Sharon Castro is an accomplished quality compliance leader in healthcare organizations with the goal of achieving the highest level of accreditation and quality outcomes.
Prior to joining HMA, Sharon was director of quality compliance at CIGNA, where she assured sound quality program structure and oversaw audit procedures to meet Medicare requirements, accreditation standards and organizational goals. She directed and supervised the quality compliance team, including oversight of Special Needs Plan (SNP) activities, utilization management (UM) and case management (CM) delegates, and internal and external monitoring of UM and CM activities against Centers for Medicare & Medicaid Services (CMS), state and accreditation requirements. She managed the clinical risk management program and reviewed and investigated quality of care grievances, adverse events, critical incidents and never events. She also served as a subject matter expert in National Committee for Quality Assurance (NCQA) and Accreditation Association for Ambulatory Health Care (AAAHC) accreditation for internal consultants.
Sharon is currently a contracted NCQA surveyor. She conducts surveys for health plan accreditation, credentialing verification organizations, utilization management and credentialing organizations, multicultural healthcare distinction, health equity and wellness and health promotion organizations. She reviews organizations’ documented processes, files, reports and materials and develops comprehensive reports detailing the findings and recommendations for improvement.
As national quality director for accreditation with Magellan Complete Care, she led state health plans into successful NCQA accreditation by providing consulting, guidance and tools. Sharon’s other prior roles include quality improvement director with Prominence Health Plan, corporate director of quality compliance and manager of quality improvement compliance with Molina Healthcare, and regional accreditation manager and accreditation coordinator with Kaiser Permanente.
Sharon has a Master of Science in public health/health education and promotion from Walden University, a Master of Science in project management/information technology from Colorado Technical University and a Bachelor of Science in business-information systems from University of Phoenix.