes

PHOENIX, Ariz. (Feb. 18, 2022) — In response to continued expansion of the Vālenz® ecosystem and rapidly increasing demand for its solutions, Valenz leaders have announced a new position on their executive tram: Jordan Hersh, MBA, has been appointed to Senior Vice President, Channel Distribution.

This appointment marks a promotion for Hersh, who initially joined Valenz in 2007 and has served as Vice President, Business Development since early 2019. Hersh is known as an excellent cross-functional leader, bringing the organization together to meet business goals through client-focused solutions and services.

“Since joining Valenz at the very beginning of our ecosystem journey, Jordan has been a catalyst for ensuring our vision, organizational strategies and new product development are delivered to the market,” said Nathan Nelson, Chief Revenue Officer. “His passion for success, combined with his proven track record of delivering results, make him the ideal fit to head up channel distribution for our company.”

Hersh’s career spans 15 years at the intersection of healthcare and technology, focused on solving client and member challenges in the employer-sponsored healthcare domain. He has an MBA from the University of San Francisco School of Management and extensive experience in business development, strategic partnerships, product marketing, account management and sales strategy.

“I believe deeply in the Valenz mission, vision and promise, and I’m excited to take on this new opportunity,” said Hersh. “I have a lot of ideas and an incredible team here to further enhance our distribution strategy for the benefit of our clients and their members, as well as our own company and ecosystem partners.”

Learn more about the Valenz leadership team.

About Valenz

Vālenz® simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement. To balance the relationship between healthcare quality, advocacy and cost, the Valenz approach aligns the patient, payer and provider. We deliver this synergy through a strong foundation with deep roots in clinical and member advocacy, alongside decades-long expertise in claim reimbursement and payment validity, integrity and accuracy. By establishing ‘true transparency’ and offering data-driven solutions that improve cost, quality and outcomes for you and your members, Valenz engages early and often for smarter, better, faster healthcare. More information is available at valenzhealth.com. Valenz is backed by Great Point Partners. 

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