Lauren Wetzlau

Dynamic healthcare leader with 12+ years of progressive experience in nursing and quality management, including emergency care and managed care. Proven ability to drive strategic quality initiatives, achieve accreditation milestones, and lead high-performing teams. Expertise in HEDIS, NCQA, health equity, and population health programs. Recognized for fostering collaboration, implementing innovative solutions, and delivering measurable improvements in care outcomes.

Quality professional with extensive experience in spearheading quality assurance and control processes. Proven track record of fostering team collaboration and ensuring compliance with industry standards. Known for adaptability and delivering consistent results through strategic quality management.

Quality management professional with robust background in driving process improvements and ensuring compliance with industry standards. Strong focus on team collaboration and achieving results, consistently adapting to changing needs. Skilled in quality assurance, risk management, and operational efficiency. Known for reliability, leadership, and strategic vision.

• Directed a multidisciplinary quality department of 20+ staff, including managers, analysts, RNs, APRNs, social workers, and administrative support.
• Led NCQA accreditation readiness, documentation, and continuous compliance activities.
• Oversaw HEDIS reporting, measure validation, and audit preparation.
• Ensured compliance with state Medicaid requirements, CMS expectations, and internal governance standards.
• Oversaw provider engagement strategies to improve performance under value-based contracts.
• Collaborated with providers, health systems, and community partners to address gaps in care and access barriers.
• Developed provider education materials and workflows to support quality improvement and incentive alignment.
• Served as liaison between health plan leadership and provider organizations on quality and performance expectations.
• Improved provider compliance with preventive care measures through targeted outreach, education, and data-driven interventions.
• Partnered with data analytics to translate complex performance data into actionable strategies for providers and internal teams.
• Led multiple Performance Improvement Projects (PIPs) resulting in measurable improvements in HEDIS and Medicaid quality measures.

• RN Licensure: Louisiana Board of Nursing (RN157529, Exp. 01/31/2027)
• CSSGB – Certified Six Sigma Green Belt
• Pending: New York RN Licensure