Debra Chastain
Health Plan Ops Manager with Curative
- Role
- Health Plan Ops Manager at Curative
- Location
- Oklahoma City, OK, US
- LinkedIn followers
- 500 followers
About Debra Chastain
I am an enterprise healthcare operations and compliance executive with 28+ years of…
Experience
Health Plan Ops Manager
May 2024 — Present · US
Lead operations for a rapidly scaling health plan, reporting to Leadership and partnering with Finance, Compliance, Network, Claims, OpsSys and IT to align enterprise strategy with execution.Scaled operations from 20K to 240K members by implementing workflows, policies, and training that supported growth while maintaining compliance.Directed ecosystem partner transitions (Boomtax, Tendo, SDS/Lob/Sandy Alexander, EXL, Fabric/telehealth, portals) to streamline operations and improve member experience.Authored member reimbursement, appeals, and payment tracer policies, ensuring TDI and CMS compliance while reducing rework and cycle times.Partnered with Finance/Actuary to integrate budget discipline and PEPM modeling; delivered executive reporting on risks, savings, and vendor ROI.Built CAPAs, escalation models, and Desk Level Procedures (DLPs) that improved audit readiness and reduced compliance risk.Acted as a cross-functional integrator, aligning Claims, Config, Member & Provider Services, Payment Integrity, Sales/Account Management, Compliance and Network on escalated issues and expansion readiness.Provided operational readiness documentation for RFP, ensuring competitive positioning with state-level decision makers.Identified workforce gaps, proposed new roles, and created training to strengthen workforce capability and scalability.
Education
Langston University
Associates, Business
1988 — 1991
Southern Nazarene University
Bachelor in Science, Business Administration
2010 — 2012
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