Maureen Simmonds, MBA

Maureen has more than 15 years’ healthcare experience with health plans, behavioral health, long-term care, physical health managed care organizations, and insurance companies. Maureen is proficient in all aspects of health plan operations and technology, including claims, system configuration, enrollment, billing, customer service, provider network management, implementations, and health insurance exchange (HIX) products.

Experience

  • Project manager and COO for a mid-size California health plan overseeing claim inventory reduction and auto adjudication improvement strategies for all lines of business, including Medicaid, Medicare, and commercial
  • As vice president of implementation for a 22 million-member behavioral health managed care organization, oversaw successful Medicaid program implementations in Maryland, Washington, D.C., Texas, Illinois, and Kansas
  • Acted as a subject matter expert for QNXT system implementations, including process redesigns to support the new systems

Qualifications

  • ACHE
  • 15+ Years’ Experience

Education

  • Master of Business Administration, Marylhurst University
  • Bachelor of Science, Health Services Administration, City University of New York

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