The National Voice for Special Needs and Medicare-Medicaid Plans

Our Board

John Baackes, Chair – CEO, L.A. Care (California)

John Baackes is Chief Executive Officer of L.A. Care Health Plan, the nation’s largest publicly operated health plan serving over two million members. L.A. Care is dedicated to providing access to quality and affordable health care for Los Angeles County residents through a variety of health coverage programs, including Medicaid, L.A. Care Covered™ (California Health Benefit Exchange), L.A. Care Cal MediConnect Plan (duals demonstration pilot), and PASC-SEIU Homecare Workers Health Care Plan.

Mr. Baackes works collaboratively with the Board of Governors to set the organization’s strategic vision and ensure its successful implementation. He also oversees the day-to-day operations, while guiding L.A. Care through the ever-evolving health care landscape. Additionally, he is responsible for maintaining the integrity, quality and accountability of the health services L.A. Care provides to its members.

Mr. Baackes brings more than 40 years of health care experience. Before joining L.A. Care, he served as president of Philadelphia-based AmeriHealth Caritas VIP Plans where he oversaw the Medicare Advantage business unit. Prior to that position, Mr. Baackes was CEO of Senior Whole Health in Cambridge, MA, a voluntary health care plan for more than 10,000 low-income seniors in Massachusetts and New York.

He currently serves on the boards of America’s Health Insurance Plans (AHIP), Medicaid Health Plans of America (MHPA), California Association of Health Plans (CAHP), and Local Health Plans of California (LHPC.

Throughout his career, Mr. Baackes has served in a number of executive leadership roles across the health care industry, including Senior Vice President for Group Health Incorporated in Albany, NY; President of Kaiser Permanente's Northeast Division in Latham, NY; and CEO of Community Health Plan, also in Latham. He is also a trustee at Southern Vermont College.

Mr. Baackes holds a bachelor’s degree from Southern Illinois University, Carbondale, and is a native of Evanston, IL.

Helene Weinraub, Treasurer – Vice President, UPMC Health Plan (Pennsylvania)

Throughout her career, Helene has worked with Medicare and dual populations. Initially with the Social HMO at Metropolitan Jewish Geriatric Health System in Brooklyn, NY, she is now Vice President of Medicare at UPMC Health Plan. In this position, she is responsible for the overall performance, strategic direction, and program development for UPMC Health Plan’s Medicare SNP and non-SNP products. Prior to joining UPMC, she led W Squared Health, a national consulting firm specializing in Medicare Advantage and Dual products. She has also held senior leadership positions In Medicare at Highmark Blue Cross Blue Shield. Helene has taught at the University of Pittsburgh School of Public Health and Rutgers Medical School and has served on the Pennsylvania Governor’s Intergovernmental Council on Long Term Care and boards dedicated to the needs of the special needs of the aging population. Helene received her Bachelor’s degree cum laude from the University of Michigan and her Master’s in Public Health from the University of Michigan School of Public Health

Lois Simon, Secretary – Executive Vice President, SeniorLink (Massachusetts)

Lois Simon is the Executive Vice President of Policy and Programs at SeniorLink, a national caregiving company providing care collaboration solutions that leverage human touch and technology to truly integrate and activate consumers, caregivers, payers and providers to deliver person and family centered care resulting in better outcomes at lower costs. In this executive leadership role, Lois is responsible for federal and state government relations, new product development and cross-functional executive teamwork associated with business strategy and development.

Prior to joining Seniorlink, Lois was the Co-founder and former President of Commonwealth Care Alliance, a nationally recognized pioneer in the design and operation of programs integrating Medicare and Medicaid financing (through FIDESNP and MMP frameworks) and service delivery for populations with complex needs: elders and individuals with disabilities across the age spectrum. In her fourteen years with CCA, Lois led the organization to achieve desired care, cost and consumer satisfaction outcomes by designing innovative approaches to the integration of Long Term Services and Supports (LTSS) and behavioral health with medical care.

