India Thomas Email & Phone Number

Roanoke, Virginia Area

Regional Practice Director – Family and Community Medicine Provides leadership to providers and practice managers in support of high quality patient-centered care, an exceedingly competent and engaged staff, and the achievement of fiscal, score card and process improvement goals and objectives. Oversee standards of care, clinical services and development of budgets for all departments within the service line to support continued fiscal growth. Oversees departmental revenue cycle… Show more Regional Practice Director – Family and Community Medicine Provides leadership to providers and practice managers in support of high quality patient-centered care, an exceedingly competent and engaged staff, and the achievement of fiscal, score card and process improvement goals and objectives. Oversee standards of care, clinical services and development of budgets for all departments within the service line to support continued fiscal growth. Oversees departmental revenue cycle of medical coding, billing and collection processes. Guides management in development and implementation of policies, procedures and programs for compliance, quality, patient safety and according to all regulatory, licensure and accrediting standards.  Advise and make recommendations to practice managers on the prioritization and allocation of department resources and all aspects of the recruitment and retention of staff, instituting office standards and sound budgeting to ensure the financial health of the department is preserved. Identify growth opportunities and provide project oversight for acquisition initiatives.  Develop medical home structure and oversee implementation within all practices. Provide leadership, direction and ongoing administration to the transition of existing and newly acquired practices to Rural Health Clinics. Ensure appropriate applications, regulatory requirements and standards are developed and filed as needed to be in compliance. Show less

Roanoke, Virginia Area

Compliance Officer - Medicare and Government Compliance  Focus on Strategy, Operations, Start-up Development and Management for Managed Care Organizations – Medicaid and Medicare Advantage Plans. Direct and implement strategies relating to the development and management of recruitment/contracting and network development. Work effectively with Board of Directors, for-profit and not-for –profit companies, community leaders, regulators, providers, legislators & government officials and… Show more Compliance Officer - Medicare and Government Compliance  Focus on Strategy, Operations, Start-up Development and Management for Managed Care Organizations – Medicaid and Medicare Advantage Plans. Direct and implement strategies relating to the development and management of recruitment/contracting and network development. Work effectively with Board of Directors, for-profit and not-for –profit companies, community leaders, regulators, providers, legislators & government officials and member/consumers, including special needs populations. Serve as point of contact for all State and Federal regulators. Maintain comprehensive knowledge and monitor relevant CMS, DMAS, BOI, State and Federal systems, regulations and guidance. Implement and lead initiatives to communicate changes, develop and modify processes and documentation as needed to adhere to appropriate governmental and plan processes, methodologies, policies and procedures. Develop, implement, and oversee operational processes to ensure maximization of Medicare reconciliation, accurate and timely transaction processing. Analyze identified discrepancies, understand discrepancy root cause, and recommend system enhancements to prevent discrepancy in the future. Actively participate and provide oversight for CMS complaints, CMS non-compliance, site preparations and in any corrective actions; including review survey documents and training. Provide oversight for operational areas including Compliance, Quality, Medical Management, Disease Management, Accreditation, Provider Relations, PBM/Part D, Operations, Enrollment, STARS, Risk Management, Sales, Marketing, and Delegated Entities. Project management and oversight for NCQA Accreditation, Medicaid plan, Data Validation Audit, annual application and bid process. Show less

Roanoke, Virginia Area

State and regional oversight to include fiscal responsibility. Regional oversight of HR, Administration, Marketing, Sales, Member Operations, Provider Relations, Medical Management, Disease Management, Compliance, Quality, HEDIS, Accreditation, Risk Management, Budgeting and Transportation. Business development leader with experience analyzing and executing business expansions or targeting key areas for growth Maintained communication and transparency with regulators to include… Show more State and regional oversight to include fiscal responsibility. Regional oversight of HR, Administration, Marketing, Sales, Member Operations, Provider Relations, Medical Management, Disease Management, Compliance, Quality, HEDIS, Accreditation, Risk Management, Budgeting and Transportation. Business development leader with experience analyzing and executing business expansions or targeting key areas for growth Maintained communication and transparency with regulators to include CMS, DMAS, BOI, VDH, JACHO, Delmarva and NCQA Developed and oversaw operational aspects of the Medicaid Managed Care and Medicare Advantage Special Needs Plan, including meeting State & Federal regulatory requirements, recruiting and training employees, developing operational processes, and program benefits and materials. Managed daily operations for Administration, Member Operations, Transportation, Network Development / Contracting, Provider Services, Sales and Marketing departments. Managed daily operations of Medical Management (UM, CM, DM, BH, Quality, Referrals, Outreach, and Health Education). Developed and maintained budget to ensure optimum allocation and utilization of resources to accomplish defined company goals and contractual obligations Analyzed and maintained departmental statistics for reporting activities to the Department of Medical Assistance Services (DMAS), Bureau of Insurance, Centers for Medicare and Medicaid Services (CMS) and corporate Metrics. Processed reengineering projects utilizing Six Sigma methodology Instrumental in the preparation, department training and participation in accreditation process for JACHO, Delmarva, URAC and NCQA. Achieved NCQA “Excellent” rating for the first time. Recruited provider network of over 4,000 providers. Show less

Mha, Health Administration

Bachelor Of Science (B.S.), Criminal Justice