Gilma Clara

Ms. Clara has over 25 years of behavioral health experience overseeing all functional areas of a Managed Behavioral Health Organization (MBHO). Ms. Clara joined Carisk in 2013, and was a key resource in transitioning the University of Miami’s academic MBHO – University of Miami Behavioral Health (UMBH) – into Carisk’s operations. She is responsible for ensuring University of Miami Health Plan Members receive the best possible care, and Providers provide timely access to Members and receive prompt and accurate claims processing. She also works with the Benefits Office to coordinate resolution to Member complaints, and the medical insurance carrier to remedy complex claim matters. Additionally, she represents Carisk at annual Open Enrollment Wellness/Benefit Fairs, and supports the University’s EAP.

Her areas of expertise include NCQA and AAAHC accreditations, the development and implementation of organizational Managed Care Applica on (MCA) modules, call center reporting metrics, and policies and procedures.

Previously, she was Director of Business Operations for UMBH from 1993 to 2012, serving more than 400,000 Members and ensuring compliance with State and Federal guidelines, NCQA standards and established corporate performance standards.

Ms. Clara earned a BA in Business Administration and Communications from the University of Miami.