Serves as the Medicare Compliance Officer for PHP Medicare, a Medicare Advantage plan established in 2019. Responsible for providing leadership, assuring compliance and oversight for the PHP Medicare compliance program to current and new CMS rules and regulations across all business units. Primary interface with CMS related to all communications and activities.

Served as the Medicare Compliance Officer and managed the Medicare compliance program. Successfully led a 2016 CMS Program Audit, with a final audit score of 0.47. Responsible for directing and assuring compliance to current and new CMS rules and regulations across all business units including policy/procedure creation, risk assessment, monitoring and auditing activities, and first tier entity oversight. Lead interface with CMS related to all communications and relationships.

Combined role of serving as the Medicare Compliance Officer and leading the Medicare 5-Star Ratings program.Led the Medicare 5-Star Ratings quality program (143,000 members) by creating a comprehensive program management plan with initiatives to maintain and improve quality ratings. Accountable for overall star ratings. Achieved an overall 4.5 star ratings for 2018. Responsible for working with cross-functional groups and managed department of analysts and coordinators to execute the initiatives. National conference speaker for Medicare Star Ratings and Medicare Compliance: 2018 Understanding the Impact the Timeliness Monitoring Project has on Star Ratings; 2017 Integrating Compliance and Quality; 2017 Lessons Learned & Insights Gained from Undergoing a CMS Audit.

Responsible for operations of a 380 employee $20 million CARF accredited Continuing Care Retirement Community. Campus consisted of two Skilled Nursing Facilities (including Green House® Homes), Home For the Aged licensed apartments, and independent Life Lease apartments & town homes, for a total of 430 residents. Responsibilities included developing and implementing a strategic plan to achieve operational efficiency, programmatic excellence, and financial health, along with keeping abreast of economic conditions and making adjustments as necessary. Achieved and maintained 5-Star Rating of excellence, along with stellar annual surveys five consecutive years. Increased revenue by >5%

Oversaw Medicare product (75,000 members) performance, defined and measured by clinical requirements, member satisfaction, and regulations. Assured product performance related to Member Services, Appeals, Grievance, Marketing, and other departments. Used focus group approach to seek input to enhancing services and further developing brand loyalty, while maintaining member retention. Worked collaboratively with UPMC Health System, Quality Improvement Organization (QIO), Area Agency on Aging (AAA), healthcare providers, and others to effectively reduce costs through care management, preventive care, and quality improvement. Initiatives included: post-hospital transitional care program, palliative care program, use of telemedicine, and the provision of quality supportive care and services for Specialty Needs Plan (SNP) members to remain in their homes.

(Formerly Tendercare (Michigan), Inc. – Acquired 11/07)Senior Administrator/Special Projects Manager 2000 - 2008Established operations for two $7 million, 77 & 80 bed, newly constructed Skilled Nursing Facilities; obtained State Licensure, Medicare/Medicaid Certification and associated regulatory compliance. Developed budget, contracts, acquired equipment & supplies; established advertising; public relations; community involvement, market analysis; initial census growth planning. Worked collaboratively with the construction project manager and human resources including recruitment, selection, and training of staff (80 employees) at each center. Implemented a customer service program empowering employees to cultivate customer engagement and loyalty. Evaluated and introduced programs to enhance the customer experience. Established processes for the introduction of the Eden Alternative principles.