Founded in 2005 and based in Santa Ana, California, Advantmed, LLC is a healthcare information management company that helps health plans and managed care organizations optimize revenue and improve quality outcomes.
Advantmed partners with managed care organizations to deliver the optimal combination of capabilities unique to each organization needed to achieve the objectives, including risk analytics, software containing NCQA-certified HEDIS ® measures, medical record retrieval, medical record abstraction, risk adjustment coding and provider education.
Akash Patel, Chief Executive Officer
Akash Patel is the co-founder and CEO of Advantmed. In 2005, Akash and Jignesh Patel founded the company with a vision of helping Managed Care Organizations optimize risk adjustment scores and quality improvement. Prior to launching Advantmed, Akash served as Chief Financial Officer for medical record retrieval, consumer electronics, and business process outsourcing organizations. In addition to his work at Advantmed, Akash serves on the board for Aluratek, a digital technology company.
Akash holds a Bachelor of Arts degree in Business from California Polytechnic State University of Pomona and is a Certified Public Account (CPA) in the State of California. In his free time, he enjoys traveling, sports, and spending time with his wife, two children, and his extended family.
Dr. Jignesh Patel, Chief Operating Officer
Dr. Patel has worked in the healthcare industry for more than fifteen years. He also has over ten years of experience building, managing and leading operations. He managed operations for CVS before joining Advantmed. Now Dr. Patel oversees and directs all operations for Advantmed, including software development. He is continually focused on operational improvements that provide benefit to our client base, thereby spurring revenue growth for the company. He holds a Doctor of Pharmacy degree from the University of the Pacific.
Scott Howell, M.D., Chief Medical Officer
Dr. Howell is a physician leader with over 25 years of experience working in clinical, health plan, provider organizations and public health settings. His professional experience includes a breadth of experience in risk adjustment, quality performance improvement, analytics, predictive modeling, clinical consulting and acquisition. Prior to joining Advantmed, Dr. Howell served as an Executive Medical Director at Heritage Provider Network. He has also held executive positions at Optum Insight and the Northeast Region of Americhoice, Inc. Dr. Howell is board certified in Family Practice, Preventative Medicine and Public Health and Addiction Medicine. He earned a Masters of Economics from the University of Miami, a Masters in Public Health and Tropical Medicine (MPH & TM) from Tulane University and a Masters of Business Administration (MBA) from California State University Fresno. He is also certified by the American College of Physician Executives as a Certified Physician Executive (CPE).
For 25 years, Dr. Howell has served the military. His current reserve assignment is with the Office of the Secretary of Defense (OSD) at the Department of Defense Inspector General (DoDIG). He has also published several peer-reviewed articles in financial and medical journals.
Nilay Shah, Chief Operating Officer - Provider Solutions
Nilay has a proven executive management track record and over 15 years of healthcare management experience, including operations and financial responsibilities for health plans, medical groups and IPAs. Nilay’s leadership experience also includes Chief Operating Officer at Sierra Medical Group and Vice President of Finance and Operations at Heritage Provider Network. Under Nilay’s leadership, Sierra Medical Group achieved a five-star rating for two consecutive years and grew their membership by more than 80 percent. Nilay earned an executive education in Managing Healthcare Delivery from Harvard Business School, has earned a Masters of Business Administration in Information Systems and a Masters of Commerce in Economics.
Jay Baker, Senior Vice President - Quality & Risk Adjustment Solutions
Jay most recently was responsible for the ACA risk adjustment strategy and execution for UnitedHealth Group’s, Optum division. His accomplishments included standing up an end-to- end service offering and exceeding revenue goals for the first two years of the program. As one of the founders of Dynamic Healthcare Systems, he was responsible for the original design for each of their ten Medicare Advantage software modules. Jay is an ACA and Medicare Advantage industry leader and expert in policy, compliance, systems and plan operations.
Sanjeev Balsara, Senior Vice President - Client Engagement
Sanjeev’s (Sanj) career spans over 25 years with the majority of his time being spent at KPMG and two of the largest health plans in the country, UnitedHealth Group and Anthem. Sanj held various senior management positions at UnitedHealth Group and Anthem. His responsibilities included building and managing go-to-market teams and strategies, as well as leading delivery teams focused on execution. Sanj joined Advantmed in 2017 and is responsible for business development, client relationships and customer satisfaction. He is focused on providing solutions to help healthcare clients maximize performance by providing best-in-class revenue and quality optimization services.
Doug Loop, Senior Vice President - Strategy and Finance
Doug joined Advantmed in 2017 to further the organizational goal of improving the healthcare system for patients, providers and health plans. He has held senior leadership positions at medical groups, hospitals and provider service organizations. Doug has an extensive background in process improvement, revenue optimization and operational execution. Prior to joining Advantmed Doug lead risk adjustment initiatives for a national team at Optum. He has also served as CEO and CFO for multi-specialty medical groups, and as CFO for the launch of a new hospital. He enjoys the challenge of working with our partners to determine the optimal strategic and practical approach to achieve best practices and outcomes.
Don Gerdts, Chief Development Officer
Don has demonstrated a thirty-year record of leadership within the managed care community in his roles as CIO of two large health plans, his helping with creating of a two-state Medicaid plan and a management role in at a Blues plan. He also has a decade of managed care strategic advisory experience, including the creation, implementation and operations of two successful health information management companies. As a Principal of Advantmed, Don is responsible for market-facing strategy and solutions, including Sales, Marketing, Account Management, Alliances and Product Strategy.
“Combining people, process and technology to achieve great results.”
When you work with Advantmed, you have the power of world-class IT infrastructure and the confidence of strict policies and procedures to protect your patient and company data. We are fully compliant to all of the latest security regulations and operate with a strict adherence to HIPAA guidelines.
Additionally, we understand how damaging any security breach could be to your company’s reputation and financial position. That is why we are committed to providing the highest level of service and protection in the industry.
We invest heavily in our infrastructure; spending the time, money and energy to carefully select the best equipment, hire only the best personnel and house our data in prime locations. Because we know uptime, support and security are the most valuable assets we can provide, our infrastructure is constructed this way.
HIPAA & COMPLIANCE
Advantmed is committed to protecting the privacy of your member’s personal health information. Part of this commitment is strict compliance with the Privacy Rule of the Health Portability and Accountability Act of 1996 (HIPAA) and the American Recovery and Reinvestment Act of 2009 (HITECH Act), which requires us to take additional measure to protect personal information.