Gloria Bush currently serves as the Director of Utilization Management at Health Choice, where she leverages over 30 years of nursing experience and a robust background in managed care to enhance patient outcomes and streamline healthcare delivery. Her extensive expertise encompasses a wide array of...
Gloria Bush currently serves as the Director of Utilization Management at Health Choice, where she leverages over 30 years of nursing experience and a robust background in managed care to enhance patient outcomes and streamline healthcare delivery. Her extensive expertise encompasses a wide array of critical areas, including Disease Management, Case Management, and Medical Claims Review, making her a pivotal figure in the organization’s efforts to optimize resource utilization and improve patient care pathways.
In her role, Gloria spearheads key projects aimed at enhancing the efficiency of utilization management processes, particularly within the Medicaid and Medicare frameworks. She is instrumental in developing strategies that align with regulatory standards while also addressing the unique needs of diverse patient populations. Her proficiency in HIPAA compliance ensures that patient privacy and data security remain paramount in all initiatives.
Gloria’s leadership extends to fostering strong provider relations and network development, which are essential for effective care coordination and the successful implementation of health insurance programs, including HMO and PPO models. Her commitment to continuous improvement is evident in her approach to risk management and her ability to navigate the complexities of the healthcare landscape. With a Master of Arts in Organizational Behavior Studies from the University of the Pacific, Gloria combines her clinical acumen with strategic organizational insights, making her a valuable asset to Health Choice and the broader healthcare community. Through her innovative initiatives and dedication to excellence, Gloria is shaping the future of utilization management and contributing to the advancement of healthcare delivery systems.
