Rush University, Nursing, MSN, BSN
Centers for Medicare and Medicaid Services (CMS)
LAN Advisory Board
CMS ACO Quality Standards
American Society for Healthcare Risk Management (ASHRM)
Carol Burkhart is responsible for overseeing all risk and regulatory compliance for Allēus Health Analytics and ensuring our Mass Tort (MDL) healthcare revenue recovery processes comply with federal and state HIPAA regulations and all applicable laws and regulations. She is a masters-prepared Nurse Practitioner with more than 25 years of leadership experience in healthcare risk, insurance management, regulatory compliance, healthcare operations, and healthcare information privacy and security for national and international healthcare industry clients. Drawing on her in-depth knowledge of healthcare data compliance regulations, Carol guided Allēus to achieve HITRUST CSF Certification.
Over the course of her career, Carol has designed enterprise and clinical risk management and compliance programs and led internal and external investigations for hospitals, integrated delivery systems, large medical groups, ACOs, and other specialty healthcare services providers. She also has conducted HIPAA state preemption analysis for healthcare systems in collaboration with large insurers and law firms.
Prior to joining Allēus, Carol served as Associate Director, Government Relations, for The Joint Commission. Notably, she has served as Regional Risk Management Consulting Manager for AIG; Director, Performance, Risk, Governance and Compliance for PwC; and Senior Vice-President for Aon Global Strategy. She has also served as an IRO auditor for the Office of the Inspector General. Carol developed the start-up risk and compliance programs for the Chicago Institute for Neurosurgery & Neuroresearch and has provided risk and compliance consultation to domestic and international clients including large Integrated delivery networks, regional and local hospitals, ACOs, and large multi-specialty medical group practices.
Carol is currently serving on the National Accountable Care Learning Collaborative Taskforce (ACLC) and the Centers for Medicare and Medicaid Services Learning and Action Network (CMS LAN). She earned her Master of Science in Nursing and Post-Master’s Certificate in the Family Nurse Practitioner Program at Rush University in Chicago. She is a member of Sigma Theta Tau, the International Honor Society for Nursing and currently holds designations for the Certified Professional Healthcare Risk Management (CPHRM), Certified Healthcare Compliance (CHC) and Certified HIPAA Professional (CHP).