Victoria Phan

About Victoria Phan

Experienced health care executive in diverse managed care health plan operations for $1B+ agency, specializing in Epic Enterprise Implementations, Credentialing, Claims, Provider Data Management, Configuration, Provider Operations, Provider Relations, Provider Disputes, Member Grievances, Member Services & Call Centers, Business Analytics and Compliance & Privacy. Results driven executive with a proven record of translating strategy into disciplined execution. Known for building high complex transformation models, optimizing performance, managing large-scale budgets, delivering consistent outcomes, driving member growth, and ensuring regulatory compliance across Medi-Cal and Commercial Line of Businesses. Skilled in health plan operations, leadership development, strategic planning, process improvements, audits, laws and regulations, compliance and privacy rules (HIPAA, LPS, 42C.F.R. Part 2).Recent Highlights & Accomplishments: Delivered measurable operational improvements by reducing claims volume and administrative burden through workflow Saudization and performance discipline. Strengthened inventory management to improve visibility, control costs, and reduce waste across operations. Served as executive sponsor and directed Epic Tapestry system transformation for the entire Knox-Keene managed care departments, including but are not limited to claims, configuration, medical management (e.g. UM, CM, QI, etc.), provider and member portals, configuration, provider management data, provider relations, provider disputes, member services, & member grievances.

Experience

1. Chief Operations Officer

   Valley Health Plan

   Jun 2023 — Present

Education

• California State University, Fullerton

  Bachelor of Science - BS

• San José State University

  Master of Public Health (MPH), Community Health Education