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Kim EversonKE
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Kim Everson

@kimeverson

I lead Medicare and Medicaid care management operations that improve compliance, team performance, and member outcomes.

United States
Message

I lead clinical health services and care management operations across DSNP, HIDE, and FIDE-SNP plan models, currently guiding a multidisciplinary organization of approximately 100 colleagues.

I've partnered with Virginia Medicaid, LTSS stakeholders, and cross-functional leaders to implement contract and Model of Care changes, align FIDE-SNP workflows, strengthen reporting accuracy, and support Medicaid RFP strategy. My work translates complex regulatory and operational requirements into practical workflows that improve compliance, quality, and member outcomes.

At Aetna's Virginia FIDE-SNP and DSNP programs, I led teams of up to 40 and 20 colleagues while driving care management operations, training, onboarding, performance analysis, and targeted improvement plans.

My foundation includes managing complex DSNP member cases and delivering high-acuity bedside care as an ICU registered nurse. I bring evidence-based case management, motivational interviewing, trauma-informed care, and a strong commitment to developing capable teams and sustainable clinical operations.

Experience

Work history, roles, and key accomplishments

AE
Current

Senior Manager, Clinical Health Services

Aetna

Feb 2024 - Present (2 years 7 months)

Lead a multidisciplinary care management organization of approximately 100 colleagues, serving as a subject matter expert in case management operations across DSNP, HIDE, and FIDE plan models. Implement contract and Model of Care changes, partner on quality improvement initiatives, and support Medicaid RFP strategy.

Education

Degrees, certifications, and relevant coursework

Capella University logoCU

Capella University

Doctor of Nursing Practice, Nursing

Doctor of Nursing Practice degree from Capella University, completed in 2022.

Western Governors University logoWU

Western Governors University

Master of Science in Nursing, Nursing

Master of Science in Nursing with a focus on Management and Leadership, completed in 2020.

South University logoSU

South University

Bachelor of Science in Nursing, Nursing

Bachelor of Science in Nursing from South University, Richmond, Virginia, completed in 2017.

Tech stack

Software and tools used professionally

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