Thomas Murar Email & Phone Number

Lansing, Michigan Area

Health Management Associates (HMA) is a consulting firm concentrating in government financed health programs, Medicare and Medicaid. HMA has an extensive list of health plan clients looking for expertise in finance and operational analysis engaging HMA principals in a variety of projects designed to positively affect operational efficiency, compliance, financial performance, procurement processes and RFP responses. More than 30 years of organization, financial, and executive leadership in Managed Care organizations, including finance, operations, quality and risk performance programs and board governanceSkills include:Organizational leadership, strategy and strategic planning, financial analysis and modeling, rate setting, Medicaid and Medicare expertise, plan quality and risk performance programs and complianceUnderstanding of managed care and health care providers’ contracting, financial and administrative requirements, particularly related to Medicaid and MedicareExtensive experience with Medicaid and Medicare quality performance and risk adjustment programs and the development of operational systems to effectively manage performanceRecent Assignments:Interim CFO and COO positions with multiple Medicaid and Medicare health plans, assisting them with licensure, operational assessments, and readiness reviews with government entities.Assisted health plans in managing their HEDIS, STARS and risk adjustment programs, including developing operational procedures and metrics for both the plan and providers, supporting annual reporting to NCQA and CMS and defining corrective action plans to improve performance.Supported health plans in doing market assessments for service area expansions, application processes, operational reviews, and program audits.Worked with health plans in the development of responses to State Medicaid procurement processes for finance, operations, quality, and network adequacy

Lansing, Michigan Area

Consumers Mutual Insurance of Michigan (CMI) is a Consumer Operated and Oriented Plan (CO-OP), nonprofit health insurer licensed as a mutual insurance company. CMI was established through low- interest and no-interest loans from the U.S. Department of Health and Human Services (HHS) created by the federal Affordable Care Act (ACA). CMI was awarded its health insurance license from the Michigan Department of Insurance and Financial Services (DIFS) in May 2013, offers individual, small group and large group health insurance products both on and off the healthcare exchange.

Mount Laurel, Nj

Altegra Health supports health plans with Medicaid or Medicare contracts where the revenue is risk adjusted based on the health status of their members. Altegra has a technology solution which replicates the risk models the agencies have implemented allowing health plans to prospectively manage their risk. Additionally, Altegra supports health plans through consultative services related to risk models, encounter reporting processes and other operational issues.

Greater Detroit Area

• Responsible for reporting the financial conditions of the company to the President/COO and Board of Directors. Directed the development of financial budgets/forecasts and models. Reported on significant events that could affect the financial performance of the company to the President/COO and Board of Directors. Supported the COO and the Board of Directors in the financial and accounting procedures of the company.• Treasurer of the Board of Directors and member of the Executive Committee of Cape Health Plan, responsible for the strategic direction of the health plan.• Directed all financial reporting requirements related to both internal and external clients, including the selection of and coordinating independent external audits. Reviewed and monitored the plans regulatory compliance of financial conditions, coordinate financial reporting and responses to OFIS. Created policies and procedures for the accounting and finance departments to have appropriate controls and compliance with GAAP and Statutory requirements.• Directed both Claims and the Information Technology Departments. Responsible for the evaluation and recommendation of IT/IS strategies and the performance of claims payment/ processing functions. Developed and maintained strategies with external vendors that support the operational efforts of the health plan. Maintained relationship with key components of provider network to align plan objectives with network resources.• Developed the Pricing Proposal, financial plan and narrative filed in response to the Michigan Department of Community Health’s Medicaid Managed Care initiative. Coordinated the activities of external consultants, actuaries and the executive committee with regards to pricing implications. Assisted in the assessment and implementation of policy changes related to the plans Medicaid contract with the State of Michigan’s Department of Community Health.

Greater Detroit Area

• Coordinated the development of the budget for Henry Ford Medical Group, including the development of models used to project gross and net revenues. Evaluated variances in capitated managed care business, payor mix and other reimbursement changes. Created analyses evaluating the financial performance of various specialty practices and supported the development of business plans, health care studies and new product offerings.• Developed costing studies used in the analysis of the financial performance of the capitated managed care population of the system, including product costing models used in the formation of rating proposals filed with the Michigan Insurance Bureau.• Member of the Subcapitation Committee and Managed Care Advisory Committee, both charged with evaluating the managed care operations of the system. Assisted in the development of the standardized reporting system for managed care operations.

Greater Detroit Area

• Involved in the development and assessment/settlement of various risk sharing and capitation arrangements with providers. Evaluated the financial implications of contractual arrangements with providers, including the analysis of fee schedules for appropriateness of reimbursement.• Member of the planning committee involved in the development and implementation of the point-of-service product offering. Involved in the development of the reporting system used to report plan performance to groups and the system specifications required for the settlement of capitation and withholds.• Assisted in generating financial statements, including the estimation of monthly health care expenditures, and the development of operating budgets and forecasts.

Greater Detroit Area

• Responsible for the implementation and documentation of the corporate budgeting software. Coordinated the budget activities and reporting with both the accounting department and the corporate budget department.• Involved in the development of the financial statements, including the estimation of monthly health care expenditures.

Master Of Business Administration (M.B.A.), Accounting And Finance, Graduated With Honors

Bs Finance, Accounting And Finance, Graduated With Honors