Tracy McCaughey

Tracy McCaughey brings over 30 years of experience in the Medicare Advantage space, specializing in Medicare readiness, CMS audit preparedness, and regulatory compliance for health plans operating in highly regulated environments.

Tracy most recently served as Managing Director of Claims Operations and Grievances & Appeals at a large Blues organization, where she led operational areas central to Medicare compliance, including claims processing, appeals administration, and delegated vendor oversight. She successfully led the organization through multiple CMS Program Audits and CMS Financial Audits, enabling continued participation in Medicare and government programs.

Previously, as Managing Director of Compliance & Ethics and Corporate Compliance Officer, Tracy oversaw enterprise‑wide Medicare compliance programs, audit response, corrective action planning, and board reporting. She led a top‑quartile CMS Program Audit, restructured compliance functions to improve effectiveness, and ensured ongoing alignment with CMS, Department of Labor, ACA, and state regulatory requirements.