Engage in leading and managing the Medical Loss Ratio (MLR) compliance and reporting program. Provide strategic guidance across business lines, ensuring accurate reporting, risk mitigation, and regulatory adherence while driving operational excellence and team development.

Drive operational excellence by leading market strategies that enhance performance, build partnerships, and foster growth in Medicare markets. Leverage a results-oriented approach to inspire teams and authentically represent business objectives.

Lead the charge in ensuring accurate MS-DRG and APR-DRG coding while exercising autonomy in clinical documentation reviews. Collaborate with medical experts to optimize compliance and enhance reimbursement accuracy across diverse healthcare records.

Lead the charge in optimizing third-party risk management, enhancing operational effectiveness, and ensuring compliance with regulations. Oversee due diligence, audits, and cross-functional initiatives to strengthen accountability and transparency across the organization.

Lead the charge in building a high-performing Sales Investigations Team, guiding investigations into Medicare Advantage misconduct while ensuring compliance and operational excellence across the organization.