Deborah Rothman

Experience

1. Senior Associate General Counsel

   Elevance Health

   Mar 1998 — Present

   Corporate name change from Anthem, Inc. to Elevance Health in August 2022)Health Care Management:Currently provide legal support for Health Care Management which includes medical operations, utilization management, case management and disease management enterprise wide. Support senior leadership in highly complex legal projects, analyzing strategic initiatives and providing legal guidance. Provide support for day to day Care Management operations, the Office of Medical Policy and accreditation.Provider Contracting:Provided legal support for the most complex provider contracts, narrow networks and related provider issues, including regulatory issues and filings. Provided enterprise legal support for Centers of Medical Excellence and the Transplant Quality Review Committee. Support all facets of Blue Precision cost and quality designation transparency program.Commercial Managed Care Organization Products and Operations: Provided legal support for products, operations and initiatives (PPO, HMO, EPO, Senior and self-funded). Provide legal support for required filings. Provided legal review of documents such as evidence of coverage documents, advertising, agent and broker materials, underwriting manuals and operations policies and procedures. Participate in market conduct examinations and audits. Medicaid: Provided comprehensive legal support for Medicaid products offered by the Company in multiple states, including CA, VA and OK. Review agreements with governmental entities, RFPs, member evidence of coverage and medical management programs. Supported new business initiatives, obtaining HMO licenses, managed care plan certification and establishing provider networks.Elevance/Anthem: Sr. Associate General Counsel (2/2/15 to present), Managing AGC (7/5/2010 to 2/2/2015), AGC (8/18/08 to 7/4/10), Sr. Counsel/ Executive Counsel (11/22/99 to 8/17/08), Counsel (8/17/98 to 11/21/99), Sr. Contract Analyst (3/23/98 to 8/16/98), Contractor (9/97 to 3/98)

Education

• Boston University

  Bachelor of Science (B.S.), Journalism

• Whittier Law School

  Doctor of Law (J.D.)

• University of Notre Dame - Mendoza College of Business

  University of Notre Dame, Certificate in Leadership and Management

Skills

• Hmo
• Provider Relations
• Healthcare Management
• Case Managment
• Health Policy
• Claim
• Insurance
• Employee Benefits
• Healthcare
• Utilization Management
• Hipaa
• Medicare
• Policy
• Healthcare Industry
• Disease Management
• Medical Compliance
• Medicare Part D
• Health Care Reform
• Health Savings Accounts
• Medicaid
• Ppo
• Leadership
• Health Insurance
• Managed Care