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Portrait of Ashley CarrAshley Carr

Consultant

Ashley Carr is a Health Plan Services Consultant and BluePeak Advisors, a division of Gallagher Benefit Services, Inc. Ashley is a Licensed Practical Nurse and has served as leader in management with more than 10 years of experience in managed care at the corporate and local plan levels. Ashley has extensive knowledge of Medicaid contracts, process, and health plan operations; with specific expertise in grievance and appeal operations, NCQA accreditation processes, quality of care investigations, critical incidents, utilization review (concurrent review) for all levels of care, use of InterQual criteria.

Prior to joining BluePeak, Ashley worked as a manager for one of the nation’s largest managed care organizations. Ashley led the enterprise appeals team that was responsible for new business acquisition from the Request for Proposal stage to implementation and successful integrations of new health plans, as well as providing appeals process and system support to 30+ individual health plans. Ashley served as the subject matter expert for appeals and grievance system updates as well as the creation of a cloud-based appeal module for the Medicaid product.

Having worked in both in clinical settings and managed care, Ashley, is able to bring a wholistic approach and innovative solutions to mitigate risks and improve quality and service.

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Experienced Medicare staff: Ready when you are!

BluePeak knows how difficult it can be for Medicare Advantage plans and TPAs to find knowledgeable resources with experience in Medicare, especially when demands increase sharply given the Medicare annual cycle. BluePeak maintains a wide variety of experienced Medicare personnel to help you with seasonal projects, operational backlogs, compliance monitoring, remediation activities, and more.

Examples of projects that BluePeak has assisted plans in 2022 include:

  • Clinical chart review by licensed clinicians
  • Call center oversight, including listening to calls for accurate classification and calibration
  • Operational support to resolve grievance backlogs and provider directory compliance
  • Pharmacy support to resolve coverage determination backlogs
  • Program area specific operational and administrative responses to a corrective action (initiated internally or externally)
  • Compliance resources to support compliance program initiatives

Whether you need one resource or many, BluePeak can quickly staff any project, train resources, track results, and deliver success.

Contact us today!