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Rachna Pandya, MPH

Regional Strategic Implementation Leader, Medicare Operations & Strategy, Kaiser Permanente

Rachna leads the National Benefits, Claims and Coding efforts for Kaiser Permanente’s Advanced Care at Home initiative across the Enterprise as part of overall strategy to develop a long-term roadmap with the patient at the center.

Her dual role across National and Regional strategy has led to development of benefit policy, exploration of clinical/non-clinical code sets to advocate for Advanced Care at Home with Payor lens and enhancement of Benefit operations across different lines of business in the Care at Home space. As part of her Regional Strategic leader role she helped lead the development of the 1st ever Medicare Supplemental Benefit for Advanced Care at Home effective 1/1/2022 bridging alignment across Clinical Operations and HealthPlan SME’s.

Rachna has over 20 years expertise in leading teams in transformative design, performance improvement, and development of strategic pipeline initiatives including supplemental benefits across healthplan & hospital operations for complex care populations. Her strengths are putting large complex ideas into action partnering with leadership, clinical operations, and cross functional teams with enterprise wide lens. Specialties include focus on social determinants of health with complex and vulnerable populations in partnership with SME’s across care providers, clinical operations, legal, compliance, IT, pharmacy, claims, revenue cycle and benefits administration.