Jose Valenzuela Email & Phone Number

Extensive health care regulatory affairs and compliance experience. Recent success overseeing a team of Regulatory Analysts accountable for product form filings and network adequacy related filings for the 13 West Region States. Experience managing all aspects of the OptumCare compliance program for the care delivery businesses in California, including AppleCare, Monarch, NAMM (PrimeCare), and OptumCare Medical Groups. Prior accountability for legislative intake and distribution for all states and territories in the United States. Experience aligning business operations and optimizing systems and processes to meet regulatory, contractual, and state/federal requirements. Management of market conduct examinations, specializing in Appeals & Grievance, Call Center Operations, Claims transactions and Provider Dispute regulatory compliance requirements. Effective Project Management of mid-large scale projects. Strong supervisory and health plan governance experience.Specialties: Medicaid New Business Implementations, Business Operations Optimization, National Alignment, Regulatory Affairs, Compliance, Market Conduct Examination Processes, Project Management, Appeals & Grievances Processes and Compliance, Claims Transaction Compliance, Call Center Operations Compliance, Process Improvement, Change Management, & Corrective Action Plan Development & Management

Listed skills include Healthcare, Hipaa, Leadership, Managed Care, and 30 others.