Cotrina McGue
Senior Consultant
Health Management Associates
Washington, DC
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Cotrina McGue is a highly skilled information technology (IT) professional with over 35 years of experience and over 25 years specializing in healthcare systems. Her expertise in IT, health plan operations, compliance, Centers for Medicare & Medicaid Services (CMS) audits, X12 transaction datasets, Medicaid and Medicare allow her to operate horizontally and vertically in healthcare IT and program management.
Before joining Health Management Associates, Cotrina was Optum Technology’s chief information officer for the District of Columbia (DC), where she oversaw day-to-day operations between corporate IT, the health plan and the district’s Medicaid management information systems. Cotrina also conducted and presented an in-depth assessment of system-wide issues and risks.
Utilizing her skills in operational process improvement and her expertise in DC Medicaid contracts, Cotrina streamlined information system operations and application workflows to support new stakeholders in the region. She also leveraged her in-depth understanding of the end-to-end claim process, modifying Health Insurance Portability and Accountability Act (HIPAA) data transaction data sets and ensuring regulatory compliance.
Cotrina’s experience assessing operational systems and workflows is further demonstrated in her previous role as an independent consultant, leading her own business McGueConsulting LLC. Working as the project business lead with DiVurgent for the Sentara Health Plan, Cotrina investigated and assessed the plan’s systems, data workflows and operational workflows as they migrated and updated products. As the project manager for Catalyst Solutions, she assessed a health plan with pain points across systems and operations, covering multiple areas including overpayment reconciliation, explanation of benefits, member billing, limited English proficiency, capitation and provider match logic. Cotrina has held positions with Cognizant, Change Healthcare, UnitedHealth Group, AmeriGroup Corporation, and ValueOptions Inc.
During her career, Cotrina has demonstrated her skills in system enhancement and operational improvement as well as success leading system implementations. She has led Medicaid, Medicare, federal and commercial implementations across multiple states, directing complex IT and operational implementations from proposal responses to post-go-live support. Her implementations have included the development of complex code and applications that integrate medical, behavioral health, health assessment and pharmacy data required for clients to fully manage their accounts.
Cotrina has a master’s degree in information systems management with a concentration in healthcare systems from the Keller Graduate School of Management. She also earned a master’s degree in project management from Keller and a bachelor’s degree in computer science for business from the DeVry Institute of Technology.
When not serving as an IT subject matter expert, Cotrina enjoys swimming, taking long walks and cooking southern dishes for her family.