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She is professional with undertaking management methodologies, controlling job stakeholder responsibilities and anticipations, and has led small teams of direct studies.
Jennifer Venditti has much more than thirty a long time of knowledge supporting application/venture management and small business/IT solution implementations. During her job, Jennifer has centered on working with companies to maximize the use of technologies to guidance operational and money targets. A short while ago, she has labored with businesses to establish populace well being, wellness equity, care administration, and member/provider engagement techniques and remedies to cross scientific, operational and technical boundaries.
She excels at a chance to analyze processes for improvement and execute adjustments essential in the well timed and efficient way. Ms. Regalado has broad experience in healthcare claims capabilities.
Just before becoming a member of ACG, Jon served as director of hazard adjustment to get a multi-state regional overall health prepare that available ACA /MA and Medicaid goods, together with serving as regional supervisor for chance adjustment in a nationwide health and fitness plan.
He also guides task teams supporting business system Investigation, reengineering and style and design and enhancements of core systems supporting the professional, Medicare and Medicaid sectors. Ilya has held consulting roles with other corporations and served as Medicare operations guide for Horizon BCBS As well as in operations capacities at Aetna, Inc.
Darlene is a member of ACG’s Federal government Plans Follow Group. She brings broad expertise in organizational improvement and compliance administration while in the Medicare and Medicaid arenas. For over a dozen a long time, she has held senior lawful and compliance roles throughout the insurance plan and managed treatment industries, in which she has led routines as diverse as health approach get started-up, management of JCAHO and NCQA accreditation, state and CMS regulatory oversight audits, managed line obligation for grievances and appeals, income agent oversight and industry conduct along with business enterprise procedures and policy for company document retention. She has Beforehand worked for Centene Company, AmeriGroup and United Healthcare.
Mae has comprehensive knowledge in evaluating and developing operational processes within just complex, delegated and/or matrixed environments. She brings wide practical experience in business, Medicare Edge, and several condition Medicaid packages to bear on shopper engagements. She has experienced wide abilities in the key details devices made use of within the wellness coverage industry.
Sharon can be a member of ACG’s medical pharmacy team supporting Medicare Section D, Medicaid, and pharmacy reward management groups. Sharon has intensive expertise in integrated scientific follow, formulary administration, operational method reengineering and PBM oversight. She has created and executed utilization management courses for extended-expression treatment service provider groups (Medicare Component A/ managed care) and it has structured and participated on corporate JCAHO certification teams, for both of those experienced nursing services and pharmacies.
Her fingers-on expertise supports companies in getting ready for NCQA accreditation and CMS utilization management audits, and in driving cost reduction through effective treatment administration and utilization administration packages.
At SXC Overall health Solutions (now Section of UnitedHealth Group), Chhaya was the clinical operations director for prior authorization and utilization administration, overseeing a center with in excess of 100 pharmacy professionals and scientific pharmacists.
Mia has mental health parity more than sixteen several years of knowledge in regulatory compliance management with a specialization in compliance in scientific things to do and oversight of behavioral wellbeing and substance abuse products and services. She delivers authorized, regulatory and compliance in clinical products and services for business and Medicaid specialty in significant mental ailment, thorough lengthy-time period care and youngsters’s health-related products and services.
Darlene can be a member of ACG’s Government Packages Practice Group. She delivers wide know-how in organizational progress and compliance management from the Medicare and Medicaid arenas. For more than a dozen many years, she has held senior authorized and compliance roles in the coverage and managed treatment industries, exactly where she has led routines as assorted as wellbeing approach begin-up, management of JCAHO and NCQA accreditation, point out and CMS regulatory oversight audits, managed line obligation for grievances and appeals, sales agent oversight and market perform along with small business procedures and coverage for corporate history retention. She has Earlier worked for Centene Corporation, AmeriGroup and United Health care.