Open to opportunities

Roseanne Brown

@roseannebrown

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Healthcare Program Manager and Certified Risk Adjustment Coder improving HEDIS outcomes.

United States

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What I'm looking for

I’m seeking a compliance-focused healthcare program leadership role where I can improve HEDIS/risk adjustment performance, lead cross-functional teams, and drive measurable results for patients, providers, and operations.

I’m a results-driven Program Manager and Certified Risk Adjustment Coder with over 10 years in the healthcare industry, focused on compliance, accuracy, and measurable quality gains.

I’ve consistently improved performance—recognizing a 4.4 STAR HEDIS score and maintaining MRA scores above 1.90—by aligning operations, provider engagement, and documentation standards to CMS and Medicare/Medicaid requirements.

I’ve led high-performing teams across multiple states, including managing a multi-state division and building standardized training programs for high-risk disease detection, CMS coding, and documentation guidelines.

My approach blends process improvement, strategic planning, and hands-on case oversight to optimize workflows, strengthen provider relationships, and ensure data quality through continuous education and quality assurance.

Experience

Work history, roles, and key accomplishments

Current

Executive Case Manager

Current

PharmaCord

Nov 2024 - Present (1 year 7 months)

Managed complex patient cases to ensure timely access to therapies and support services. Coordinated with providers, payers, and patients to streamline care delivery while maintaining compliance and quality standards.

Case Management Patient Care Coordination Compliance Oversight Quality Assurance

Care Management Support Assistant

CenterWell

Sep 2022 - Sep 2023 (1 year)

Provided non-clinical support for patient assessments and care planning and connected patients and families to appropriate healthcare resources. Completed administrative and operational customer support tasks to enhance care coordination.

Care Coordination Administrative Support Customer Support Operational Support

Senior High-Risk Manager

ChenMed

Jan 2021 - Aug 2022 (1 year 7 months)

Led a multi-state division across five markets, overseeing teams and standardizing training for high-risk disease detection. Built provider enablement tools and delivered CMS coding/documentation training, improving risk adjustment initiative accuracy and performance through cross-functional collaboration.

Disease Detection Provider Education Risk Adjustments

High-Risk Disease Manager

ChenMed

Nov 2019 - Jan 2021 (1 year 2 months)

Reviewed medical charts for accuracy, completeness, and compliance, and educated providers on Medicare risk adjustment and coding guidelines. Identified performance gaps and implemented process improvements while building strong relationships with physicians and clinical teams.

Medical Chart Review Coding Guidelines Provider Education Process Improvement Compliance Monitoring Cross Functional Collaboration

HEDIS Manager

JenCare (ChenMed)

Jan 2016 - Nov 2019 (3 years 10 months)

Achieved and maintained a 4.4 STAR HEDIS rating by developing standardized operating procedures and training materials. Ensured compliance with HEDIS measures and regulatory requirements through collaboration with providers and internal departments to improve quality metrics.

HEDIS Management Quality Improvement Medicare Medicaid Compliance SOP Development Regulatory Compliance

Front Desk Team Lead

JenCare (ChenMed)

May 2015 - Jun 2016 (1 year 1 month)

Supervised and trained a team of 20 staff members while managing daily operations including insurance, collections, and patient services. Ensured confidentiality and compliance with operational standards.

Team Leadership Staff Training Front Desk Operations Insurance Processing Collections Support Patient Services Confidentiality Operational Management

Referrals Coordinator

JenCare (ChenMed)

Sep 2013 - May 2015 (1 year 8 months)

Processed and tracked patient referrals with high accuracy, achieving top performance in referral authorization completion. Coordinated scheduling, medical records, and insurance approvals to keep referrals moving efficiently.

Scheduling coordination Medical Records Coordination Patient Coordination

Front Desk Associate

JenCare (ChenMed)

Feb 2013 - Sep 2013 (7 months)

Managed patient check-in, scheduling, and communications while maintaining HIPAA compliance and confidentiality. Handled calls, records management, and co-pay collections to support smooth front-desk operations.

Patient Check In Scheduling coordination HIPAA compliance Records Management Administrative Support