Vice President Medicaid Compliance
TMG Health Inc is a healthcare organisation that specializes in BPO/ITO government health plans.
Accomplished Managed Care executive, health plan Vice President and COO with an outstanding record of success in leading and transforming health care organizations in operational excellence, compliance, program service and business performance for Arizona healthcare delivery systems, Medicaid and Medicare programs. Demonstrated expertise in leading managed care operations including claims adjudication and reimbursement, encounters, TPL and reinsurance, contracting, credentialing, member services, grievance and appeals, and large group practice operations. An outstanding, values-based executive, and communicator who builds strong business teams and collaborative partnerships with key internal and external stakeholders across all organizational levels. Professional Competencies • Managed Care Executive/VP/COO • Medicaid/Medicare Administration • Operations/Organizational Excellence • Program Compliance/Audit • Strategic Planning/Budgets & Forecasts • Policies/Procedures/Process Improvements • Excellent Communicator/Collaborator • Employee/Stakeholder Engagement • HR/People Systems & Tools • Organization/Culture Change • Customer Care/Member Services • Contract Administration/Oversight Specialties: Certified in Healthcare Compliance (CHC) - June 2008
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