Lois has over three decades of leadership experience serving complex and high cost government supported populations in clinical program development, government service and executive management roles. Lois served in a variety of government positions, most notably as the Director of Long Term Care for the Massachusetts Medicaid program and as the Assistant Secretary of the State Unit on Aging. She went on to serve as Senior Vice President and Regional General Manager for The Mentor Network, a national leader in health and human services providing home and community based care to individuals with disabilities. Lois served as Chief Operating Officer at the East Boston Neighborhood Health Center where, among her responsibilities, she oversaw the management of the home care program and the Program for All-inclusive Care for the Elderly (PACE). She also served on the executive leadership team as the Vice President for Care Delivery at Neighborhood Health Plan, a large Medicaid Managed Care Organization in Massachusetts, overseeing care management and care delivery services.

Lois received her Master’s degree in Public Health with a concentration in Health Systems from the Boston University School of Public Health, from whom she received a Distinguished Alumni Award in 2015. She serves on several boards both locally and nationally and through her role as Founder and Principal of L. Simon Solutions LLC, has provided strategic and operational consultancy services to a diverse array of organizations across the country focused on fostering the integration of long term services and supports with medical and behavioral health care -across policy, financing and care delivery dimensions.

Ghita Worcester – Vice President, Public Affairs and Chief Marketing Officer, UCare (Minnesota)

Ghita Worcester brings more than 35 years of health care management experience to her role as Senior Vice President, Public Affairs and Chief Marketing Officer for UCare. She provides strategic direction for marketing, business development and strategy, public relations, legislative, regulatory, government programs, and community outreach activities. She oversees the organization’s federal and state health care reform efforts and policy formulation related to national and state health policy issues. Worcester is also instrumental in the development and implementation of UCare’s strategic and operational plans.

Worcester has significant legislative and public policy experience at both the state and federal level on health care reform, and Medicare and Medicaid policy. She serves as a national expert and speaker in the field of Medicare, Medicaid, and Special Needs dual-eligible programs. In 2015, Worcester was recognized with a Women in Business Award by the Minneapolis/St. Paul Business Journal. She serves on several community boards and healthcare policy committees at both the state and national levels.

Before joining UCare, Worcester served as Director of Policy and Operations for Minneapolis-based University Affiliated Family Physicians (UAFP), the management company that started UCare in 1984. In that role, she directed the development of new HMO products and policies, and helped develop and implement HMO strategic and operational plans. Before that, she worked for 13 years in a community-based family medicine residency program operated by the University of Minnesota Department of Family Practice. Worcester holds a bachelor’s degree from the University of Minnesota-Twin Cities.

Michele Lepore – Chief Operating Officer-Optum State Government Solutions, Massachusetts TPA

Michele joined UnitedHealth Group (UHG) in 2009 serving as Plan President for UnitedHealthcare Community and State- Massachusetts, responsible for one of the nation’s original FIDESNP’s.  Currently she is President, East Region for OptumCare (a division of UHG), and has been in her current position since 2013 where she oversees several eastern state sites operating special needs plans, inclusive of ISNP and DSNP programs.

Prior to joining UHG, Michele was Chief Operating Officer for Boston Medical Center HealthNet Plan, (BMCHP) Massachusetts’ leading state wide managed care organization for uninsured and low income populations.

Before joining BMCHP in 2005, Michele held several positions in health industry related organizations, such as Bankers Life and Casualty in Chicago, IL, Henry Ford Health System (HFHS) and Health Alliance Plan in Detroit, MI.   During her tenure with HFHS, Michele implemented one of the original PACE demonstration sites in the nation and served on the board of the National Chronic Care Consortium.

Sepideh Chegini, MD - Senior Medical Officer for CareMore’s Touch Program (California)

Dr. Chegini graduated from University of Rochester School of Medicine in 1999. There, she developed her passion for the bio-psycho-social medicine model and palliative and end-of-life care. She went on to George Washington University for her post-graduate training, where she recognized her life’s mission to contribute to the care of medically and psychosocially complex patients. Yet she found the general fragmentation of care and lack of adequate services for the vulnerable population frustrating.  It was during that time, when she was drawn to the CareMore’s integrated model of care. She has been a practicing physician with CareMore since 2002, focusing on the geriatric population and those with complex medical and psychosocial needs. She has delivered care in different clinical settings. She was instrumental in developing CareMore’s first palliative care program. Prior to her current position, she was one of CareMore’s Regional Medical Officers in Los Angeles County, overseeing the care of patients in hospitals, skilled nursing facilities, as well as the disease management programs for high risk and vulnerable SNP members with chronic conditions in CareMore Care Centers.

