Toni Prine

Background

About Toni Prine

With more than 20 years of experience specializing in Medicaid and Managed Care, I have developed a deep understanding of state and federal policy. I have focused my career on payment accuracy in the healthcare delivery system and have developed a firm foundation in payment integrity with a wide range of public sector insurer experience. Executive level experience in government managing fraud, waste, and abuse efforts. My background also includes clinical expertise and delivering top quality, innovative payment integrity services. As a registered pharmacist and certified coder, I have the ability to view issues from a continuum of care and a payment accuracy perspective. This global view of healthcare enables me to design solutions that take delivery and payment accuracy into account. With my robust knowledge of policy development, enforcement, and governance, I can provide clients with thought leadership and cutting-edge fraud, waste, and abuse detection methods.My philosophy during my government tenure was to assure that every taxpayer dollar was spent in the most appropriate way so that those who needed services would have access. This mindset has carried me through my career. I firmly believe in an accountable, transparent healthcare payment system.