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Darlene Black

Darlene Black, is a Senior Consultant at BluePeak Advisors, a division of Gallagher Benefits Services, Inc.  Darlene has been in the healthcare industry for over 20 years and she advises clients on Compliance Program Effectiveness (CPE), management of Coverage Determinations, Appeals and Grievances (CDAG), Organizational Determinations, Appeals and Grievances (ODAG)

Prior to becoming a consultant, Darlene served in various leadership roles for local and national Medicare Advantage and Prescription Drug plans as well as a national Pharmacy Benefits Manager (PBM).  Darlene’s experience is in the areas of compliance, sales and marketing and appeals and grievances.  She has held leadership roles in both compliance and operational areas.

Darlene has participated in, conducted and supported numerous audits. In her previous role, Darlene assisted with readiness for CMS audits as well as worked with a plan that was under sanctions.

Darlene was Director of Regulatory Compliance at her last plan where she was responsible for overseeing  an effective Compliance Program.   She supported several operational areas within the organization such as enrollment, delegation oversight and marketing misrepresentations .

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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!