Lee Coffman Email and Phone Number
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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, business development and strategy, program service excellence and business performance for healthcare delivery systems and Medicaid and Medicare programs. Demonstrated expertise in leading managed care operations including quality audit, claims adjudication and reimbursement, encounters, TPL and reinsurance, contracting, credentialing, member services/call center, grievance and appeals, training and development, and large group practice operations. An outstanding, values-based executive, compliance professional, and excellent 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• Regulatory Compliance/Audit/Monitoring• Strategic Development and Planning/P&L/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/Vendor OversightSpecialties: Certified in Healthcare Compliance (CHC) - June 2008
Cognizant
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Global Head Of Operations Support ServicesCognizant Feb 2018 - PresentTeaneck, New Jersey, UsOversees global operations support services functions, which include Quality Audit supporting Customer Service, Claims and Enrollment functions, Performance Reporting & Analytics, and Operational Training. • Championed account-wide automation initiative that delivered $950,000 in cost avoidance through reduction in FTEs. Established and staffed the Automation Center of Excellence, facilitated automation training, and led team to create 670 user stories (against a goal of 200). • Reduced cost of delivery for quality program by leading onboarding initiative to increase offshore staff from 28% to 58% of the total team.• Engaged in M&A of TMG Health by Cognizant Technology Solutions by driving synergies of the two companies and implementing best practices in performance measures, quality, training, and reporting across the organization. Implemented new processes throughout the acquisition to increase focus on processes, performance measures, automation and contractual adherence
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Vice President Medicaid ComplianceTmg Health Oct 2016 - Feb 2018Conshohocken, Pa, UsLed the Medicaid compliance and regulatory functions for TMG Health and its Medicaid clients. • Introduced compliance monitoring tool for Medicaid programs, encompassing state reporting standards and regulatory & compliance adherence, service level agreement metrics, and regulatory guidance review and impacts. • Responsible for the development and implementation of TMG's Compliance Plan and Medicaid Work Plan and ensuring compliance with various state Medicaid and regulatory requirements. -
Executive Advisor Medicaid Program, Ops Support Services; Director Of Medicaid Support ServicesTmg Health Oct 2014 - Oct 2016Conshohocken, Pa, UsLeveraged expertise in Medicaid regulations to support strategy and growth initiatives in the Medicaid business. Collaborated across the organization to steer Medicaid program and product development. • Managed implementation team for health plan acquisition as parent organization transitioned from WellPoint to TMG Health. Played key role in establishing standard measurements, protocols, and best practices to successfully integrate teams with disparate processes and cultures, resulting in on-time go-live and 100% achievement of all KPIs. • Developed project management tracking tool for implementation team, which significantly improves ability to monitor implementation progress of core initiatives and streamlines reporting to Executive leadership.
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Vice President Of Medicaid ProgramsThe University Of Arizona Health Plans Nov 2013 - May 2014Phoenix, Az, UsAdministered State Medicaid contract with 180,000+ enrollees and $500+ million in revenues through directing operations and ensuring plan met Medicaid contractual and regulatory obligations. Responsible for and managed administrative service agreement for Maricopa Integrated Health Systems’ (MIHS) Medicaid & Medicare Advantage Special Needs program. • Successfully led Medicaid and Service Area Expansion increasing health plan membership by 70+%. Recent State Medicaid Operational Review (02/2014) for both Medicaid plans exceeded 92% compliance; highest Operational Review results recorded. -
Chief Operations OfficerThe University Of Arizona Health Plans Jul 2011 - Nov 2013Phoenix, Az, UsOversaw health plan operations and facilities including Claims, Member Services/Customer Care, Grievance and Appeals, and HR. Managed leadership team of nine Directors, Managers and Operations staff, with 130 indirect employees. • Reduced employee turnover from 18% to 11% over 2 years by aligning performance planning/evaluation with corporate processes. Implemented collaborative goal and evaluation system that increased employee satisfaction and engagement. • Transformed health plan processes into Operational Excellence model by championing an operational improvement plan focusing on heightening accountability and transparency. • Co-created Joint Operations Committee (JOC) to institute more standardized and sophisticated talent/HR processes, resulting in reduced time-to-hire, better employee-leadership relationships, and improved communications.
