Experience

Anthem

• United States
• Insurance
• 700 & Above Employee

• Director HCM

  • Aug 2015 - Present

  Manage relationships with key stakeholdersManagement of Utilization Review and Care Managment ProcessesManage day to day activity of program operations and performance metricManage utilization, cost and quality objectivesEnsure program compliance with state contract/NCQA/CMSOversight of P&P/Guideline development and executionGrowth and development of HCM team



UBC

• Director Clinical Operations

  • Nov 2014 - Aug 2015

  Manage launch of new Clinical Adherence ProgramMonitor program statistics and metricsManage day to day activity of program operations, including supervision of 120 FTE’sResponsible for day to day contact with complex clients and issue resolution



HealthSouth

• Hospitals and Health Care
• 700 & Above Employee

• Administrator

  • Feb 2013 - Nov 2014

• Director Care Management Services/Regional Director of Case Management

  • 2010 - 2013

• Administrator

  • 2008 - 2010

• Director Of Case Management

  • 2004 - 2008

• Case Manager/Team Leader for Traumatic Brain Injury Program

  • 2000 - 2004



Kinetic Concepts Inc

• Medical Device
• 1 - 100 Employee

• Clinical Consultant

  • 1996 - 2000

  Conduct physician sales callsParticipate in business sales review Marketing and sales for acquiring new accounts & maintain existing businessAnalyze and determine strategies to improve product placement and obtain sales goalsPlan and achieve business goals for each accountProvide continuing education programs on wound managment/VAC therapy