Our Auditors

Paul Mertel, Ph.D., CHCA, Senior Vice President HEDIS Development and an NCQA-Certified HEDIS Compliance Auditor, specializes in HEDIS consulting, auditing and reporting, and also conducts special research studies. He was formerly Executive Director of the Manpower Standards and Efficiency Review Program at the U.S. Army Health Services Command at Fort Sam Houston, Texas, and held health care administrative executive positions at several U.S. Army hospitals and health clinics. Dr. Mertel holds a Doctorate in Public Administration from Penn State University and a Masters in Health Care Administration from Baylor University.

Mary E. Case, MS, CHCA, Consultant and an NCQA-Certified HEDIS Compliance Auditor, has conducted HEDIS Compliance Audits since 2000. Prior to her work as an auditor, Ms. Case worked for Preferred Care, Inc., an HMO in upstate New York. During her six-year tenure there, she was responsible for commercial, Medicare and Medicaid state and national performance reporting. Ms. Case's career also includes program management experience in an urban community mental health center as well as teaching in the New York State Public School system. She received her master's degree from Arizona State University and her undergraduate degree from the State University of New York at Buffalo.

Michael Campbell, MPP, CHCA, Consultant and an NCQA-Certified HEDIS Compliance Auditor, provides services in the areas of auditing and source code review. Mr. Campbell formerly served as Audit Manager for the National Committee for Quality Assurance (NCQA) where he managed training, certification, testing, quality assurance, technical assistance, audit methodology, and other aspects of the HEDIS Compliance Audit Program. He earned a Masters in Public Policy from Duke University.

Susan Moschella, RN, CHCA, Consultant and an NCQA-Certified HEDIS Compliance Auditor, provides auditing and source code review services. Ms. Moschella received her Master's of Science from Georgetown University with a concentration in Healthcare Management. She has over 15 years of experience as a Pediatric Nurse Practitioner and clinical supervision and management. Trained in TQM principles, Ms. Moschella has instituted and monitored quality improvement programs and coordinated quality management efforts in a variety of healthcare settings to meet NCQA and HEDIS standards. Ms. Moschella has extensive experience with the HEDIS reporting process and five years experience conducting HEDIS Compliance Audits as a Lead Auditor.

Ross Segel, MPA, CHCA, Consultant and an NCQA-Certified HEDIS Compliance Auditor, provides services in the area of auditing. Mr. Segel is proficient in SPSS and SQL programming and has written programs for many of the HEDIS measures. Prior to affiliating with HealthcareData Company, LLC, Mr. Segel was HEDIS Coordinator for Preferred Care in Rochester, NY, a legislative auditor for the Virginia Joint Legislative Audit and Review Commission, and a legislative auditor for the New York State Legislative Commission on Expenditure Review. Mr. Segel earned a Master of Public Administration from Penn State University.

Suzan Mora, M.P.A., CHCA, is a Certified HEDIS Compliance Auditor and independent consultant to HDC. She brings over fifteen years of healthcare delivery experience in the medical group, hospital, and health plan arenas with seven years of experience as Director of Quality Improvement for a health plan. She possesses over five years of experience in HEDIS project management, including the development of data collection systems, medical record review training, claims/encounter oversight, and intervention measurement. Her management background includes provider credentialing, peer review, network management, data management, site evaluation, quality improvement, delegation oversight, and HEDIS auditing. Ms. Mora completed a Master of Public Administration degree from the University of San Francisco and completed her undergraduate degree at the University of California at Irvine.

Michael Albornoz, MPH, CHCA, Consultant and an NCQA-Certified HEDIS Compliance Auditor, provides auditor services. Mr. Albornoz has extensive experience in state and local government having served in various positions of data manager, biostatistician, data analyst, and research assistant. Mr. Albornoz also has more than 8 years of practical experience in HEDIS by managing and directing the HEDIS reporting project for the largest public health plan in America and one of the most experienced managed healthcare companies serving patients who have traditionally faced barriers to quality healthcare. In this capacity, Mr. Albornoz has concurrent experience in the California managed care market and the P4P program. Mr. Albornoz holds a Masters in Public Health (Epidemiology) from San Diego State University.

John Couzins, MPH, CHCA, is a certified auditor since 2003. Mr. Couzins brings advanced knowledge of the NCQA accreditation, health plan compliance audit processes and International Standards Organization (ISO) 9001 certification. He currently serves as the director of an External Quality Review Organization and oversees the state Medicaid contract. With more than 11 years experience in healthcare assessment, data and analyses he has conducted Medicaid contract compliance and network adequacy audits, as well as led healthcare improvement projects and epidemiological initiatives. Mr. Couzins earned his Master of Public Health in Epidemiology from Emory University and his undergraduate degree in Microbiology from the Ohio State University.

Poornima Dabir, MPH, CHCA, has been involved with HEDIS auditing since 1999, and has served as a lead auditor since 2003. She has served as the Medicare Part D compliance manager for a large health care company, conducting audits of various business operations including functions related to Medicare. Ms. Dabir has extensive experience as a Senior Data Analyst and Project Manager, with multiple large-scale projects for NYS DOH External Quality Review contract including the Prenatal and Postpartum Care Medical Record Review Study, Adolescent Preventive Care Study and the ADHD Quality of Care study. She earned her Master of Public Health in Health Administration from SUNY Albany.

Galina Priloutskaya, Ph.D., MBA, BS, and CHCA, has participated in HEDIS Compliance audits since 2006. She brings extensive experience in the area of analytical support for HEDIS indicators for all lines of businesses. Her statistical expertise includes quality improvement activities in managed care. Ms. Prilouskaya currently manages drug safety projects, overseeing the analytical department responsible for the support of CMS, EQRO and Alliance forces as well as serving as a member of the National Technical Expert Panel for Medicare Part D measures. Prior to becoming a HEDIS auditor, she was the data analyst and HEDIS project manager for a health plan in New Mexico. A former assistant professor at Moscow Academy of Management, her Ph.D. is in Economic Science. She earned a master’s degree in Economic and Industrial Management and an MBA in Management Information Systems.