Simplify Healthcare

Excited to welcome Elissa Moreh to the Outmarket AI Client Success team. Elissa brings a combination that is hard to find. She started her career at Newfront, moved into Heffernan Insurance Brokers, and most recently was at Trios — their wholesale subsidiary — where she managed roughly dozens of renewals a month across cyber, tech, management liability, and professional liability. She also built AI into her daily workflow before most people in her seat were even thinking about it. That means she understands commercial insurance from the inside. She understands what producers actually need. And she knows what it looks like when the right tools change how work gets done. What stood out to me is range. She has worked retail, wholesale, and specialty lines. She has handled volume at scale and still stayed close to the detail. That creates versatility. It creates credibility with clients. And it creates the instinct to know what matters when things get complicated. That matters a lot at Outmarket, where we are helping modern insurance agencies grow faster and operate smarter with AI. Elissa Moreh , glad you’re here. So proud of Joanna Paredes who is buildings a team that reflects her industry expertise and passion for customer success.

It’s been over 7 years since I started my corporate journey. Somewhere between delivery deadlines, stakeholder meetings, and constantly evolving technology, I became deeply focused on execution — delivering, fire-fighting, resolving, learning. What I probably didn’t prioritize enough was sharing. Sharing - thoughts, experiences, lessons, observations gathered along the way. Perhaps because I felt I needed to know more before putting my thoughts out publicly. Over time, I’ve realized that having all the answers is not necessary to have something meaningful to contribute. Working across enterprise programs and fast-moving technology environments has taught me quite a bit — through both — successes and difficult situations. So this is me starting. Not as someone trying to be a “thought leader” (yet!) but simply as a professional hoping to share meaningful perspectives on delivery, leadership, and growth — while continuing to learn from others along the way. #ProgramManagement #ProfessionalGrowth #Leadership

Member experience has become a key priority for health plans, and for good reason. With measures like CAHPS and HOS gaining importance, experience is no longer a “soft metric.” It directly impacts performance and outcomes. But there’s often a gap in how this is approached. Improving member experience isn’t just about adding new touchpoints. It’s about addressing what happens underneath. In many cases, the real challenges are operational: • Inconsistent or inaccurate data across systems • Delays in benefits configuration or updates • Gaps between claims, provider data, and member communication • Fragmented workflows across teams The result? Members experience confusion, delays, or lack of clarity even when the intent is right. Payers attempting to transform the experience for members need to focus on: • Data accuracy and consistency • Alignment across operational functions • Designing experiences that reflect how systems actually work Member experience doesn’t break at the front end. It breaks in the handoffs between systems, teams, and processes. That’s where most of the opportunity lies. #healthcare #healthplans #memberexperience #digitaltransformation #CAHPS

Watch this space for an exciting announcement from Simplify!

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Hello #PayerData , #PayerAnalytics visionaries & execution leaders, excited to invite you to learn about real impactful #PayerInsights stories!! #HealthcareAI #DataAndAnalytics #AgentFirst

In my experience working within the US healthcare industry one of the most underestimated challenge is the variation across markets. Working with payers across different states and segments, a few patterns stand out: • Medicaid programs vary significantly state by state • Medicare Advantage plans face different competitive pressures depending on geography • Provider networks and contracting dynamics shift across regions This creates a ripple effect across: → Benefits configuration → Claims processing → Provider data management → Member experience Which means: A solution that works well in one market often requires significant adaptation in another. The organizations that navigate this well are the ones that: • Build flexibility into their systems and processes • Prioritize data accuracy and governance • Stay closely aligned with evolving regulatory and market dynamics Healthcare is often discussed at a national level. But execution success almost always comes down to local realities. And that’s where most transformation efforts are either won or quietly struggle. #healthcare #healthplans #payers #healthcaretechnology

CMS just handed health plans more freedom than they've had in years. Here's what last Friday's ACA PBT PY2027 updates actually mean for the business: 🔓 Non-network plans can now get QHP certification on exchanges for the first time. Direct-pay and reference-based pricing models are no longer locked out. That's a new competitive dynamic. 🎯 Standardized plan mandates are gone. So is the cap on non-standardized plans per metal tier. Issuers now have full latitude to differentiate on plan design — which means competing on product strategy, not just price. 📅 Catastrophic plans can now offer multi-year enrollment — up to 10 consecutive years. Real retention upside with young, healthy members. Real actuarial complexity underneath it. 🦷 Adult dental waiting periods must now be disclosed at enrollment. A previously buried plan attribute becomes a shopping comparison point overnight. #Simplify #Filings #Regulatory #Marketplace

I’m happy to announce that I have successfully completed the “Generative AI for Software Testing” course on Udemy. This course helped me gain valuable insights into: 🔹 Applying Generative AI in software testing 🔹 Improving efficiency using AI-driven approaches 🔹 Understanding modern trends in AI-powered QA As the field of software testing evolves, integrating AI into testing processes is becoming essential. I’m excited to apply these learnings in real-world projects and continue growing in this space. Looking forward to explore/enhance skills more and contributing to innovative solutions! #GenerativeAI #SoftwareTesting #AIinTesting #AutomationTesting #Learning #Upskilling #QualityAssurance