Karen has worked in and around the State of Nevada since 1997. First as a consultant for the implementation of the Nevada Public Employees’ Retirement System’s computer system and then as the Operations Officer of the Public Employees’ Benefits Program bringing the plan from a deficit into a surplus. Prior to that, Karen worked within the University of California Davis in various roles: retirement and benefit program project manager, Surgical Intensive Care nurse, as an internal consultant reengineering the Department of Environmental Health and Safety, writing contracts for services and research collaborations for the Campus, and subsequently as the Administrative Officer (AO) of the School of Medicine and University of California Davis Medical Center’s Pediatrics Department. In her AO role, she had over 100 employees and 30 physicians located at 15 different sites funded by federal, state, grant and private sources working in clinical, administrative and research positions. In her most recent positions she was a revenue cycle consultant performing audits of hospital systems, hospitals, FQHCs, CAHs, clinics and medical groups identifying operational issues and missteps requiring changes, updates, and reimbursements. Karen has also managed joint ventures and investments for a medical group, funding these efforts with the group’s retirement funds with the expectation that profits were payable at retirement. In addition, in her various roles, Karen has implemented small and large systems including electronic medical records.