Chris Senz
Principal
Health Management Associates
Portland, OR
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Chris Senz has over 30 years of experience working in managed care plan operations, including Medicaid, Medicare, and Dual-eligible Special Needs Plans (DSNP) administration. Her areas of expertise include Centers for Medicare and Medicaid (CMS) regulatory compliance, CMS bids and Value-Based Insurance Design (VBID) applications, Stars performance and risk scoring strategies, and National Committee for Quality Assurance (NCQA) and Utilization Review Accreditation Commission (URAC) accreditation. She has advanced training in diversity, equity and inclusion (DEI) and has implemented strategic plans for both payers and providers.
Before joining Health Management Associates, Chris was CareOregon’s vice president of Medicare, where she directed the organization’s Medicare Advantage DSNP plan. Chris’ responsibilities included oversight of risk scoring, Stars performance, sales and retention programs, utilization management and cost containment, branding and marketing, network performance and contracting, and clinical programs. In this role, she designed and implemented a new organizational structure, hired and trained a new team, implemented a health equity plan, and developed a three-year strategic plan for the Medicare business line. To improve sales, she spearheaded a community outreach program, increasing membership by 31 percent over two years.
Prior to her work on CareOregon’s DSNP plan, Chris was executive director of United Healthcare’s Colorado DSNP program. Under her leadership, the plan transitioned from the Medicare and Retirement Division to the Community and State Division and targeted 15 percent membership growth year-over-year. Through Chris’ efforts, the plan achieved 29 percent membership growth per year over 21 months.
Chris also has proven success improving risk scoring and Star ratings. For United Healthcare, she improved the DSNP plan’s Star rating from 3.5 to 4.0, resulting in an additional $12 million in revenue. While Chris managed Tuality Health Alliance’s (THA’s) Medicaid managed care plan operations, she built community infrastructure that enabled physician members to succeed in risk contracting. For AllMed Healthcare Management, an independent review organization, she proactively performed risk analyses, monitoring product quality and strategically intervening with clients to ensure positive interactions, build relationships and increase switching costs.
In addition to these quality measures, Chris has experience in accreditation and regulatory compliance. With THA, she oversaw all regulatory compliance including HIPAA, fraud waste and abuse, appeals and grievances, and regulations relating to Medicaid and Medicare programs. For AllMed, Chris designed and implemented all programs relating to fraud and abuse monitoring, regulatory and URAC accreditation compliance, confidentiality, and conflict of interest. She also developed corporate compliance programs, monitored and implemented state-level regulations on healthcare appeals and confidentiality, and trained staff on regulatory compliance programs.
Chris received her master’s degree in organizational management from the University of Phoenix. She has a bachelor’s degree in political science from Southern Oregon University.
Chris is Oregon-born and currently lives in Portland with a canine roommate named Freddie Mercury. She recently took up swing dancing, and she loves scary movies.