Patricia Richards serves as the Vice President of Medical Management at Managed Health Services, where she plays a pivotal role in overseeing the Medical Management department for a statewide managed care organization that caters to nearly 200,000 Medicaid members. With a wealth of experience in...
Patricia Richards serves as the Vice President of Medical Management at Managed Health Services, where she plays a pivotal role in overseeing the Medical Management department for a statewide managed care organization that caters to nearly 200,000 Medicaid members. With a wealth of experience in both commercial and Medicaid managed care organizations, Patricia brings a deep understanding of the complexities of healthcare delivery systems. Her primary expertise lies in Medical Management, encompassing Prior Authorization (PA), Concurrent Review, and Case Management, which are critical components in ensuring that members receive timely and appropriate care.
In her current role, Patricia leads a diverse team responsible for various functions, including Utilization Management, Case and Disease Management, and the specialized Children With Special Needs department. Her leadership is instrumental in driving initiatives that enhance operational efficiency and improve patient outcomes. Under her guidance, the Medical Management department has achieved significant milestones, including successful NCQA accreditation, where her team achieved a remarkable 100% file review compliance. This accomplishment underscores her commitment to maintaining high standards of quality and accountability in healthcare management.
Patricia’s strategic vision and hands-on approach enable her to foster collaboration across departments, including operations, claims management, and provider relations. Her extensive background in healthcare management equips her with the skills necessary to navigate the challenges of the ever-evolving healthcare landscape. As a member of the Senior Leadership Team, she is dedicated to advancing Managed Health Services’ mission to provide comprehensive and compassionate care to its members, ensuring that they receive the support and resources they need to thrive.
