Mae Regalado is a Senior Consultant at Gorman Health Group (GHG). In this role, she leads many of GHG’s client engagements, as one of GHG’s most versatile consultants. Mae brings GHG clients more than 20 years of senior management and consulting expertise in complete operations services and managed care product lines – including Medicare, Medicaid, and the Health Insurance Marketplace – representing health plans, integrated delivery systems, large multi-specialty provider groups, and hospitals. She is technically and operationally focused and fully capable of both high-level strategy as well as “in the weeds” detail. By leveraging these elements, her end-to-end understanding of managed care operations enables her to effectuate business process improvements, compliance, and convert leading edge ideas into best practices and tangible results throughout health plan operations.
Mae is a seasoned executive having experience in large-scale systems implementations with Facets™, QNXT™, ikaSystems, Xcelys™, and EZ-CAP. She is a specialist in claims administration, system configuration, quality control, compliance, provider network, and data management.
Mae has been involved in operational turnarounds, employing formal project management techniques and detailed work plans to execute timely and effective process improvements for corporate turnaround goals. Particular skills include developing infrastructure for start-up managed care organizations or end-to-end operational departments, assuring full integrations of newly developed systems, policies and procedures, people development, and training.
Mae has been a Vice President of Claims for a major west coast health system, leading initiatives to streamline processes, consolidate operations, and improve service levels. She maintains a successful record of supporting prestigious clients and employers renowned in the healthcare industry and contributes to corporate objectives through innovative programs to maximize operational efficiencies in balance with quality outcomes.