Senior Consultant, Clinical
Anita provides expertise to health plans regarding quality improvement, the CMS Quality Bonus Program, Special Needs Plans (SNP) Model of Care (MOC), HEDIS, and Star Ratings improvement. She brings clients more than 30 years of experience in the healthcare industry. Her areas of experience include medical necessity compliance, quality management and improvement, preventive programs, and clinical practice.
Anita has designed programs and initiatives to support preventive health and disease management business goals. She has a proven track record in developing various quality assurance programs, a public health online web-base, and written educational tools. Her diverse leadership expertise extends to managing people and leveraging team-building skills and situational leadership. She utilizes and values cross-functional relationships both internally and externally.
Anita has guided plans in readiness for CMS review of Models of Care, NCQA Accreditation Preparation, and Chronic Care Improvement Programs (CCIPs). She has also developed project management tools, readiness assessments, and corrective action plans.
Anita served as Director of Quality Assurance for a leading organization in a new industry of second-level review for appropriate hospitalization. Anita has held numerous positions as Director of Quality for multiple markets in the managed care industry for multiple lines of business (Medicare, Medicaid, Commercial, Exchange).