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Director Of Compliance And AuditThe University Of Arizona Health Plans Jul 2007 - Jul 2011Phoenix, Az, UsIntroduced a comprehensive Medicare Compliance Program and Medicaid regulatory program to monitor for federal/state regulations and statutes for Medicare and Arizona Medicaid programs. Managed team of 12 employees which included Compliance Analysts, Quality Auditors, FWA Analyst, Grievance and Appeals Coordinators. • Developed/implemented comprehensive Compliance Program within three months meeting seven OIG elements, and UAHP Board approval. Created, administered mandatory Medicare 101 Board/staff training for 200+ employees prior to Medicare Advantage Prescription Drug Plan go-live. Designed and implemented audit/monitoring program included 320 required audits. Established tracking database for reporting, trends and compliance activity to Board and CEO.
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Vp Of Program ServicesPlanned Parenthood Of Arizona Sep 2001 - Jun 2007Reporting to the CEO, oversaw multi-million dollar healthcare delivery system in multi-site affiliate. Managed leadership team of five, and 120 indirect staff. Provided executive leadership to 17 health centers in operations, market and strategic analysis, managed care contracting, insurance/patient billing, and customer service center. • Heightened focus on health care delivery and increased medical visit capacity by 5%. Developed strategic plan and gained Board approval to centralize call center, streamline operations, and lay the foundation for service expansion.
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Claims Manager (Quality Assurance And Recoveries)Mercy Care Plan Sep 2000 - Sep 2001Reporting to Claims Director, planned and implemented quality assurance program (consisting of claims auditing, adjustments & reconsiderations and pended encounter correction) and financial recoveries for multiple lines of business (includes AHCCCS; Acute and LTC, Health Care Group, DES/DDD & Vent and premium sharing). • Directed design and implement of claims policies and procedures and claims operations manual. Reengineering for claims call center for better customer service and response of provider claim inquiries. Facilitated the financial recoveries, which include third party liability, coordination of benefits, reinsurance and overpayments.
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Director Of Reimbursement ServicesHealth Choice Arizona Apr 1997 - Sep 2000Reporting to the COO. directed operations, planning and compliance of claims administration and provider capitation for all contracted lines of business. Facilitated the maintenance, and review of all health plan contracts, interfaced with credentialing department, maintained all provider demographics to include fee schedules, monitor all encounter and adjustment functions to ensure timely and accurate reimbursement to providers. Chair of the Dental Quality Initiative Committee for over-site of dental utilization and reimbursement.
Lee Coffman Skills
Lee Coffman Education Details
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University Of PhoenixOrganizational Management -
University Of PhoenixHealth Care Administration
Frequently Asked Questions about Lee Coffman
What company does Lee Coffman work for?
Lee Coffman works for Cognizant
What is Lee Coffman's role at the current company?
Lee Coffman's current role is Senior Healthcare Executive | Managed Care Operations | Healthcare Compliance | Medicaid & Medicare Administration | Quality & Reporting.
What is Lee Coffman's email address?
Lee Coffman's email address is lc****@****lth.com
What is Lee Coffman's direct phone number?
Lee Coffman's direct phone number is +157034*****
What schools did Lee Coffman attend?
Lee Coffman attended University Of Phoenix, University Of Phoenix.
What skills is Lee Coffman known for?
Lee Coffman has skills like Medicaid, Medicare, Managed Care, Healthcare, Hipaa, Healthcare Management, Healthcare Industry, Leadership, Healthcare Information Technology, Hospitals, Healthcare Consulting, Process Improvement.
Who are Lee Coffman's colleagues?
Lee Coffman's colleagues are Kumar Munuswamy, Jyotsna Balagurunath, Madan Pudasaini, Aruna Kanth, Junu Dhungana, Anjan Basu, Mouparna Ghosh.
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