Kelly Wallington serves as the Director of Utilization Management at Health First Health Plans Inc, where she leverages her extensive expertise in healthcare management to drive impactful population health initiatives. With a robust background in Utilization Management and a deep understanding of regulatory requirements such...
Kelly Wallington serves as the Director of Utilization Management at Health First Health Plans Inc, where she leverages her extensive expertise in healthcare management to drive impactful population health initiatives. With a robust background in Utilization Management and a deep understanding of regulatory requirements such as CMS and NCQA, Kelly is adept at navigating the complexities of the health insurance landscape. Her role involves overseeing the integration of population health services, ensuring that both downstream clients and vendors are aligned with Health First’s strategic objectives.
One of Kelly's key projects includes the enhancement of resource utilization strategies, which are critical for optimizing care management and improving patient outcomes. By fostering strong relationships with external partner care teams, she ensures that the implementation of these strategies is seamless and effective. Her leadership is characterized by a commitment to leading positive change, as she actively engages in the development and refinement of policies and procedures that support efficient healthcare delivery.
In addition to her management skills, Kelly’s expertise in prior authorization and auditing plays a vital role in maintaining compliance and enhancing operational efficiency. Her proficiency in medical policy and health policy positions her as a thought leader in the field, enabling her to advocate for best practices within the organization. As she continues to drive innovation in managed care, Kelly Wallington remains dedicated to improving the quality of healthcare services and ensuring that Health First Health Plans Inc remains at the forefront of the industry.
