Michael A Albornoz Email Address

MPH and CHCA and PCMH CCE and ACO and RADV and HCC and Healthcare Consulting

Inland Empire Health Plan is a healthcare organisation that provides Medi-Cal and Medicare health plans.

As IEHP’s director, I am responsible for initiating, implementing and reporting on health plan quality studies, including HEDIS and Medicare Risk Adjustment Programs (RAPS). I am also responsible for assuring compliance with CMS, DHCS, DMHC and NCQA reporting requirements in the areas of quality and risk adjustment. I work closely with the Quality Management and Compliance Departments in the development, implementation and documentation of quality improvement and risk adjustment improvement activities. I have been a Certified HEDIS Compliance Auditor since 2007 and achieved NCQA certification as a PCMH content expert in 2013. I have served as lead auditor for several audit engagements of Medicare, Commercial, and Medicaid health plans, Provider Organizations, POS, and PPO plans reporting HEDIS data. I have experience conducting CMS data validation audits for Medicare Advantage plans. I hold a Master of Public Health degree (epidemiology and biostatistics concentration) and have over 20 years of professional experience in the health care field.