Rachel Wrought
Founder & CEO, ExploreCarePricing
Professional Credentials & Qualifications
Rachel Wrought, LPN, SHM, MHI
Licensed Practical Nurse (LPN) | Safety & Health Management (SHM) | Master of Healthcare Innovation (MHI)
Professional Experience
20+ years of clinical history across clinical operations, health plan management, utilization management, compliance, and healthcare innovation.
Empowering transparency. Driving better care decisions through clear, accessible pricing.
Career Highlights
A proven track record of leadership, innovation, and operational excellence across healthcare, clinical operations, and healthcare technology.
01 Healthcare Operations Leadership
More than 18 years leading healthcare operations, enterprise transformation, clinical technology implementations, performance improvement, and organizational change across national managed care organizations.
02 Enterprise Performance & Program Management
Led enterprise initiatives supporting 22+ health plans, completed 100+ operational assessments, directed implementation readiness, workflow redesign, User Acceptance Testing (UAT), training strategy, and cross-functional program execution.
03 Clinical & Regulatory Expertise
Extensive experience in utilization management, prior authorization, inpatient clinical review, delegation oversight, medical necessity determination, care coordination, NCQA compliance, and Medicaid, Medicare, Marketplace, and Dual Eligible populations.
04 Founder & Healthcare Innovation
Founder and CEO of ExploreCarePricing, developing AI-assisted healthcare pricing intelligence and transparency solutions that help consumers, providers, and organizations better understand healthcare costs through reimbursement analytics, operational methodology, and data-driven innovation.
Education & Professional Background
My educational background combines clinical healthcare, healthcare innovation, business management, safety and health management, and environmental science. This multidisciplinary foundation enables me to approach healthcare challenges from both clinical and operational perspectives, with a focus on transparency, patient experience, and system improvement.
Master of Healthcare Innovation (MHI)
Arizona State University
Completed: May 2026
Focused on healthcare innovation, digital health, patient-centered design, workflow optimization, and healthcare system transformation.
Bachelor's Studies
Central Washington University
2008–2010
Minor: Business Administration Management
Safety & Health Management (SHM) – Light Industrial Construction
Studied organizational leadership, business operations, workplace safety, risk management, and regulatory compliance.
Associate Degrees & Clinical Training
Everett Community College
1998–2006
Associate of Arts (AA)
Associate of Science (AS)
Licensed Practical Nurse (LPN) Certification – December 2003
Environmental Science Studies
Built a strong foundation in patient care, clinical practice, biological sciences, and environmental health.
Professional Perspective
My education brings together clinical experience, healthcare innovation, business strategy, safety management, and scientific research. This diverse background supports my work in healthcare pricing transparency, helping transform complex healthcare data into accurate, accessible, and easy-to-understand information for patients, consumers, researchers, and healthcare professionals.
Why ExploreCarePricing Was Created
A personal mission born from healthcare experience.
Throughout 15+ years working inside the healthcare system—on the payer side, in clinical operations, and in healthcare innovation—I observed one consistent challenge: many people struggle to understand what healthcare will cost before receiving care.
Unexpected bills, inconsistent pricing information, complex insurance terminology, and limited access to understandable cost data often force individuals and families to make critical healthcare decisions without the information they need. This gap in healthcare transparency inspired me to create ExploreCarePricing.
ExploreCarePricing was developed as my graduate capstone project for Arizona State University's Master of Healthcare Innovation program. Through that research and my professional experience, I became convinced that greater transparency is one of the most important steps toward improving patient experience and healthcare access.
"To make healthcare pricing understandable, predictable, and accessible for everyone—enabling individuals and families to make informed healthcare decisions with confidence."
— Rachel Wrought, Founder & CEO
Content Standards & Editorial Independence
Healthcare information should be accurate, understandable, and transparent. ExploreCarePricing is committed to publishing high-quality educational content that helps consumers make informed healthcare decisions.
1. Original Research & Analysis
All content is independently researched, analyzed, and written by the ExploreCarePricing Team under the direction of founder Rachel Wrought, LPN, SHM, MHI, drawing on professional healthcare experience, publicly available healthcare pricing data, government publications, regulatory guidance, peer-reviewed research, and other authoritative primary sources.
2. Plain Language
Healthcare pricing, insurance, and billing topics are translated into clear, accessible language without sacrificing accuracy. The goal is to help consumers understand complex healthcare information with confidence.
3. Source Attribution
Whenever possible, articles include citations and links to original government agencies, healthcare organizations, academic publications, or other primary sources so readers can verify information independently.
4. Editorial Review & Updates
Content is reviewed periodically and updated when significant changes occur in healthcare regulations, transparency requirements, reimbursement policies, or insurance practices. When appropriate, articles include the original publication date and the most recent review or update date.
5. Editorial Independence
ExploreCarePricing maintains complete editorial independence. Content is developed without influence from hospitals, health systems, insurance companies, pharmaceutical manufacturers, advertisers, or sponsored partnerships. Compensation is never accepted in exchange for favorable coverage or editorial opinions. ExploreCarePricing displays third-party advertising; advertisers have no influence over rankings, pricing data, or editorial content.
6. Conflict of Interest & Professional Disclosure
The opinions and analyses published on ExploreCarePricing are those of Rachel Wrought and are provided for educational and informational purposes. Unless explicitly stated, content does not represent the views of any current or former employer, client, government agency, healthcare organization, or affiliated institution.
Important Medical, Legal & Financial Disclaimer
ExploreCarePricing is an educational resource designed to help consumers understand healthcare pricing and insurance concepts. The information provided:
IS NOT medical advice and should not replace guidance from licensed healthcare professionals.
IS NOT legal advice and should not replace consultation with a qualified attorney.
IS NOT financial or investment advice and should not replace guidance from qualified financial advisors.
Should be supplemented with information from your insurance provider, healthcare providers, and other qualified advisors.