Danielle Herndon RN, CCM

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VP, Health Risk Management

Direct Phone:443-798-7356
Toll Free: 800.677.7887
Direct Fax: 443-955-6982
E-mail: dherndon@psafinancial.com
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Professional Background

Danielle has more than 35 years of nursing experience and more than 30 years of experience in the healthcare insurance industry.

Danielle has particular expertise in all facets of Health Risk Management including Utilization Review, Demand Management, Clinical Data Analysis, Disease Management, Case Management, Predictive Modeling, Management Reporting and Employee Communications.

Danielle works closely with our Population Health Expert and provides the clinical expertise.  On a regular basis, she reviews our data analytics and makes referrals to the carrier medical management system for intervention. She identifies the risk in the population and works with the employer to design meaningful wellness programs to address such risk.

In addition, Danielle works closely with members and their families as a strong clinical advocate.  Such services include assessing the member’s needs and helping them identify appropriate services/providers to treat their condition.  She acts a liaison between the member/doctor and the health plan to ensure recommended services are covered.  She assists with appeals and grievances when such care is denied.  In addition, when appropriate, she connects members to the health plan’s medical management team and provides education to members as needed.  Her passion is helping members navigate the complex health system by eliminating the fear and complications.

Prior Experiences

Prior to joining PSA, Danielle served as the Vice President of Medical Management for Nextlogical Benefit Strategies, and Fidelity Insurance Group (a subsidiary of United Healthcare) and for the Group’s predecessor organization, Fidelity Insurance Company/Health Care 2000, for 13 years.

In addition to her Medical Management responsibilities, under Danielle’s direction, Fidelity Insurance Group’s PPO provider network, PMG, grew from 9,000 providers to nearly 50,000. Danielle was also instrumental in designing, implementing and managing the exclusive Disease Management program currently being used by the City of Baltimore’s 7,000 employees.

Previously, after extensive work in the hospital arena, Danielle worked for a large national home healthcare and temporary staffing company as Director of Nursing. In this position, she supervised over 300 health care providers and obtained contracts with various insurance companies to provide services to their members.

Education

She is a licensed Registered Nurse in the State of Maryland and a Certified Case Manager with the Commission of Case Management.