Caroline McDonald

Caroline Wilson McDonald is a Principal at Prizm Health Advisory, LLC, a consulting firm focused on Medicare Advantage Special Needs Plans (SNP) implementation, quality improvement and compliance. Prior to founding Prizm Health, Caroline was the SNP Quality Improvement Director at Cigna-HealthSpring where she oversaw the Plan’s SNP products (Dual, Chronic and Institutional) representing approximately 22% of membership and over $1 Billion in revenues. During her time at Cigna-HealthSpring, she developed structures and detailed processes to monitor and comply with SNP regulatory requirements and led the department that provided oversight, quality improvement and project management functions to the operational areas responsible for implementing the company’s SNP Models of Care. Caroline began her career working in Market Intelligence for Healthways and then joined the Business Development and Managed Care Department at Community Health Systems. Caroline has a BA in Economics from Vanderbilt University and a MBA from Harvard Business School. She is also a SNP Model of Care Surveyor on behalf of the National Committee for Quality Assurance (NCQA).