In July of 2017, she became the Senior Medical Officer for CareMore’s Touch program, which is an institutional special needs plan (iSNP) of Anthem. The Touch program serves over 5,300 individuals in assisted living centers, nursing facilities and group homes in 4 different states. She is responsible for the clinical operations, the integrity of the clinical model, compliance and quality of care. Her goal is to improve coordination of care, and facilitate the delivery of high quality, high-tech and innovative care, in addition to on-site disease management and palliative care to those individuals living in institutional settings in a cost-efficient way. Her assets are her clinical experience and knowledge of both special needs plans and challenges of providing services for high-risk and high-cost populations.

Thomas von Sternberg, M.D. - Senior Medical Director of Community Senior Care, Home Care, Hospice Services, Government Programs and Care Management at HealthPartners (Minnesota) 

HealthPartners serves 1,000,000 members including 60,000 Medicare participants.  He received his medical degree from Ohio State University in 1980, did his residency at the University of Minnesota and had additional geriatrics education at the Westminster Medical School in London, United Kingdom.  He completed his residency in 1983.  He is board certified in Geriatrics and Family Medicine.

In his role as Senior Medical Director for Case Management, Disease Management and MSHO, he supervises and supports the Case Management program.  In this role, he participates on the Leadership Team, is the clinical expert for staff education and training, and is the interdisciplinary team leader.  Also, he is the liaison to primary and specialty care physicians for clinical and care plan issues, and the content expert for program development for case management/disease management physicians.  He advises and supports the clinical/medical needs of wellness activities.  He participates in committee and Medical Policy Quality Utilization Improvement teams. 

Dr. von Sternberg develops and coordinates programs for the geriatric population at HealthPartners Medical Group, Park Nicollet, and the Health plan with emphasis on frail complex elders and Medicare Advantage and Dual Eligible population.  He has developed and helps manage post-hospital subacute care network for the care system.  

He is a member of the faculty of geriatrics at the University of Minnesota Medical School.  He is medical director for a long term care facility, Ebenezer Hall, and is a member of the Minnesota Nursing Home Medical Directors.  He is also a member of the American Geriatrics Society.  He is involved in coordinating programs for the Medicaid population in the medical group and has served on the Health Services Advisory Council for the State of Minnesota. Dr. von Sternberg was the past medical director of Seniors Plus, a social HMO.

Eve Gelb - Senior Vice President of Healthcare Services
SCAN Health Plan (California)

For over two decades, Eve Gelb has championed to improve health outcomes and advance health equity for seniors and high-needs individuals.

As Senior Vice President of Healthcare Services, Eve is responsible for the healthcare services functions at SCAN including care management, care coordination, quality management, and utilization management. These are the areas that deliver the SCAN Model of Care, a person-centered approach that focuses on the unique needs of each member. Eve and her team strive to ensure that SCAN members receive the right care in the right setting at every stage of their healthcare journey.

Eve continues her work beyond SCAN in personal philanthropic endeavors. She serves as a mentor with SHE-CAN, an organization dedicated to equipping and empowering young women from post-conflict countries to become leaders who advocate for change in their nation, and as a volunteer for People Assisting the Homeless (PATH).

Before joining SCAN in 1997, Eve worked at Texas Children’s Hospital in Houston. She holds a Master of Public Health at Tulane University and her Bachelor of Arts at the University of California, Los Angeles.

Michael Polen - Executive Vice President, Medicare and Operations, WellCare (Florida)

Mike is responsible for WellCare’s Medicare and ACO lines of business and oversees enterprise-wide operations, sales and marketing, and network organizations.  He leads WellCare’s dual-eligible special needs plan (D-SNP) and dual-eligible integrated program efforts in 21 states across the country serving over 170,000 members. 

Mike joined WellCare in May 2005. Before assuming his current position, he served as senior vice president of operations and information technology. He also held positions as senior director of health plan finance, director of health plan operations and director of health business planning and analytics.

Mike earned a bachelor’s degree in decision and information sciences from the University of Florida and a Master of Business Administration from the University of South Florida.