A driven and dynamic healthcare professional with over 25 years of experience in health utilization management, known for a proven track record in process improvement, policy development, and health plan medical management operations. Extensive expertise in developing and managing clinical staff, with a deep understanding of managed care principles and utilization management. Demonstrated ability to achieve high standards, including a 100% score on URAC Accreditation, and excel in cross-functional team management, relationship building, and problem resolution.