Laurie Delgado, who over the past two decades has overseen Medicare appeals and grievances for two of the nation’s largest and most highly respected health plans, has been named vice president of appeals and grievances for Beacon Healthcare Systems, effective immediately. Beacon is home to the health care industry’s leading compliance and risk management technologies.
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Laurie Delgado, Vice President of Appeals and Grievances, Beacon Healthcare Systems (Photo: Business Wire)
For the past five years, Delgado has served as director of Medicare grievances and appeals for Anthem where she led and developed a team of over 120 staff, including clinicians, auditors, analysts and support personnel to achieve a level of excellence in handling customer appeals with strict compliance of regulatory processes and timeframes. Immediately prior she served in a similar role for UnitedHealth Group where over an 18-year career she was responsible for various aspects of appeals and grievances operations, project management and process improvement.
At Beacon, Delgado will oversee the company’s highly acclaimed Virtual Appeals Manager (VAM), the industry’s most intuitive and easy-to-use appeals and grievances tool. Designed by health plan compliance and operational experts, VAM is a highly configurable and automated solution that can be implemented in record time and provides unparalleled control and transparency of cases from intake to review, thus ensuring complete compliance with the Centers for Medicare & Medicaid Services. VAM also helps reduce a massive amount of health plan letters into a manageable and efficient core of templates. As a result of its reliability, transparency and ease of use, VAM has been shown to improve star ratings, translating into additional dollars from CMS to the health plan that can be investing into better serving members.
“We are thrilled to have someone with Laurie’s leadership experience join our team and oversee the products and capabilities we offer our health plan clients in the area of appeals and grievances,” said Beacon CEO Ken Stockman. “Her deep experience with government regulations, compliance standards and process improvement will help us achieve an even greater footprint in the Medicare Advantage space as we continue to develop innovative solutions that our customers and their members find of enormous value.”
Beacon Healthcare Systems is home to the health care industry’s leading compliance and risk management technologies, providing health plans of all sizes and sponsorships with customizable and scalable SaaS (Service as a Software) solutions that ensure accountability, accuracy and operational efficiency. With a focus on appeals, grievances, compliance and analytics, Beacon HCS is the first place health plans turn to when they are looking for a trusted, experienced partner who can help them reduce costs, grow revenue and achieve their strategic goals. Founded in 2011, Beacon HCS is a privately held California-based company with a technology center located in Austin, Texas. beaconhcs.com