Leader recognized for service to most vulnerable

In August 2023, CenCal Health’s Associate Director of Utilization Management Ana Stenersen received the 14th Annual Making a Difference award from the Washington, D.C.-based Association for Community Affiliated Plans (ACAP). ACAP is the national trade organization representing not-for-profit Safety Net Health Plans, of which CenCal Health is a member. “Ms. Stenersen’s passion exemplifies what the Making a Difference Award is all about,” said Enrique Martinez-Vidal, ACAP Vice President for Quality and Operations.

Throughout her 26-year career in nursing and healthcare administration, Ms. Stenersen has remained committed to addressing the needs of vulnerable individuals; 22 of those years have been devoted to serving vulnerable children and youth with complex needs, such as cancer, cerebral palsy, and hemophilia. 

Ms. Stenersen’s career began in 1998 as a Registered Nurse at the Intensive Care Unit of Redlands Community Hospital, where she worked with critically ill patients, their families, and caregivers to determine the best treatment, diagnosis, and prevention options. In 2002, eager to more fully support vulnerable children and their families, Ms. Stenersen began a position at San Bernardino County Public Health Department as a Public Health Nurse Care Manager for the California Children’s Services Program (CCS). CCS is a State program that provides access to healthcare services for children up to 21 years old with certain physical and chronic health conditions or diseases. Ms. Stenersen managed a caseload of approximately 500 pediatric clients who required seamless and comprehensive care management. She performed intricate care coordination there between doctors, specialists, case managers, and social service providers. 

In 2008, Ms. Stenersen relocated to Santa Barbara to oversee CCS services, followed by a move to CenCal Health in 2017 to establish the Whole Child Model Program, a pilot project created to increase care coordination by moving responsibilities from CCS to local managed care health plans. With Ms. Stenersen’s guidance, CenCal Health became one of five health plans in California to assume CCS responsibilities, simplifying healthcare navigation for members eligible for CCS services. The program offered a single point-of-contact for health services and case management, including primary care, preventive care, transportation, and more.

Since the Whole Child Model program launched, CenCal Health’s CCS population has increased by 29%. In addition, CenCal Health maintains one of the highest referral and identification rates for CCS services. “Over the past five years, Ms. Stenersen has been instrumental in not only making the Whole Child Model program work for our members and community partners but making it thrive,” said Dr. Rea Goumas, CenCal Health Whole Child Model Program Medical Director. “She is the reason why I joined CenCal Health’s Whole Child Model program. This is ‘her baby.’”

Now, as the Associate Director in the Utilization Management Division of CenCal Health, where service and support are provided to the health plan’s most vulnerable members — children and adults living with complex, often incapacitating medical conditions - Stenersen ensures that her 45-person team provides proper and prompt reviews of proposed medical procedures. Her responsibilities include delivering guidance to medical providers and members about treatment requests and authorizations; serving as liaison to providers and other agencies to ensure exemplary care coordination; and offering swift resolution of issues affecting vulnerable beneficiaries and their families.

Click here to read the press release.

CenCal Health CEO Marina Owen (left), CenCal Health Associate Director of Utilization Management and awardee Ana Stenersen (center), and ACAP Vice President for Quality and Operations Enrique Martinez-Vidal (right), during the Making a Difference Award presentation at CenCal Health’s Santa Barbara headquarters.