People of Providence Health Plan
People of PHP: Kelly Fitzhugh
06 February 2026
Kelly Fitzhugh often calls Care Management “home,” and it’s easy to see why. Before stepping into her current role, she spent years as a nurse case manager, connecting with members one‑on‑one and getting to know their stories. Today, she brings that same perspective to her work as a clinical nurse program manager, supporting the teams who serve Providence Health Plan’s Dual Special Needs Plan members.
Even though data, quality measures, and complex regulations are part of her everyday work, Kelly never loses sight of what matters most: people. Her role sits at the intersection of clinical care, operational clarity, and member experience, helping ensure caregivers are equipped to deliver care that is not only compliant, but compassionate and effective.
A big part of Kelly’s job is making sure caregivers feel confident before they reach out to members. When a caregiver runs into a challenging situation like a missed appointment, a recent hospital stay, or other barriers to care, Kelly doesn’t just point to a policy or checklist. She walks through the care plan step by step, helps simplify the next actions, and works with caregivers to find the right language for difficult conversations. Those moments of preparation make a real difference, allowing caregivers to approach members with clarity and empathy instead of uncertainty.
This hands‑on support directly contributes to quality outcomes. Kelly’s work is closely tied to CMS Star Ratings, but she and her team will tell you that their goal isn’t chasing numbers – it’s doing the right thing for members every time. Completing health risk assessments, following up after hospitalizations, closing gaps in preventive care, and supporting chronic condition management all add up to better health, fewer complications, and more stable lives for the people they serve.
When a member hasn’t received an eye exam, foot exam, or follow‑up visit, Kelly and her team look beyond the metric to understand the reason (or reasons) why. Transportation challenges, difficulty finding a provider, housing instability, or confusion about benefits can all stand in the way of care. Kelly helps caregivers identify and address those barriers, whether that means scheduling appointments, coordinating medical equipment, or connecting members with community resources so care plans turn into real‑world action.
Kelly is also passionate about correcting a common misconception about health plans. Care managers are not looking for ways to deny care or cut corners. As she often says, “We’re the good guys.” The work is about helping members access the care they need – especially preventive care, because that leads to better outcomes, fewer emergency room visits, and a higher quality of life over time. Sometimes, that progress happens quickly. Other times, it takes months or even years of persistence, trust‑building, and partnership.
Her leadership extends beyond Care Management. Kelly regularly collaborates with pharmacy teams, utilization management, prior authorization partners, and medical directors to problem‑solve complex cases. This cross‑functional approach ensures that members experience coordinated, seamless support and that caregivers across the organization are aligned around shared goals of quality, safety, and member well‑being.
For Kelly, the most meaningful moments come from seeing the impact of that alignment. When a member becomes connected to ongoing care, gains confidence managing a chronic condition, or avoids another preventable hospitalization, it reinforces why the work matters. These are quiet successes, often unseen, but they are the foundation of strong quality performance and long‑term member trust.
Through her focus on clarity, teamwork, and compassion, Kelly helps ensure caregivers have the tools they need to do their best work. When members feel heard and supported, outcomes improve. Quality follows. And the organization’s commitment to excellence shows not just in performance measures, but in the everyday experiences of the people it serves.
Hear directly from Kelly about how she supports caregivers and helps strengthen the member experience.
