Katherine Charron
Commonwealth Care Alliance
North Kingstown
1
Certification
11
years of professional experience
Highly motivated and experienced executive leader with a strong background in compliance, legal analysis, and operations.
Experienced with executive leadership and strategic planning. Utilizes innovative approaches to drive business growth and operational excellence. Track record of effective team collaboration and achieving results.
Work History
Vice President Regulatory Compliance
2 Years 5 Months- Healthcare subject matter expert responsible for regulatory compliance functions.
- Led team of compliance professionals overseeing Medicare and Medicaid operations, ACO, PO, and Clinical delivery functions across four states.
- Represented organization with all Federal and State regulators including CMS, OIG, OCR, and DOI.
- Achieved positive audit results with no compliance findings in most recent CMS Program Audit.
- Advised C-Suite and Board on regulatory requirements, compliance risks and strategy. Responsible for Board reporting.
- Led teams responsible for risk assessments, Compliance Committee, Corrective Action Plans, investigations, audits (internal and external) and monitoring programs.
- Analyzed performance metrics to identify areas for improvement and drive data-informed decision-making across departments.
- Mentored senior leaders and staff, promoting professional development and leadership skills within the organization.
Senior Director Regulatory Compliance
1 Year 8 Months- Built team of compliance professionals overseeing the health plan products in four states including MAPD and Duals products.
- Built and implemented a compliance program including risk assessments, CAP process, investigations, auditing and monitoring programs and implemented a GRC system,.
- Created and maintained organizational policies, procedures, and SOPs
- Developed and implemented policies to ensure compliance with state and federal regulations.
- Oversaw cross-functional teams to drive organizational change and improve service outcomes.
- Facilitated executive meetings to align organizational strategies with overall mission and vision.
- Developed strong relationships with key industry partners, fostering collaboration and mutual growth opportunities.
- Worked closely with Legal and Policy teams to interpret and disseminate regulatory guidance to the organization.
Senior Manager Regulatory Compliance
5 Years 2 Months- Implemented and managed compliance programs for Medicare, Medicaid and Commercial lines of business including:
- Implemented an auditing and monitoring program
- Managed the FDR oversight program
- Oversaw the HIPAA Privacy program
- Streamlined reporting processes using data analytics tools to drive decision-making for program enhancements.
- Mentored junior managers, fostering a culture of continuous improvement and professional development within the team.
- Provided strong leadership to enhance team productivity and morale.
Operations Oversight Manager
1 Year 5 Months- Led cross-functional teams to implement innovative healthcare programs and initiatives. including an MMP product
- Worked with CMS and State officials to implement operational and contractual requirements.
- Oversaw development of the bid, policies and procedures, member materials, and contract development.
- Developed training materials and conducted workshops for staff development and compliance.
Education
Juris Doctor - Law
B.A. - Political Science
Skills
Deep knowledge of CMS
OIG
HHS
and State Regulations
Data Analytics
Regulatory Analysis
Strong Leader
Excellent Communication Skills
Critical thinking
Decision-making
Certification
- Admitted to the RI Bar Association
- CCB CCEP
- Lean Six Sigma Black Belt
Timeline
Vice President Regulatory Compliance
Commonwealth Care Alliance
03.2024 - CurrentRead More
Senior Director Regulatory Compliance
Commonwealth Care Alliance
07.2022 - 03.2024Read More
Senior Manager Regulatory Compliance
Neighborhood Health Plan of Rhode Island
05.2017 - 07.2022Read More
Operations Oversight Manager
Neighborhood Health Plan of Rhode Island
12.2015 - 05.2017Read More
Wellesley College
B.A. from Political Science
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Roger Williams School of Law
Juris Doctor from Law
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