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Elizabeth Gartman

Consultant

Elizabeth Gartman is a diverse executive with two decades of operational experience working in commercial, Third- Party Administration (TPA), Medicare and Medicaid products, and health and wellness services. Prior to becoming a consultant, Elizabeth was Chief Operating Officer for a regional Medicare Advantage Plan that successfully expanded on a national scale. Elizabeth was accountable for the enrollment, claims, customer service, and appeals and grievances departments.

Prior to this position, Elizabeth was responsible for ensuring that the contractual and operational requirements for each product were successfully resolved for a regional Medicare, Medicaid, commercial, and self-funded plan. Additionally, Elizabeth was responsible for ensuring that the benefits were administered in accordance with the product materials for all lines of business as well as directed the development of biometric screening events for a TPA employer.

Elizabeth began her career in claim operations, and then expanded into benefit administration, contractual expertise, and operational oversight of all product lines. Elizabeth has diverse experience in implementing regulatory requirements and projects that are of a large scale, as well as managing vendor relationships to successfully resolve expectations.

Elizabeth earned her bachelor’s degree in healthcare administration and is also certified with America’s Health Insurance Plans both as a Health Insurance Associate (HIA) and as a Managed Healthcare Professional (MHP).

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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!