Marta Willoughby
About Marta Willoughby
Marta Willoughby serves as the Medical Director of Appeals at Clover Health, bringing over a decade of experience in Medicare Advantage and Commercial appeals utilization review. She holds an MD from the Geisel School of Medicine at Dartmouth and specializes in genetics testing review, chemotherapy review, and process efficiency.
Work at Clover Health
Marta Willoughby serves as the Medical Director of Appeals at Clover Health. She has held this position since 2022, contributing her expertise in appeals utilization review. In her role, she focuses on overseeing the appeals process, ensuring compliance with regulations, and enhancing the efficiency of operations within the organization.
Education and Expertise
Marta Willoughby earned her Doctor of Medicine (MD) degree from the Geisel School of Medicine at Dartmouth. Her educational background provides a strong foundation for her work in the medical field. She possesses subject matter expertise in several areas, including genetics testing review, Part B chemotherapy review, and post-acute facility review.
Background
Before joining Clover Health, Marta Willoughby worked at Humana as a Medical Director for a decade, from 2012 to 2022. During her tenure, she gained extensive experience in Medicare Advantage and Commercial appeals utilization review, which has informed her current role in appeals management.
Achievements in Process Efficiency
Marta Willoughby has a special interest in process efficiency, which is evident in her experience creating and revising interdepartmental claims processing guidelines. Her efforts aim to streamline operations and improve the overall effectiveness of claims processing within healthcare organizations.
Experience in Appeals Utilization Review
With over 10 years of experience in appeals utilization review, Marta Willoughby has developed a comprehensive understanding of the complexities involved in Medicare Advantage and Commercial appeals. Her expertise supports her role in ensuring that appeals are handled effectively and in accordance with established guidelines.