Experience

Chamber Cardio

• United States
• Hospitals and Health Care
• 1 - 100 Employee

• Co-Founder & CEO

  • Dec 2022 - 1 year 1 month

  Washington, District of Columbia, United States



The George Washington University Hospital

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Board Member on Board of Directors

  • Sep 2022 - 1 year 4 months

  Washington, District of Columbia, United States



Somatus

• United States
• Hospitals and Health Care
• 400 - 500 Employee

• Group President

  • Apr 2022 - Nov 2022

  Washington D.C. Metro Area



CareFirst BlueCross BlueShield Community Health Plan DC

• President & CEO

  • Jan 2020 - Apr 2022

  Washington, District of Columbia, United States As the President and CEO of CareFirst BlueCross BlueShield CHP, Mr. Aloth leads the strategic vision to successfully achieve business growth and maximize business outcomes. Responsibilities: - Develop and manage the senior leadership team - Optimize efficiencies and drive streamlined operations - Deliver financial and performance reporting to the Board of Directors - Ensure compliance with all regulatory requirements - Lead execution of tactical programs to boost… Show more As the President and CEO of CareFirst BlueCross BlueShield CHP, Mr. Aloth leads the strategic vision to successfully achieve business growth and maximize business outcomes. Responsibilities: - Develop and manage the senior leadership team - Optimize efficiencies and drive streamlined operations - Deliver financial and performance reporting to the Board of Directors - Ensure compliance with all regulatory requirements - Lead execution of tactical programs to boost performance Show less



Trusted Health Plans, Inc.

• Chief Operating Officer

  • Aug 2017 - Jan 2020

  Washington, District of Columbia, United States As the COO for Trusted Health Plans, Mr. Aloth guided the strategy and execution of key business initiatives including merger & acquisitions, market expansion, and organizational transformations. Responsibilities: - Led the acquisition by CareFirst BlueCross BlueShield - Translated market insights into strategic action plans - Mitigated financial risk through due diligence and informed decision making - Worked with local and federal regulators - Integrated and measured… Show more As the COO for Trusted Health Plans, Mr. Aloth guided the strategy and execution of key business initiatives including merger & acquisitions, market expansion, and organizational transformations. Responsibilities: - Led the acquisition by CareFirst BlueCross BlueShield - Translated market insights into strategic action plans - Mitigated financial risk through due diligence and informed decision making - Worked with local and federal regulators - Integrated and measured KPIs to assess progress toward goals - Forecasted business needs and hired talent to deliver on future goals - Introduced wellness centers to reduce ER visits - Transformed the corporate structure and operational model

• Chief Compliance & Privacy Officer

  • Jun 2014 - Aug 2017

  Washington, District of Columbia, United States In this role, Mr. Aloth established the compliance department to improve regulatory adherence across the organization. Responsibilities: - Developed and integrated SOPs - Analyzed law and regulations to update internal processes - Launched a vendor oversight program - Conducted and assessed privacy risk and compliance audits - Developed a Compliance & Performance Monitoring program - Delivered measurable bottom line improvements



Cigna Healthcare

• Hospitals and Health Care
• 700 & Above Employee

• Regulatory Medicare/Medicaid Compliance

  • May 2013 - Jun 2014

  Baltimore, Maryland, United States Managed implementation of Illinois Medicaid and Medicare-Medicaid dual plans to improve compliance efforts and deliver organization-wide training in response to challenges. Responsibilities: - Led internal compliance audits - Defined corrective action plans for deficient areas - Launched and scaled the new product line within the IL market



Centers for Medicare & Medicaid Services

• United States
• Government Administration
• 700 & Above Employee

• Senior Associate at Clifton Larson Allen

  • Dec 2010 - May 2013

  Baltimore, Maryland, United States Served as a contractor to perform Compliance & Performance Reviews of Medicare health plans for the Centers for Medicare & Medicaid Services. Responsibilities: - Managed teams of auditors to carry out all compliance and performance evaluations - Reviewed plans to ensure compliance with federal Medicare laws - Performed reviews for Compliance, Agent/Broker, Coverage Determinations, Organizational Determinations, Appeals and Grievances, Part C Access, and Enrollment - Prepared… Show more Served as a contractor to perform Compliance & Performance Reviews of Medicare health plans for the Centers for Medicare & Medicaid Services. Responsibilities: - Managed teams of auditors to carry out all compliance and performance evaluations - Reviewed plans to ensure compliance with federal Medicare laws - Performed reviews for Compliance, Agent/Broker, Coverage Determinations, Organizational Determinations, Appeals and Grievances, Part C Access, and Enrollment - Prepared and presented findings to CMS management and health plan executive leadership Show less