PHOENIX, Ariz. (Sept.28, 2023) — Brad Lewis, who has served the stop loss insurance industry for more than 40 years, will retire December 1 as Executive Vice President of Certus Management Group, a Vālenz^® Health Affinity Company. Senior Vice President of Operations Beth Madden, CEBS, will become Executive Vice President, effective immediately.

Lewis has had an incredible career and has made an indelible impact on the stop loss insurance industry, providing clients with his tremendous expertise in claims, underwriting, auditing, account management and marketing. After getting his start in stop loss through an on-the-job training program with the Brougher Insurance Group while in school, Lewis began a full-time position there in 1983 with the accounting department. In 1998, he became a founding member and Executive Vice President of IMG-Stop Loss. Nearly 20 years later, Lewis was one of four principals who transitioned IMG-Stop Loss to its current incarnation as Certus Management Group.

“Brad’s leadership was instrumental in guiding the Certus transition to becoming a key part of the Valenz Health family. I am thankful that I have had the past 18 months to work with him and learn from him during that time,”said Rob Gelb, CEO Valenz Health.“Of course, every great leader has a great team behind them, and Certus is no exception to this rule. Today, I am incredibly excited and honored to share that effective immediately, Beth Madden, CEBS, will become the EVP of our stop loss group,” added Gelb.

At Certus, Madden served as Executive Vice President, Chief Underwriting and Operations Officer before her current role as Senior Vice President of Operations. As another member of IMG-Stop Loss since its founding, she was Chief Underwriting Officer with responsibility and oversight across the spectrum of international and domestic products. Her earlier roles included Director and Vice President of the Stop Loss Underwriting department, providing underwriting oversight, actuarial and program management.

Madden also has worked in the domestic fully insured space, underwriting multiple employer, association, and alternative risk and funding arrangements. She earned a bachelor’s degree in finance from Indiana University’s Kelley School of Business.

About Vālenz^® Health

Vālenz^® Health simplifies the complexity of self-insurance for employers by consolidating health plan solutions on a single platform – the industry-leading Healthcare Ecosystem Optimization Platform. Valenz has deep roots in clinical and member advocacy, alongside decades of expertise in the validation, integrity and accuracy of claims, and a suite of risk affinity solutions. With a steadfast commitment to data transparency and decision enablement, and an omnichannel approach across the healthcare journey, Valenz engages early and often to optimize healthcare for the provider, payer, plan and member, delivering improved cost, quality and outcomes for employers and their members – for smarter, better, faster healthcare. More information is available at valenzhealth.com.

PHOENIX, Ariz. (Oct. 28, 2022) — Self-insured employers looking for cost containment strategies should be open to solutions that prioritize the member first– a shift in thinking that can have a big payoff for both the member and the employer, according to Vālenz^® Health CEO Rob Gelb.

As part of a recent HCAA-sponsored “Voices of Self-Funding” podcast with host Ramesh Kumar and Imagine360 CEO Jeff Bak, Gelb addressed key trends in driving lower costs and managing risk for self-funded plans, including the roles played by enhanced transparency, data and technology.

“It starts with the employer being willing to get comfortable being uncomfortable, accepting that they may not have all the answers, and making changes in the spirit of the member to do what’s right,” Gelb said. “More than just cutting the cost of an individual claim, the conversation has to evolve around the total cost of care and placing the member first in the equation while you measure quality of care, reasonable cost and reasonable reimbursement.”

An important first step, Gelb said, is to establish transparency from the start among the provider, payer, plan and member – aligning all parties in achieving a balance of cost, quality and utilization of care.

“There’s a misalignment of incentives with the way that traditional plans design their networks, and an expectation from employers that any provider network that has broad coverage is good for their employees,” Gelb said. “When you have full alignment upfront, all parties understand throughout the process what their role is in balancing the equation of quality, advocacy and cost. That’s how we arrive at cost containment options that benefit everyone involved in the claim.”

“We’ve designed a solution as a platform that becomes a full BUCAH replacement option,” Gelb said, referring to the Valenz Healthcare Ecosystem Optimization Platform. “Economics are a big part of that. We use local and national data sets to feed UCR, paid claim data, other forms of data, and Medicare into an algorithm to determine what we call market sensitive repricing. In addition to determining what services and the price point for those services, we determine what shouldn’t even be on the claim. Then, we typically get provider signoff 50 percent of the time on all of those factors to eliminate any friction. That’s part of our methodology to contain costs and serve the member.”

Hear more from Rob in the full podcast.

About Vālenz^® Health

Vālenz^® Health 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. Offering a strong foundation with deep roots in clinical and member advocacy, alongside decades of expertise in claim reimbursement and payment validity, integrity and accuracy, as well as a suite of risk affinity solutions, Valenz optimizes healthcare for the provider, payer, plan and member. By establishing “true transparency” and offering data-driven solutions that improve cost, quality and outcomes for employers and their members, Valenz engages early and often for smarter, better, faster healthcare. Valenz is backed by Great Point Partners.