Jane Scott

Jane brings to Gorman Health Group clients more than 30 years of experience in the health care industry. Her experience expands to the areas of quality improvement, utilization and medical management, claims operations, and provider/associate education. She also has an extensive knowledge of federal regulations and health plan compliance. To compliment her health plan background, Jane has 15 years of clinical nursing experience.

In her role at GHG, Jane has provided her broad health industry expertise to dozens of health plans and providers across the country. Jane has guided new Medicare Advantage plans and ACOs on the development of CMS applications and plan implementation processes. In addition, she has helped to ensure health plan compliance with Medicare regulations and CMS guidelines by performing audit readiness assessments and mock audits. From leading plans through development and submission of CMS applications and plan implementation to operational assessments and audits, Jane has contributed to the success of many of GHG’s clients.  As one of the leaders of GHG’s Star Ratings optimization program, Jane currently leads assessments and strategic plans to drive plan ratings.

Prior to joining GHG, Jane served as the Medicare Compliance Officer and continued on as the Director of Medicare Program Management for Government Programs for HealthNet of Arizona. Under her leadership, HealthNet of Arizona experienced increased total revenue for their Medicare programs of over six percent per year.  Jane has held a number of other senior positions in the Medicare managed care industry.

Jane is in demand as a speaker at industry conferences on such topics as Prescription Drug Events, membership reconciliation, Medicare Part C and Part D audits and Special Needs Plans.