Cindy Baumhardt Rivera, BSN, RN, CCM

Cindy Baumhardt Rivera, BSN, RN, CCM has extensive experience in healthcare management and clinical operations. Cindy is currently serving as the Senior Vice President of Medical Management at Clinical Care Medical Centers. Prior to this role, they worked as the Senior Director of Managed Care Services at Kelsey-Seybold Clinic, where they oversaw the operations of the managed-care division and directed the administration of the population health program.

Previously, Cindy held the position of Director of Integrated Health Services Government Programs at CareFirst BlueCross BlueShield. In this role, they provided oversight of utilization management, appeals and grievances, and care management for government programs such as Medicare, Medicaid, and Employer Group Waiver Plans.

Prior to their time at CareFirst BlueCross BlueShield, Cindy worked at Humana as the Associate Director of Utilization Management for Florida Medicaid. Cindy was responsible for managing a team that performed prior authorization, concurrent review, discharge planning, and claims review. Cindy also served as the Associate Director of Case, Obstetric, Pediatric, and Disease Case Management, overseeing the day-to-day operations of the department.

Earlier in their career, Cindy served as the Interim Director of Utilization Management at Avalon Healthcare Solutions, where they built and managed the utilization department for a laboratory management company. Cindy also worked as the Senior Director of Utilization Management at WellCare Health Plans, managing members in multiple states for Medicaid, LTSS, MLTC, FIDA, and Medicare lines of business.

Cindy has also gained experience at Select Medical as the Interim Lead Case Manager, Freedom Health as the Manager of Concurrent Review, and CarePlus Health Plan as the Regional Inpatient Team Manager.

Overall, Cindy Baumhardt Rivera has a strong background in healthcare management, utilization management, case management, and population health, with diverse experience in both government and commercial insurance programs.

Cindy Baumhardt Rivera, BSN, RN, CCM has a comprehensive education history in the field of Registered Nursing. Cindy obtained their Bachelor of Science (BS) degree in Registered Nursing/Registered Nurse from Keiser University in the year 2020. Previously, Cindy pursued their Associate of Arts and Sciences (A.A.S.) degree in Registered Nursing/Registered Nurse at Excelsior College, although the specific start and end years for this program are unknown. Additionally, Cindy has earned the certification of Certified Case Manager from the Commision for Case Manager Certification. The exact month and year of obtaining this certification are not specified.