Optimize medical management and quality initiatives, ensuring effective utilization and improvement in care while providing leadership and collaboration across teams to enhance patient outcomes and operational efficiency.

Explore the future of clinical decision-making by leading data science initiatives, driving predictive modeling, and advancing AI capabilities to enhance patient care. Collaborate with cross-functional teams to implement scalable analytics solutions.

Contribute to a high-performing clinical review team by supervising utilization management operations, resolving complex care issues, ensuring compliance with standards, and driving quality improvements in healthcare service utilization.

Optimize HEDIS quality oversight and audit processes by independently leading complex audits, interpreting regulations, and ensuring compliance with NCQA and CMS standards, while driving initiatives for continuous improvement.

Optimize data management strategies by designing scalable solutions and enhancing operational ETL workflows, collaborating with stakeholders to drive analytics and compliance reporting improvements across health insurance systems.