Stephanie Karama

Led hybrid Agile and program delivery for Medicare Advantage, Medicare Part D, D-SNP, and Medicaid initiatives while aligning execution to CMS regulations and payer operations. Facilitated scaled Scrum delivery (SAFe/Scrum at Scale) and supported CMS regulatory changes to improve audit readiness and HEDIS/HRA/Star Ratings reporting accuracy and member outcomes.

Directed enterprise AI-driven healthcare data and analytics programs, integrating with EHR workflows (Epic/Cerner) while maintaining interoperability and HIPAA-aligned delivery. Built an internal LLM/generative AI research platform, advanced HL7 interface work (ADT/ORU), and drove CMS-aligned interoperability and APD execution to secure funding.

Led healthcare data integration projects using APIs, HL7 v2/v3, ORU, XDS, and secure transfer protocols (SFTP/VPN) to enable exchange across clinical scheduling and claims systems. Coordinated clearinghouse and vendor workflows (e.g., Waystar, Greenway, Availity, Change Healthcare, Optum) to optimize EDI 837/835/834 processing and improve claims outcomes and revenue cycle performance.

Delivered enterprise EHR and clinical research transformation programs, aligning clinical, research, and operational stakeholders for multi-workstream execution across Epic (Ambulatory/Inpatient/MyChart). Implemented SafeTrace and blood management systems to improve patient safety and traceability, while managing clinical trials with FDA Good Clinical Practice (GCP) compliance.

Led utilization management and care management transformation programs, optimizing care delivery workflows and improving patient outcomes across payer and provider operations. Supported CMS-regulated initiatives (Medicare Advantage and Medicaid), improving care management platform and authorization workflow efficiency while aligning to HEDIS quality measures.

Led EHR platform consolidation transitioning from Cerner and AdvancedMD to athenahealth, improving system usability, interoperability, and revenue cycle efficiency. Managed ICD-10 transition and migration activities (data mapping/testing, CCD/CCDA integrations) and supported interoperability via HL7/FHIR to enable compliant, secure patient information exchange.

Managed enterprise interoperability and patient access programs aligned to USCDI and CMS interoperability mandates, enabling compliant release of patient health data across EHR platforms. Led Epic upgrade/change management, designed patient portal release workflows with appropriate safeguards, and delivered patient-facing digital experiences (e.g., touchless check-in) with measurable KPI/OKR track

Implemented and optimized payer systems for Medicare-focused utilization management, care management, and claims adjudication, improving prior authorization and claims processing efficiency. Reduced complex delivery delays by 30%, coordinated vendor integrations under HIPAA/SLAs, and supported EDI transactions (834/835/837) with UAT and production issue triage.

Led enterprise initiatives supporting Arizona Medicaid (AHCCCS) and Medicare programs, focusing on claims lifecycle optimization and operational performance. Managed eligibility/claims intake and claims adjudication enhancements, supported provider network expansion, and delivered compliant system updates through structured UAT/QA and change management.

Implemented a statewide Health Information Exchange platform connecting hospitals, clinics, payers, and public health entities for secure, real-time patient data exchange. Directed HL7/interface architecture using Mirth (NextGen Connect), APIs, and CCD/CCDA standards, managed integrations/data migration, and ensured HIPAA and state HIE compliance through onboarding, governance, and executive repor

Master of Healthcare Administration program at Grand Canyon University, with estimated completion in October 2017.

Bachelor of Applied Science in Healthcare Administration from Grand Canyon University (2016).