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Carol Potts

Senior Vice President of Healthcare Economics

Carol Potts is the Senior Vice President of Healthcare Economics at Health Partners Plans (HPP). Ms. Potts is responsible for creating and evaluating utilization, enrollment, clinical analytics, productivity and other reports that assist with the company’s mission to improve member outcomes. Her team is responsible for quality reporting for measures related to HEDIS and STARS.  She is also responsible for risk adjusted rate score validation and improvement, including clinical chart reviews, for both the Medicaid and Medicare lines of business.

Ms. Potts joined HPP in 2002 as Manager of Actuarial Services. In 2003, she was instrumental in the development of HPP’s Healthcare Economics Department and was named the department’s director upon its inception. In 2010, the Healthcare Economics department’s role expanded to include HEDIS reporting and monitoring and improvement of risk adjusted rate scores. 

Ms. Potts was promoted to Vice President of Healthcare Economics in 2012. She has a proven track record of utilizing business intelligence and predictive modeling tools to monitor member risk scores, provider efficiency and effectiveness, and evaluate disease management programs. She was named Senior Vice President of Healthcare Economics in 2017.

Ms. Potts received her Bachelor of Science in actuarial science from Lebanon Valley College. She lives in New Jersey with her husband and has three adult children.

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