13point1 Advisors
The people best equipped to solve Payment Integrity challenges are the ones who’ve shaped the industry from the inside.
We transform healthcare payment accuracy, cost optimization, and claim processing efficiency by leading journeys for clients that unlock incremental value and create lasting impact.
Our team has worked for and with the nation’s largest payers, providers, and payment integrity partners, and understands the motivations and business drivers of these stakeholders like no one else.
We tell you what you need to hear — not what you want to hear. Objectivity isn’t a talking point for us. It’s how we operate.
Payment Integrity is complex. We make it understandable. Our framework and common taxonomy cut through the noise so you can make decisions with confidence.
We don't boil the ocean. We identify what matters, build momentum, and drive transformation. Every engagement moves you forward.
Complex problems require resourceful people. That's who we hire and how we work. The people in the room are the people doing the work.
Why 13point1?
It takes 8 to 16 weeks of focused, disciplined training — and the commitment to that process is what transforms you. You're never too far behind to start, and you can always get better. That's how we think about the work we do.
Leadership
Managing Partner & Intelligence Practice Lead
Dan built a career guiding major initiatives for top payers, providers, and technology partners. Recognized across the industry for his expertise in payment integrity and data-driven change management, Dan's disciplined approach ensures that 13point1 can confidently deliver on even the most challenging healthcare technology projects.
View LinkedIn Profile →Technology Practice Lead
Neil helps clients modernize platforms, unlock data, and scale confidently by applying decades of technology leadership across healthcare, retail pharmacy, and SaaS. As former VP of Engineering and CTO, he has led AI-, ML-, and automation-enabled transformations that improved access, cut costs, and reduced risk.
View LinkedIn Profile →Content Practice Lead
Mark is an accomplished strategy and operations leader. He has guided organizations to maximize resources and align capabilities to evolving industry needs. His background spans technology consulting, content evaluation, and strategic advisory, making him adept at ensuring clients realize more value from their assets.
View LinkedIn Profile →OoN & IDR Solutions Practice Lead
Scott brings more than twenty years of payer operations experience and deep expertise in payment integrity, having served as a McKinsey consultant and as an executive at Elevance and BCBS Michigan. He has ideated and delivered nearly a billion dollars in savings for payers and is now focused exclusively on helping health plans and issuers improve their performance under the No Surprises Act.
View LinkedIn Profile →Strategic Advisors
Vinay has sat on every side of the payer table. Most recently he was CEO of SimplifyX, an AI platform firm built around practical payer use cases, and before that Chief Strategy Officer of Simplify Healthcare, where he shaped its SaaS approach to product and benefits lifecycle management. He led the Payer Domain Practice at Genpact and the Performance Practice as Partner at First Quadrant Advisory, consulting for Elevance, Centene, HCSC, and BCBS plans in Massachusetts and Kansas. As Divisional Vice President at HCSC he ran large-scale transformation programs from inside the plan. Client advocacy comes first, and senior executives across health plans treat him as a trusted advisor.
View LinkedIn Profile →Subject Matter Advisors
Sherri brings extensive leadership in healthcare insurance, with deep expertise in program integrity and operational efficiency across Medicare, Medicaid, and commercial sectors. She has led teams and strategic initiatives that enhanced compliance, improved coordination of benefits, and delivered billions in savings across stakeholders.
View LinkedIn Profile →Janet is a results-driven payment integrity executive with 20+ years leading claims operations, audit functions, and financial integrity programs across major payers including UnitedHealth Group, Cotiviti, Harvard Pilgrim, and BCBS of Rhode Island. She brings a proven track record of optimizing workflows, managing vendor relationships, and delivering significant cost savings.
View LinkedIn Profile →Corey is a seasoned executive with deep roots in payment integrity and cost containment. As former President of CERiS, a subsidiary of CorVel, he built and scaled a national prospective claim review organization recognized for industry-leading accuracy in itemized bill review and DRG validation.
View LinkedIn Profile →Jay is a clinically trained payment integrity leader with more than 35 years spanning health-plan reimbursement strategy, vendor-side operations, and military medicine. As Vice President of Pre-Payment Business Solutions at Cotiviti, he carried full P&L for the company's largest and fastest-growing unit. At Elevance Health he set reimbursement policy across markets covering 40 million members, where annual program savings grew past $5 billion. He is also a former Navy Chief Petty Officer.
Amy spent a decade inside Payment Integrity building and leading vendor management programs at Elevance Health and Carelon. As Strategy Director for Payment Integrity Strategy and Planning, she owned the vendor life cycle from RFP authorship through contract negotiation and performance oversight. She knows vendor capability well enough to judge when to keep work vended and when to bring it in house, a discipline that produced more than $90 million in annual spend reduction.
View LinkedIn Profile →Operations
Market Intel & Operations
Brian leads the Market Intelligence function at 13point1 and manages the path from client opportunity through research, proposal development, onboarding, and execution. He came to healthcare after nearly two decades in collegiate athletics, where his teams posted five consecutive top-20 NCAA cross-country finishes and he was named conference Coach of the Year 10 times. Recruiting and championship hosting built the pipeline and coordination discipline he now applies to engagements.
View LinkedIn Profile →Client Engagement
Margo brings decades of healthcare operations experience and deep market insight honed through years of proposal development and competitive positioning. At 13point1, she mentors our associate team and drives consistency across engagements — ensuring that the frameworks and standards the firm is built on are carried through in every deliverable.
View LinkedIn Profile →Associates
Market Research
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