About HHP


Population Health Services

Population Health Services comprises a comprehensive set of support services that make care delivery easier for both patients and physicians. These services are designed to maximize physicians’ quality scores, support the PCMH model, deliver an exceptional patient experience, create positive relationships with physician practices, encourage shared learning, maintain data integrity in Cozeva, and understand and address the needs of independent physicians.

The Population Health Services team assists members with:

  • Needs assessments for clinic workflow and patient outreach optimization
  • Patient outreach campaigns to follow-up with patients on scheduling regular exams and procedures, which includes cancer screenings, childhood immunizations and Well Visits
  • Requests for reconsideration to HMSA related to patient attribution and quality measures
  • Cozeva support and training
  • Cozeva interface to Epic EHR for outcome-based quality metrics
  • Care planning, resources and services for patients with complex medical conditions


Eleanor Naone
Eleanor Naone, Care Coordinator 1
Ph: 808-535-0972
Aileen Crisostomo
Aileen Crisostomo, Care Coordinator 1
Kelson Oshiro
Kelson Oshiro, Care Coordinator 2
Ph: 808-535-0967
Brian McClendon
Brian McClendon, Care Coordinator 2
Stephanie Nobriga
Stephanie Nobriga, Care Coordinator 3
Ph: 808-522-4583
Victora Gualdarama
Victora Gualdarama, Care Coordinator 3
Hazel Madueno
Hazel Madueno, Care Coordinator
Ph: 808-535-0976
Richie Valentin
Richie Valentin, Care Coordinator 4
Ph: 808-522-4525 
Eleanor Naone
Leticia Ruiz
Ph: 808-246-2957 
Aileen Crisostomo
Lerma Catiggay, Care Coordinator, Kaua'i 5


Population Analytics and Management

Population Analytics and Management provides timely and accurate data gathering, analysis and reporting to support the business and clinical management of Hawaii Health Partners’ attributed patient population.

Population analytics and management staff assist with:

  • Population health data analytics and reports distribution
  • Support and facilitation of contracts, programs, initiatives and patient outreach through data processing and analysis
  • Identifying trends, opportunities, gaps in care and high-risk/high-cost patient populations


Melanie Nordgran, Supervisor
ACO Analytics Management
Ph: 808-522-4130
Clementine Tran Tang
Clementine Tran Tang, Analyst
Tyler Barnett
Tyler Barnett, MHSA, Analyst
Ph: 808-535-0966 
George Kingston
Joey Kingston, Data Quality Specialist


Managed Care Services

Managed Care Services provides referral management for HMSA patients, directs appropriate care coordination of patients, and serves as a resource guide for providers.


Martie Tibayan, RN, Manager
(HMO and health center referral managment)
Ph: 808-535-7262

Georden Hirai, Specialist

Rachelle Gallegos, Specialist
Ph: 808-535-7261 




Vanessa Sim, Manager, Provider Communications

Jeruzel Gonzales, Network Coordinator
Ph: 808-522-4557 

Charlotte Mattice, Office Clerk

Complex Care

The Complex Care services are designed for patients with two or more major medical conditions. Our goal is to give the best care possible to patients and their families, in a holistic approach, to achieve the best outcomes. The care team works closely with patients and their families and assist with scheduling medical appointments, understanding and following instructions for taking necessary medications, receiving health education and identifying and accessing community resources. This ensures patients receive the right care at the right time at the right place.

Laura Pladson, RN, Program Manager 
Ph: 808-535-0980 
Warren Wong, MD
Warren Wong, MD, Associate Medical Director 
Ph: 808-522-3831
Geldilyn Ebbay, RN, BSN, Case Manager 
Christy Agmata-Aurelio, RN, BSN, Case Manager 
Ph: 808-535-2970
Julie Van Poele, RN, BSN, Case Manager  
Ph: 808-535-0974
Ryan Yamane, LSW, Social Worker  
Ph: 808-535-0969

HealthAdvantage CONNECT

HealthAdvantage CONNECT is an integrated, provider-based EHR and practice management system that provides seamless integration between registration, scheduling, clinical documentation and billing, as well as access to clinical quality programs, including integrated chronic disease registries and best-practice reminders for preventive care. A dedicated HealthAdvantage CONNECT team provides implementation services, practice support and training.

Anna Smolentzov
Anna Smolentzov, Business System Analyst
Ph: 808-522-4386