Prudence Carter

Background

About Prudence Carter

I am a compliance professional who guides health care executives, operational hospital staff and physicians to juggle all those regulations without losing sight of member engagement and patient care. My clinical background, case management knowledge and compliance certification provides my colleagues with a consultant who can guide and answer questions across health plans and hospitals. My success stems from a respect for others, leading by example and working inclusively. I held a Regional Consulting Position for Northern California Kaiser Permanente (KP) Health Plan for the past five years. I was the project manager for KP Northern California 2012 NCQA Certification. I guided the 21 medical centers to comply with CMS and state regulations concerning utilization and case management. I am a subject matter expert in Medicare, Medicaid and commercial insurance gained from my regional work with Aetna Insurance and California Medi-Cal Managed Care Plans. My colleagues see me as the "go to" person to solve and manage compliance issues and as a resource for case management challenges.