Kathy Parsons Email and Phone Number

CareAllies is Cigna's service company that works closely with physician organizations and health systems to help them focus on improved patient outcomes and achieve better health care quality and affordability for the populations they serve.CareAllies delivers the systems, capabilities and management solutions that providers need to be successful under a variety of value and risk models no matter where they fall on the value-based reimbursement spectrum. Its solutions help ease providers’ administrative burden across payers and can help providers launch their new business models including ACOs, clinically integrated networks and care delivery products.

Supervise clinical directors, partnership account managers, and supervisors of support services for Senior Health Partners, a managed long-term care plan, and Assured Care, an institutional special needs plan. Oversee and indirectly supervise more than 150 staff. Operational focus on clinical data collection sets used in monthly outreach to program beneficiaries with productivity metrics, disenrollment triggers, managed long-term care quality incentive measures, and evidence-based care plans for fall prevention, emergency room utilization, pain management, loneliness/depression, influenza vaccination, and participant satisfaction.

Interim Clinical Director, Managed Long Term Care Program, 2013-2014Assumed supervision of clinical operations. Created viable POD structure with delineation of titles, roles, and responsibilities. Outlined role and responsibilities of registered dietician, pharmacy case manager, concrete social worker, and behavioral health specialist social worker. Defined criteria for referral, referral processes, and standardization of their specialty assessment based on national standards of care. Delineated and clarified need for and value of operational processes, process flow documents, narrative workflows, orientation checklists, and training materials. Director, Disease Management, 2006-2014Led clinical and administrative support staff. Monitored and maintained compliance with regulatory and accreditation requirements, including Centers for Medicare and Medicaid Services (CMS), New York State and New York City Departments of Health, Take Care New York, NYS Managed Care Plan Performance Reports (QARR), NCQA, HEDIS, and URAC standards for accreditation for chronic condition PATH programs – asthma, COPD, diabetes, depression cardiovascular disease, hypertension, New York Bridge Plan Navigation Program, and Medicare and Medicaid Health Risk Survey programs. Created Employee Better Breathing PATH Program for Asthma and the Employee Hypertension Care PATH Program providing information about asthma and hypertension, medication adherence, and the importance of healthy lifestyle for employees. Led and enhanced the Healthy Beginnings PATH Prenatal Program providing pregnancy identification, health risk assessment in prenatal and postpartum period, and case management of high-risk pregnancies.Coordinated and maintained clinical oversight of disease and case management relationships between organization and vendors/delegated entities.

Provided direct oversight of respiratory and rare disease management programs. Formulated and successfully launched integrated depression education program offered to participants enrolled in chronic condition programs. Led team responsible for development, implementation, and maintenance of DM department policies and procedures. Ensured all DM programs met external accreditation agency requirements and standards. Achieved full URAC accreditation for all programs.

Directed development and implementation of disease management and health promotion programs including diabetes, heart failure, COPD, prenatal care/high-risk pregnancy, and smoking cessation education. Standardized all activities related to program administration and outcomes measurement. Served as project manager for implementation of McKesson Health Solutions Care Manager software and designated clinical systems administrator for plan. Led training, workflow development, and implementation for medical department and associated staff in member services, claims, and quality improvement departments.Participated in creation and implementation of plan’s first quality improvement program and authored plan’s first quality management program description, becoming foundation of QI program.