Lesa Galloway

Experience

• 

  Woodlands Sports Medicine Ctr

  Mar 2006 - Jan 2008

  Orthopedic Physician Assistant

  Orthopedic surgical assistant for shoulder, hip and knee surgeries.

• 

  The Hartford

  Jan 2008 - now

  Responsible for strategy and regulatory requirements with Workers Compensation Medical Networks. Team leader for Long Term Disability, Medical Case Managers URAC AccreditationInternal and external quality auditsDue diligenceRegulatory filings and compliance • Effectively identify and manage opportunities for negotiation with CMS.• Perform clinical reviews on conditional payment liens. • Staff training including nurse case manager training, developmental coaching, and in-service training on such topics as return to work programs, diagnoses, network usage, and medical investigations.• Oversight and development regarding nurse case managers, URAC, regulatory compliance, and participation in file reviews and round-tables.

  • Manager, Regulatory and Workers' Compensation Practices

    Jan 2019 - now

  • Medical Strategy Networks Manager

    Dec 2016 - Dec 2018

  • Clinical Team Leader for Group Benefits

    Mar 2016 - Dec 2016

  • Medical Quality Consultant

    Mar 2014 - Mar 2016

  • Medicare Clinical Reviewer

    Feb 2012 - Mar 2014

  • Medical Management Leader

    May 2010 - Feb 2012

  • Medical Case Manager

    Jan 2008 - May 2010