Alexis Thornton

I’m a Registered Nurse with 10+ years of experience in care management, population health, and clinical quality. I focus on utilization review and medical necessity determination, aligning care decisions with payer guidelines (Medicaid/Medicare) and clinical standards.

In my current role as an RN Chronic Care Manager/Population Health, I coordinate care for complex patient populations and manage transitions of care to reduce hospital readmissions. I collaborate with physicians, nurses, and community providers, and I provide patient education, coaching, and telehealth support for chronic disease management.

I also bring deep quality-measure experience from work as a Clinical Quality Analyst (HEDIS/IOA) with UnitedHealthcare Group, where I performed detailed chart reviews and achieved 100% accuracy across multiple HEDIS/IOA seasons. Trained and supported staff on Epic workflows (including Epic Superuser responsibilities) to improve documentation accuracy and efficiency, and I maintain rigorous EMR documentation across tools like Medent, QCSS, and Lenavi.