Carmela Alcantara

Carmela Alcantara is currently a Clinical Advisor at AbleTo. Prior to their current position, they served as Practice Leader for the Health Plan Market at The Burchfield Group from June 2017 to October 2018. In this role, they worked with Burchfield’s health plan clients to support their strategic and operational needs. Carmela also assisted with the identification of pharmacy, audit and compliance solutions and coordinated implementation across the organization.

Before their time at The Burchfield Group, Carmela Alcantara served as SVP, Corporate Compliance and Government Programs at FirstCare Health Plans from December 2014 to June 2017. In this role, they served as Corporate Compliance Officer, reporting to the CEO. Carmela led and managed all compliance and government programs activities for over 180,000 members in 145 Texas counties. As a key member of the Executive team, they were responsible for setting the strategic direction of the organization.

Prior to their time at FirstCare Health Plans, Carmela Alcantara served as VP, Compliance and Audit at Healthfirst from January 2009 to November 2014. In this role, they were responsible for leading the development and execution of the compliance program. Carmela also oversaw all aspects of internal and external audits, including compliance with state and federal regulations.

Before their time at Healthfirst, Carmela Alcantara served as Compliance Officer at AmeriChoice from January 2007 to December 2009. In this role, they were responsible for developing and implementing policies and procedures to ensure compliance with state and federal regulations. Carmela also oversaw the organization’s compliance hotline and conducted investigations into complaints of potential non-compliance.

Carmela Alcantara began their career in compliance at Horizon Blue Cross Blue Shield of New Jersey, where they served as Vice President, Regulatory and Compliance from January 1994 to December 2007. In this role, they were responsible for ensuring compliance with state and federal regulations, as well as Blue Cross Blue Shield Association requirements. Carmela also oversaw the organization’s quality improvement program and developed policies and procedures to ensure compliance with accreditation standards.

Carmela Alcantara has a Bachelor of Arts in Communication from the University of Pittsburgh. Carmela is also certified as a Healthcare Compliance Professional.