Ms. Russo brings over 20 years of experience in extensive expertise in managed care performance improvement. Her knowledge spans medical management, network contracting and health plan operations for both government and commercial health plan sectors.
Acting as an attorney and a senior executive in managed care, Ms. Russo has designed integrated operational solutions that drive improved financial results while enhancing quality scores and regulatory compliance. These solutions have included contract modeling and negotiation with providers, installation of systems to drive performance improvements in utilization management and care management functions and development of medical management staffing models. She has also provided leadership and strategic guidance for change management and business transformation efforts to develop and execute cross functional business requirements for integrated operational and technological strategies.
Ms. Russo’s has held numerous leadership positions at both national and regional payers where she was responsible for provider unit cost and utilization results, care management programs, reporting and analytics, provider operations and quality performance. In this capacity, she also oversaw accreditation efforts, regulatory corrective action programs, claim system migration re-engineering and data warehouse implementation.
She has acted as CEO of a specialty care management company offering both managed long-term care and fully-integrated Dual Advantage programs and has served as General Counsel and Network Executive for a carve-out benefit management company.
Ms. Russo earned a bachelor’s degree from The Pennsylvania State University and a Juris Doctor from St. John’s University School of Law. She remains an active member of the New York, New Jersey and Florida Bars.