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First Name

Brenda
Last Name

Gross
Nickname

brenda-grosspriorityhealth-com
Years in Program Integrity

20+
Focus Area

FWA – General Program Integrity (broad fraud, waste, abuse oversight), Provider Fraud & Abuse, Member Eligibility & Fraud
Certifications (CFE, PMP, etc.)

RN, BSN, AHFI
Programs Worked With (Medicaid, Medicare, CHIP, MCO, etc.)

Medicaid Managed Care Organizations (MCOs), Children’s Health Insurance Program (CHIP), Long-Term Services & Supports (LTSS) / HCBS, Dual Eligible & Medicare Coordination
Focus Area

Fraud, Waste & Abuse (FWA), Provider Enrollment & Screening, Member Fraud & Eligibility Oversight, Audits & Compliance Monitoring, Policy Development & Guidance
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