Karly Campbell

WORK HISTORY

EDUCATION

ABOUT KARLY CAMPBELL

I am a high-energy, results-focused healthcare consultant based in Nashville, specializing in Medicaid strategy and operations for high-need and underserved populations. Over 11 years in Tennessee’s Medicaid agency, I developed deep expertise in value-based care, managed care, and large-scale program implementation.Previously, as Chief Quality Officer at TennCare, I led the development and implementation of TennCare’s comprehensive quality strategy, integrating priorities from all divisions. In this role, I oversaw managed care organizations and other contracted partners to monitor performance and ensure they met contractual expectations. I also provided daily leadership and management for the Division of Quality Improvement, including 6 direct reports and a total team of 23 FTEs.My work at TennCare gave me in-depth knowledge of Tennessee’s payment reform initiative and hands-on experience translating policy concepts into operational reality. I partnered with senior state staff, managed care organizations, and clinicians across Tennessee to design a multi-payer Patient-Centered Medical Home program and Tennessee Health Link program for TennCare members with high behavioral health needs. These efforts required making critical decisions about quality measures, incentives, activity requirements, and sustainable scale-up plans.I am a fast learner, a collaborative team player, and I hold my work to high standards. I enjoy tackling the web of challenges in our healthcare system and contributing to reforms that reward value over volume. I bring strong written and interpersonal communication skills and excel at leading cross-functional meetings, facilitating complex discussions, and presenting material to diverse stakeholders.Specialties: Medicaid policy and strategy; Managed Care; Value-Based Purchasing; Value-Based Payment Models and alternative payment models (APMs); Patient-Centered Medical Home (PCMH); integrated care; population health; social determinants of health (SDOH); and closed-loop referral systems (CLRS).