Insurance
10 health plan claims operations experts
These ten professionals have led claims operations at health plans and health insurers, with titles such as director of claims operations. A reader can learn how health plan claims teams are organized and run day to day.
Professionals to explore
01—10Alicia Mize
LinkedInExperience: Director, Claims & Configuration Management · CHRISTUS HEALTH PLAN
Director, Claims & Configuration Management at CHRISTUS HEALTH PLAN since 2017. Former Director of Data Operations (Oversight of Claims, Provider Data Mngmt, Benefits, & Eligibility) at Humana Behavioral Health (2010–2017), where the profile says this person was accountable for oversight of commercial, Medicare, & EAP claims payment trends and configuration & optimization of the claims system.
Angela Yoho
LinkedInExperience: Lead Director - Medicaid Claim Operations · Aetna, a CVS Health Company
Lead Director - Medicaid Claim Operations at Aetna, a CVS Health Company since 2021. Former Manager- Medicare Claims Operations (2019–2021), Manager - Medicare Cost Containment (2015–2021) and Medicare Claims Supervisor (2006–2015) at Aetna, a CVS Health Company.
Bryan Smith
LinkedInExperience: Director of Claim Operations · Central California Alliance for Health
Former Director of Claim Operations at Central California Alliance for Health (2021–2025), and Claims Director at Presbyterian Healthcare Services since 2026. Former Vice President of Health Plan Operations at Health First (2019–2020) and Executive Director at Community First Health Plans (2018–2019).
Burgundy Thomas
LinkedInExperience: Director of Health Plans & Medical Claims · SEIU Healthcare IL
Director of Health Plans & Medical Claims at SEIU Healthcare IL since 2021, a role the profile describes as overseeing and developing the medical claims operations, health plan and network strategies, and end-to-end claim processing automation and optimization. Former Director of Clinical Operations Support at Health Care Service Corporation (2004–2020).
Jeanette Porro
LinkedInExperience: Director of Claims Operations · AvMed
Former Director of Claims Operations at AvMed (2016–2018). Other AvMed roles listed are Manager, Provider Data and Claims Management (2009–2016) and Manager, Claims Data Unit (2006–2009). Former Director of Configuration at Centene Corporation (2019–2026).
Jennifer Holterman
LinkedInExperience: Associate Director, Claims & Configration Operations · UCare
Former Associate Director, Claims & Configration Operations at UCare (2018–2020), where the profile describes leading 150+ FTE and temporary staff responsible for processing medical claims for over 500,000 members. Former Director Operational Effectiveness (2021–2022) and Benefits Configuration Manager (2012–2016) at UCare.
John Golimowski
LinkedInExperience: Director of Claim Operations · CareSource
Director of Claim Operations at CareSource since 2025, where the profile describes enterprise oversight of claims processing, claims adjustments, provider engagement, recovery operations and knowledge management for Medicare-Medicaid (Dual Eligible) populations. Former Director of Health Plan Operations - Claims at Geisinger (2020–2025) and Director of Claims Operations at Fidelis Care - New York (2013–2019).
Patricia Barnes Hervey
LinkedInExperience: Director of Claims and Quality · Baylor Scott & White Health Plan
Former Director of Claims and Quality at Baylor Scott & White Health Plan (2021–2023), and Director of Operations there since 2024, a role the profile describes as overseeing the day-to-day operations for claims processing, benefits, configuration, quality and refunds for Medicaid, CHIP and commercial lines of business.
Shelley Adams-Slepp
LinkedInExperience: Director, Claims Operations · Ultimate Health Plans
Director, Claims Operations at Ultimate Health Plans since 2021. Former Claims Director at AmeriHealth Caritas Florida (2008–2016) and Claims Coordinator Senior Claims Examiner Provider Ops Coordinator at CITRUS HEALTH CARE (2004–2008). The profile lists a specialization with Medicaid/Medicare product lines.
Terry Grigg
LinkedInExperience: Senior Director of Claim Operations & Payment Integrity · Medica
Former Senior Director of Claim Operations & Payment Integrity at Medica (2017–2020), where the profile says this person, as Director of Claim Operations, provided leadership, direction and strategic input on service, quality and compliance. Former VP Operations Management & Claims (2015–2017) and VP Claims (2013–2015) at Assurant.
Choose the right perspective
Match the person's lines of business to yours, since Medicaid, Medicare and commercial claims each come with different rules and pressures. Also decide whether your question is mainly about claims processing, system configuration or payment accuracy, and pick someone whose titles match that focus.
Questions to take into the conversation
- 01How do you raise auto-adjudication rates without letting payment errors slip through?
- 02Which claims metrics do you review every week, and how do you act when timeliness or accuracy drops?
- 03How do you keep claims system configuration in sync with benefit and provider contract changes?
Reaching health plan claims operations experts
How can I contact one of these health plan claims operations experts?
Pick one of the 10 people on this page and choose "Book a paid call", or describe your project to find others. You offer a fee for a 15-minute call or a written answer, Instant Expert finds the person's work email and sends the invitation, and they decide whether to accept. The list covers 10 companies, including CHRISTUS HEALTH PLAN; Aetna, a CVS Health Company and Central California Alliance for Health, based on profile data retrieved on October 4, 2026. Being listed here doesn't mean someone has agreed to take calls.
How much does it cost to reach health plan claims operations experts?
You choose the offer, starting at $5 per person. It includes Instant Expert's 20% fee, so an offer that pays the person $100 costs you $125. You're charged only when the person books the call or sends the answer.
What if they don't reply?
You pay nothing. Instant Expert sends follow-up reminders, and if the person hasn't booked or answered within 7 days, the request expires and any hold on your card is released. You can invite several of the 10 people on this list at once and cap your total spend, so you pay only for the ones who accept.
About this directory
This is a professional research starting point based on business profile data retrieved on . Titles and companies reflect that source snapshot and may describe past or present roles. Check the linked profiles for current details. Inclusion does not imply Instant Expert membership or availability.
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