Dr. Harold "Lee" Sanford
Lexington,SC
Summary
Experienced healthcare leader with a strong background in Medicare Advantage quality improvement, member experience strategy, and regulator compliance. Proven track record of driving performance in CAHPS, HOS, HEDIS, and other Star Rating initiatives through cross-functional collaboration, data-informed decision making, and innovative member engagement. Skilled in managing large-scale health plan initiatives, vendor partnerships, and communication strategies that enhance member satisfaction and close care gaps. Recognized for leading high-impact teams, streamlining operations, and fostering a culture of excellence, equity, and continuous improvement.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Sr. Manager, Quality Ops & Provider Partnerships
BCBS SC Medicare Advantage
06.2024 - Current
- Provide strategic direction and leadership over quality management programs and quality improvement initiatives to ensure compliance with all regulatory requirements and internal standards.
- Coordinate and oversee cross-functional projects, collaborating with provider partners to drive measurable improvements in Stars, HEDIS, HOS, and CAHPS performance.
- Ensure accurate and timely data collection, validation, and reporting for performance improvement and regulatory submission.
- Guide internal teams in developing, implementing, and evaluating quality management activities across the Medicare Advantage population.
- Leverage data insights and member experience feedback to enhance care delivery, reduce disparities, and support equitable access to high-quality healthcare.
- Collaborate with analytics and clinical teams to assess program outcomes and recommend targeted strategies for continuous quality improvement.
- Manage vendor relationships to align performance with contractual expectations and achieve operational goals.
- Mentor team members, foster a culture of accountability and excellence, and support organizational readiness for audits and CMS reviews.
Member Experience Supervisor
BCBS SC Medicare Advantage
10.2021 - 06.2024
- Develop, plan, and direct member engagement activities to improve overall member satisfaction as reflected in member feedback and CAHPS scores.
- Leads Member Experience Committee, a cross-departmental effort bringing together MA executive leaders to collaboratively and continuously evolve member experience initiatives.
- Utilize CAHPS, HOS, and HEDIS data to improve Star program performance.
- Coordinate member health events across the state to address member care gaps, increase member retention, and positively influence overall member experience.
- Develop high-quality content for member communication activities through multimedia channels including text, email, newsletters, postcards, and member website.
- Manage vendor relationships to maximize performance and achieve objectives.
- Analyze complaint and grievance data to identify trends and mitigate risk according to regulatory guidance.
Consultant: Patient Experience
Prisma Health
10.2020 - 10.2021
- Implement patient experience strategies and best practices across continuum of care.
- Coach, consult, and support provider and operational leaders with implementation and continuous improvement initiatives that accelerate and sustain results.
- Partner with C-Suite leaders to drive team member engagement, close gaps in performance, and create seamless patient experience while supporting safety and quality measures.
Risk Manager
Cooperative Health
07.2018 - 10.2020
- Developed short-term goals and long-term strategic plans to improve risk control and mitigation.
- Employed strong program management skills to successfully define and manage ongoing initiatives designed to control clinical and organizational risk.
- Improved patient and employee safety by 23% within 6 months through development of full-scale auditing program and creation of Just Culture.
- Led multidisciplinary quality improvement program to improve patient outcomes while maintaining compliance with local, state and federal regulatory guidelines.
Healthcare Management Consultant
PwC
01.2017 - 07.2018
- Evaluated diverse organizational systems to identify workflow, communication and resource utilization issues.
- Compiled research data and gave professional presentations highlighting finds and recommended optimizations.
- Provided leadership vision, direction, development and maintenance of multiple complex and high priority contracts between company and business partners, vendors and suppliers
- Managed operational budgets of $3-$8 million.
- Managed quality assurance program including on site evaluations and internal audits.
- Measured effectiveness of customer success through operational metrics and internal tracking systems.
Operations Manager
CORA Health Services
04.2014 - 01.2017
- Worked in matrix management environment with oversight of division level managers, operations, sales, finance, human resources, safety and compliance.
- Communicated corporate objectives across all divisions through regular correspondence and scheduled status updates.
- Executed local market strategies aligned to overall strategic and marketing plans, creating tactical initiatives to meet operational, budgetary and productivity goals.
- Established and administered annual budget with controls to prevent overages, minimize burn rate and support sustainability objectives.
- Recruited, hired and trained all staff, providing direct supervision, ongoing staff development and continuing education to employees.
Nursing Technician, Unit Secretary
Richland Memorial Surgical Trauma ICU
11.2012 - 04.2014
- Observed and reported patient condition, progress and medication side effects to accurately document updates.
- Observed and documented patient factors such as diets, physical activity levels and behaviors to understand conditions and effectively modify treatment plans.
- Used first-hand knowledge and clinical expertise to advocate for patients.
Nursing Technician, Unit Secretary
Lexington Medical Center Medical ICU
06.2010 - 11.2012
- Monitored, tracked and conveyed important patient information to healthcare staff to help optimize treatment planning and care delivery.
- Complied with company-specific guidelines to perform hands-on nursing care under RN supervision.
- Assisted in emergency and routine situations to evaluate needs and deliver care.
Education
Doctor of Health Administration -
Capella University
03.2025
Master of Health Administration -
Capella University
06.2019
Bachelor of Arts - Business Management
Southern New Hampshire University
12.2016
Skills
- Medicare Advantage Quality Programs
- CAHPS, HEDIS, HOS, and Star Ratings
- Health Equity and Member Engagement Strategies
- Data Analysis & Reporting
- Project Management & Cross-Functional Leadership
- Provider Engagement & Performance Improvement
- Vendor Management & Contract Oversight
- Member Communication Strategy (Text, Email, Web, Print)
- Presentation & Stakeholder Engagement (All levels)
- Population Health & Care Gap Closure
Certification
ASHRM Patient Safety
Project Management Qualified (PMQ)
Timeline
Sr. Manager, Quality Ops & Provider Partnerships
BCBS SC Medicare Advantage
06.2024 - Current
Member Experience Supervisor
BCBS SC Medicare Advantage
10.2021 - 06.2024
Consultant: Patient Experience
Prisma Health
10.2020 - 10.2021
Risk Manager
Cooperative Health
07.2018 - 10.2020
Healthcare Management Consultant
PwC
01.2017 - 07.2018
Operations Manager
CORA Health Services
04.2014 - 01.2017
Nursing Technician, Unit Secretary
Richland Memorial Surgical Trauma ICU
11.2012 - 04.2014
Nursing Technician, Unit Secretary
Lexington Medical Center Medical ICU
06.2010 - 11.2012
Doctor of Health Administration -
Capella University
Master of Health Administration -
Capella University
Bachelor of Arts - Business Management
Southern New Hampshire University
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