Lauren Koch

Senior Client Manager with experience as a Workers' Compensation Nurse Case Manager and paralegal. Skilled in medical-legal documentation, claims coordination, compliance, and client advocacy, with a strong background in client success across healthcare, insurance, fintech, legal/compliance, and technology operations. Adept at navigating complex cases and connecting clinical, legal, and business needs to improve outcomes.

Nurse Client Manager - TRAVELERS INSURANCE - WEST BRIDGEWATER, MA

(2024-01)

• Perform Utilization Review and Retrospective Review on medical treatment requests to ensure services are clinically appropriate and necessary based on jurisdictional Medical Necessity Guidelines.
• Collaborate with Claim Professionals to Analyze clinical data and medical history, ensuring Payment Integrity by identifying discrepancies between requested and actual services.
• Consult with medical providers and attorneys to coordinate complex clinical care, maintaining strict Regulatory Compliance and documenting all interventions within Health Management Systems.
• Assess and develop strategic return-to-work plans for injured employees, focusing on Quality Assurance and maximum medical improvement metrics.

Unit Manager/staff Nurse - ROYAL HEALTH - NORWELL MA

(2022-06 - 2024-01)

• Conducted detailed Clinical Record Analysis and extensive documentation to provide continuity of care while adhering to Medicare Regulations and Medicaid Regulations.
• Executed Quality Assurance protocols for patient care, monitoring wound care and stroke recovery to ensure clinical non-compliance issues were identified and addressed.
• Managed Clinical Assessment for new admissions and implemented patient care plans aligned with ambitious standards of medical necessity.
• Leveraged in-depth understanding of drug mechanisms and pharmacology to support patient care and clinical documentation in hospice and high-acuity settings, preparing for protocol-driven research environments.
• Supervised and Provided Provider Education to nursing assistants to ensure the delivery of high-quality clinical services and adherence to unit protocols.

Clinical Client Manager - VITRA HEALTH - BOSTON, MA

(2023-01 - 2024-01)

• Analyzed and managed KPIs for a clinical team of 90+ caregivers, ensuring clinical appropriateness and operational efficiency for 300+ clients.
• Assessed and trained AFC/GAFC caregivers on Regulatory Compliance and clinical standards to minimize financial leakage and improve service delivery.
• Served as a subject matter expert in Clinical Assessment, facilitating internal audits to guarantee medical and financial integrity across client portfolios.
• Collaborate with care managers to optimize hiring forecasts and clinical staffing based on retrospective reviews of client needs.

Customer Success Manager - CORETELLIGENT - WESTWOOD, MA

(2020-01 - 2021)

• Maintained consultative relationships with clients to ensure Payment Integrity by auditing service delivery against contractual obligations.
• Advocated for client requirements across the organization, conducting Quality Assurance reviews to ensure service level agreements were consistently met.
• Documented and identified opportunities for service enhancement through data analysis and client feedback loops.

Customer Success Manager - EZE CASTLE INTEGRATION - BOSTON, MA

(2018-12 - 2020-09)

• Led access control implementation for 300 clients, ensuring Regulatory Compliance with security standards and preventing unauthorized environment access.
• Assessed and managed client onboarding and off-boarding processes, focusing on accurate documentation and clinical-style mindfulness in service requests.
• Analyzed client service trends to foster long-term partnerships and contribute to sustained organizational growth.

Client Project Manager - IHS MARKIT - CAMBRIDGE, MA

(2014-09 - 2018-11)

• Ensured on-time and on-budget completion of deliverables through rigorous Clinical-style analysis of project plans and financial invoicing.
• Trained internal teams on Salesforce CRM, functioning as a technical lead for data integrity and system implementation.
• Analyzed and monitored research updates via Connect portal, evaluating progress and ensuring compliance with established project agendas.
• Collaborate with diverse stakeholders, including CEOs and CTOs, to maintain high satisfaction rates through precise and initiative-taking project oversight.

Paralegal - Multiple Practices-Contract - Newton/Quincy, Massachusetts

(2011-05 - 2014-09)

Paralegal Internship - Norfolk District Attorney's Office - Quincy, Massachusetts

(2009-06 - 2009-06)

Nursing Certificate in Practical Nursing, Honors - Practical Nursing - BLUE HILLS PRACTICAL NURSING SCHOOL (2021-08 - 2022-05)

Bachelor's degree - Criminal Justice, Minor: Pre Law - CURRY COLLEGE (2011-05)