Christalyn M. Baker
Director, Compliance & Regulatory Affairs @Alignment Health
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WORK HISTORY
Director, Compliance & Regulatory Affairs @Alignment Health
EDUCATION
Fuller Theological Seminary
Master of Divinity - MDiv, Black Church Studies
California State University, Monterey Bay
Master of Business Administration (MBA), Business Administration and Management, General
University of Phoenix
Bachelor of Science (B.S.), Health/Health Care Administration/Management
ABOUT CHRISTALYN M. BAKER
With over 20 years of managed care compliance oversight experience, I’ve learned to solve organizational and compliance issues by- Performing program audits and assessments to identify the root cause of deficiencies and gaps. Believe it or not, it all boils down to a “person or system error.”- Develop audit tools to capture regulatory and contractual outcomes- Training line staff and leadership on the importance of correlating compliance requirements and operational processes- Strengthen organizational structures and develop functional systems, processes, and workflows that compliment the organization and the customer. I’ve worked in various healthcare compliance capacities such as- Commercial and Medicaid Claims Compliance- Commercial, Medicaid, and Medicare Compliance- Medicare Enrollment- Provider Dispute Resolution (PDR)- Provider Appeals- First Tier Downstream and Related Entities (FDR) OversightThis experience has afforded me with a demonstrated track record for identifying process improvement opportunities and contributing to operational performance and the ability to lead teams through goal setting, effective communication, and team building exercises.My specialties: Healthcare organizations, small business, start-ups, churches and ministries, nonprofits, vendor oversight, claims compliance, PDR, provider appeals, customer service audits, business operations, and organizational planning.Speaking topics: Compliance (claims, PDR, provider appeals, customer service), Audit Readiness, Compliance and Operations Goes Hand in Hand, Why Numbers Matter, and more.
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