Maria C.

I am a seasoned nurse leader with over two decades of experience spanning clinical care, healthcare operations, and managed care leadership. Currently serving as Director of Utilization Management at Centene’s Ohana Health Plan, I lead remote teams across Hawaii to drive strategic initiatives, regulatory compliance, and quality outcomes. My career has been defined by a commitment to innovation, collaboration, and excellence in patient-centered care. I specialize in utilization management, performance improvement, and cross-functional leadership, with a proven track record of developing scalable solutions that align with organizational goals and improve member outcomes. Certified in Managed Care Nursing and Lean Six Sigma, I bring a data-driven approach to healthcare strategy and operations. I’ve led initiatives that enhance compliance with NCQA standards, optimize resource utilization, and foster a culture of accountability and service. Whether mentoring clinical teams, managing complex inpatient reviews, or shaping policy at the state level, I thrive in dynamic environments where I can make a meaningful impact on healthcare delivery. Let’s connect if you’re passionate about transforming managed care, improving health outcomes, or building high-performing healthcare teams.