This compliance expert brings comprehensive health plan and provider organization experience. She is a qualified leader with expertise in compliance, state and federal regulations, appeals and grievances, and quality standards. Having held multiple leadership positions, she is known for her data-driven performance improvement ventures.
In a recent director role, this healthcare professional managed the strategic and operational oversight of appeals and grievances for commercial, Medicaid and Medicare lines of business. She ensured full compliance with all state and federal laws, regulations, rules, and contract requirements. At the same time, she participated in all regulatory audits, and facilitated policy and procedural changes to ensure plan regulatory compliance.
This consultant continuously develops and implements programs to attain and sustain improvements. Further, she’s led interdepartmental projects to maximize resource efficiency, promote consistency in the application of regulatory requirements, and ensure reliability in provider quality improvement oversight for a company’s network and membership.
Leverage this consultant’s expertise for your next project.
