Summary
Overview
Work History
Education
Skills
Certification
Timeline
HIGHLIGHTS
Generic

Amber Foster

Brandon

Summary

Experienced Registered Nurse with over 8 years of expertise in Medicare business operations and healthcare compliance. Recognized for a forward-thinking approach to regulatory compliance, risk mitigation, and audit readiness, consistently improving operational efficiency and stakeholder clarity on complex regulations. Strong leadership, mentoring, and communication abilities, with a proven track record of advancing compliance initiatives and fostering high-performing teams.

Overview

16
16
years of professional experience
1
1
Certification

Work History

Lead Compliance Program Manager

Point32Health
08.2024 - Current
  • Acted as subject matter expert on regulatory compliance, advising on best practices to ensure adherence to industry standards.
  • Partnered with internal and external stakeholders to drive compliance initiatives and promote regulatory alignment.
  • Maintained strong relationships with regulatory agencies, providing effective resolutions to inquiries and concerns.
  • Reviewed records and documentation to identify compliance risks and support mitigation strategies.
  • Monitored evolving regulations and delivered timely guidance to ensure stakeholder awareness and preparedness.
  • Supported total cost of care efforts by delivering strategic regulatory guidance and compliance support.
  • Specialized in MAPD and DSNP compliance, with deep knowledge of related state contractual requirements.

Legal Compliance Advisor, Medicare Business Support

Cigna
06.2023 - Current
  • Advised internal and external stakeholders on compliance issues to drive remediation efforts and process improvements.
  • Managed Medicare Issue Remediation and Corrective Action Plans with targeted risk assessment and timely execution.
  • Utilized in-depth knowledge of CMS, Medicare Advantage (MA), Part C, and working familiarity with PDP regulations.
  • Interpreted monthly monitoring data to identify trends and implement swift corrective actions.
  • Contributed to the 2023 Compliance Program Effectiveness Audit, ensuring alignment with CY2024 Final Rule requirements.
  • Created and assessed training materials to strengthen team proficiency in regulatory compliance.

Legal Compliance Sr. Analyst, Medicare Business Support

Cigna
08.2022 - 06.2023
  • Oversaw Utilization Management (UM) monitoring to ensure process efficiency and alignment with CMS, DSNP, and state regulatory requirements.
  • Identified compliance risks and implemented corrective actions, driving continuous process improvement.
  • Maintained monitoring dashboards to promote operational clarity and data-driven decision-making.
  • Applied subject matter expertise in CMS, Medicare Advantage (MA), and Part C regulations, with working knowledge of PDP requirements.
  • Reviewed and updated annual Compliance Policies and Procedures to ensure regulatory compliance.
  • Conducted training needs assessments, developed educational materials, and evaluated program effectiveness to enhance team capabilities.

Legal Compliance Analyst

eviCore / Cigna
07.2019 - 08.2022
  • Executed remediation plans to address noncompliance issues, minimizing risk and supporting regulatory adherence.
  • Conducted detailed quality reviews of ODAG (monthly) and Part C (quarterly) reports to ensure compliance standards were met.
  • Supported internal and CMS external audits through thorough documentation review and analysis.
  • Led Corrective Action Plans, data validation efforts, and OIG responses, contributing to process improvement and compliance integrity.
  • Served as Compliance Team Education SME and trainer, enhancing team knowledge of Medicare Advantage and Part C regulations.

Clinical Specialist

eviCore / Cigna
03.2017 - 07.2019
  • Acted as primary liaison for clinical support and processing workflows to ensure seamless operations.
  • Handled escalated provider and beneficiary inquiries, resolving issues and improving satisfaction.
  • Applied in-depth knowledge of CMS and Medicare Advantage regulations to ensure regulatory compliance.
  • Served as team lead and Subject Matter Expert, leading onboarding and training initiatives to enhance team capability.

Clinical Review/UM Nurse

eviCore / Cigna
03.2016 - 03.2017
  • Compiled and reviewed critical medical documentation to ensure accuracy, completeness, and clinical relevance.
  • Authorized medical service requests within nursing scope, supporting efficient and timely patient care.
  • Prepared complex cases for physician evaluation, applying strong problem-solving and attention to detail.
  • Gained proficiency in CMS and Medicare Advantage regulations to support compliance and mitigate organizational risk.

LPN

Wee Care For Kids Pediatrics
10.2014 - 03.2016
  • Provided comprehensive pediatric care for patients from birth to 21 years during routine checkups and acute illness visits.
  • Communicated vital signs and clinical concerns to physicians, supporting timely and effective medical decisions.
  • Educated families on pediatric health topics, creating a supportive and informed environment for child wellness.

LPN

Pediatric Healthcare Alliance
01.2013 - 10.2014
  • Provided full-spectrum pediatric care for patients from infancy through young adulthood in both wellness and acute care settings.
  • Collaborated with physicians by reporting vital signs and clinical concerns, supporting timely interventions.
  • Educated families on health issues to promote informed, compassionate care.

Patient Care Technician/CNA

Florida Hospital
11.2009 - 01.2013
  • Provided direct patient care across diverse departments, including medical, surgical, orthopedic, neurology, and cardiology, managing 10–20 patients per shift.
  • Proficient in vital sign collection, patient admissions, and routine care tasks.
  • Recognized for prompt reporting of critical changes and strong collaboration with healthcare teams to ensure safety and optimize care delivery.


Education

Bachelor of Science - Nursing

Chamberlain University
Chicago, IL
04-2025

Associate of Science - Nursing

Rasmussen University-Florida
Brandon, FL
12.2021

Diploma/LPN -

Erwin Technical College
Tampa, FL
06.2012

Skills

  • Effective leadership
  • Coaching and development
  • Regulatory compliance
  • Risk assessment expertise
  • Compliance auditing
  • Strong attention to detail
  • Cross-functional collaboration
  • Effective communication
  • Self-motivated
  • Prioritization and scheduling
  • Commitment to responsibility
  • Skilled in Microsoft Office tools

Certification

  • Certified in Healthcare Compliance (CHC), Compliance Certification Board (CCB), SCCE & HCCA - May 2024

Timeline

Lead Compliance Program Manager

Point32Health
08.2024 - Current

Legal Compliance Advisor, Medicare Business Support

Cigna
06.2023 - Current

Legal Compliance Sr. Analyst, Medicare Business Support

Cigna
08.2022 - 06.2023

Legal Compliance Analyst

eviCore / Cigna
07.2019 - 08.2022

Clinical Specialist

eviCore / Cigna
03.2017 - 07.2019

Clinical Review/UM Nurse

eviCore / Cigna
03.2016 - 03.2017

LPN

Wee Care For Kids Pediatrics
10.2014 - 03.2016

LPN

Pediatric Healthcare Alliance
01.2013 - 10.2014

Patient Care Technician/CNA

Florida Hospital
11.2009 - 01.2013

Bachelor of Science - Nursing

Chamberlain University

Associate of Science - Nursing

Rasmussen University-Florida

Diploma/LPN -

Erwin Technical College

HIGHLIGHTS

Legal & Corporate Affairs Engagement / People Leaders - 2 yrs

  • Multiple Legal internal blog postings on topics such as Development, Competencies, & WorkDay.

EMERGE Mentoring Program - 2 yrs

  • 04/2023-12/2023 Recent mentor relationship completion

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