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Over 30 years experience leading medical management, clinical strategy, and quality improvement programs in large managed care organizations. Experience implementing and leading utilization management, case management, and quality management programs for HMO and PPO products including commercial and Medicare plans.Specialties: Utilization Management, Case Management, Medical Management, NCQA Accreditation, Managed Care, Healthcare Management,
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Associate Vice President, Clinical Solutions Organization, Medicare SegmentHumana Jul 2019 - PresentLouisville, Kentucky, Us -
Director Of Health Services, Clinical Strategy TeamHumana Jan 2019 - Jul 2019Louisville, Kentucky, UsAppointed to national agile work team charged with developing the Clinical Strategy for Humana’s Enterprise Clinical Operating model. Developed care models for 8 clinical conditions including care team composition, metrics, and selection of clinical guidelines. -
Regional Health Services DirectorHumana Oct 2006 - Dec 2018Louisville, Kentucky, UsRegional leadership position overseeing the medical management programs for 200,000+ Medicare Advantage HMO, PPO, and PFFS members. -
Regional Quality Improvement DirectorAetna Apr 1993 - Oct 2006Hartford, Connecticut, UsResponsible for NCQA, URAC, and compliance activities for commercial and Medicare HMO and PPO products.Responsibilities included HEDIS Project Management, Physician Credentialing, Clinical Performance Improvement, and CMS/State Compliance Activities. Lead a team of up to 50 FTEs across a large geographic territory.
Lori Green Skills
Frequently Asked Questions about Lori Green
What company does Lori Green work for?
Lori Green works for Humana
What is Lori Green's role at the current company?
Lori Green's current role is Associate Vice President, Medicare Segment.
What is Lori Green's email address?
Lori Green's email address is gr****@****msn.com
What skills is Lori Green known for?
Lori Green has skills like Utilization Management, Insurance, Managed Care, Health Policy, Health Insurance, Hmo, Medicare, Ppo, Credentialing.
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