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Work Background
Elevance HealthStaff VP, Clinical Quality and Health Equity Improvement (CQHEI)
Jun. 2022 - Feb. 2026Staff Vice President, Clinical Quality & Health Equity Improvement Elevance Health | July 2022 – Present Indianapolis, IN I lead a 153-person organization through seven direct reports, directing clinical quality operations across Medicare, Medicaid, Commercial, and Exchange portfolios serving 28M+ members. My work involves managing multimillion-dollar vendor relationships, maintaining regulatory compliance, and improving performance across all our health plans. Key accomplishments: ► I achieved the highest HEDIS medical record retrieval rates in company history across every line of business: 98% for Medicare Top 5 H Contracts, 95% for Medicaid, 93% for California HIX, 88% across all HIX markets, and 85% for Commercial non-HIX. These results kept our NCQA accreditation intact and strengthened our competitive position in quality rankings that directly affect member enrollment and revenue.
► I manage the oversight of multimillion-dollar vendor contracts by holding vendors to strict performance requirements and pushing for continuous improvement. This work has protected revenue streams and helped us avoid regulatory penalties that could have cost the organization significantly.
► I directed outreach efforts to members and providers that improved engagement across different populations, ensuring our quality initiatives actually produced better health outcomes while meeting CMS requirements. RELEVANT SKILLS: Enterprise Operations Leadership, Regulatory Compliance (CMS, NCQA), Vendor Partnership Management, HEDIS Performance Optimization, Health Equity Strategy
Anthem, Inc.Staff VP, HEDIS & Quality Performance Improvement / Medical Record Review (MRR)
Nov. 2021 - Jun. 2022Staff Vice President, HEDIS & Quality Performance / Medical Record Review Anthem, Inc. (rebranded as Elevance Health) | November 2021 – July 2022 Indianapolis, IN I ran a 143-person operation with a $25M budget, overseeing enterprise HEDIS medical record review and supplemental data collection across all major lines of business. When I started, different business units were running their own processes, which created inefficiencies and compliance risk. My job was to standardize how we operated while getting ready for external audits. Key accomplishments: ► I built an enterprise-wide HEDIS medical record review platform that got rid of duplicate work and made our processes consistent across Medicare, Medicaid, Commercial, and Exchange. This improved our data quality, cut costs, and prepared us for audits while still allowing flexibility for different market needs.
► I prepared the organization for regulatory audits by putting quality checks directly into our daily work and making sure documentation met standards. This meant coordinating clinical teams, compliance staff, and analytics groups to ensure we passed all reviews.
► I equipped the organization for CMS and state reviews by making quality control part of everyone's regular job instead of something we scrambled to do when auditors visited. RELEVANT SKILLS: P&L Management, Enterprise Standardization, NCQA Accreditation, Audit Readiness, Quality Assurance Protocols
UnitedHealth GroupSr. Director, Value Based Care
Jul. 2020 - Nov. 2021Senior Director, Medicaid ACO Operations & Strategy UnitedHealthcare | July 2020 – November 2021 Minnetonka, MN I ran a 25-person clinical team through four direct reports, building a national Medicaid Accountable Care Organization from scratch. The challenge was creating something that could work across multiple markets while keeping costs down and helping practices improve how they deliver care. Key accomplishments: ► I built and launched a national Medicaid ACO program that improved both clinical and financial results by creating initiatives that could scale across markets while adapting to local needs. Other business units ended up using what we built as their model for value-based care.
► I used healthcare data and analytics to figure out where we were falling short, then worked with teams across the company to fix those problems and track whether our changes actually worked. This let us make adjustments quickly instead of waiting months to see if something was working.
► I helped field teams develop tools for transforming medical practices and set up ways for provider networks to learn from each other. This improved how ACOs performed and led to better patient outcomes by making participating practices stronger clinically. RELEVANT SKILLS: Program Development, Value-Based Care Models, Healthcare Analytics, Cross-Functional Leadership, Provider Network Strategy
UnitedHealth GroupAssociate Director Clinical Quality
Nov. 2015 - Jul. 2020Green Bay, Wisconsin AreaAssociate Director, Clinical Quality UnitedHealthcare | November 2015 – July 2020 Minnetonka, MN I led quality improvement work across HEDIS data collection, provider engagement, value-based contracting, and member outreach through matrix leadership—which meant I had to get results by building relationships and alignment rather than just giving orders. My work covered multiple health plans in Wisconsin and Michigan. Key accomplishments: ► I helped our Wisconsin plan secure the highest commercial membership in a 4-Star health plan nationwide in 2019 by getting market teams and regional leadership working toward the same goals. This made us a market leader and showed I could drive results in competitive environments where quality ratings directly affect how much revenue we bring in.
► I kept NCQA accreditation for three health plans (UHIC WI, UHC WI, and UHIC MI) from 2016 through 2019 by coordinating analytics, surveys, regulatory work, and product development. Maintaining this for multiple years meant staying disciplined operationally while constantly finding ways to improve.
► I was the first to obtain influenza vaccination data from the Wisconsin State Immunization Registry for our Medicare and Retirement programs, which made our HEDIS reporting more accurate and showed other teams how to use state registry data to improve quality measurement. RELEVANT SKILLS: Matrix Leadership, HEDIS Data Collection, Provider Engagement, Value-Based Contracting, NCQA Accreditation Management
HumanaClinical Taskforce Quality Improvement Consultant
Nov. 2014 - Nov. 2015Green Bay, Wisconsin Area
HumanaSupervisor Front Line Leader-Health Planning and Support-STARS
Dec. 2013 - Nov. 2014Green Bay, Wisconsin Metropolitan Area
Managed Health Services - Centene CorporationRN Case Manager and Utilization Review
Nov. 2010 - Nov. 2013Green Bay, Wisconsin Metropolitan Area
HumanaRN Clinical Advisor, Durable Medical Equipment (DME)/Clinical Claims Review Team (CCRT)
Apr. 2009 - Nov. 2010Green Bay, Wisconsin Metropolitan Area
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