Thomas Dowdle Email & Phone Number

Bloomfield, CT, US

• Promoted to lead a team of 75 with an annual budget of $22M and added responsibilities below:
• Responsibility for Cigna Medicare Part D Stars performance and oversight of Stars Part D vendors and internal team

Bloomfield, CT, US

• Promoted to lead a team of 45 with an annual budget of $9M and added responsibilities below:
• Enterprise member interventions through initiatives driven through vendor partnerships and Cigna nurse outreach team
• Oversight of Partnership for Quality (P4Q), Government business segment provider facing incentive program
• Achieved HEDIS MY 2020 Stars performance of 4.69 overall domain/4.90 MRR

Bloomfield, CT, US

• Promoted to lead a team of 25 with an annual budget of $5M and added responsibilities below:
• Develop and maintain organizational HEDIS short-term and long-term strategy and roadmap
• Oversight and leadership of full HEDIS Operations team and maintenance of annual budget spending
• Achieved HEDIS MY 2018 Stars performance of 4.30 overall domain/4.86 MRR

Bloomfield, CT, US

• Led a team of 2 responsible for all Medicare and Medicaid HEDIS submissions and activities including:
• Annual HEDIS hybrid medical record review (MRR) project and submission of HEDIS rates for ~ 40 reporting populations
• Proactive HEDIS data initiatives and onboarding of new supplemental sources driving administrative rate improvement
• Manage all plan interaction with NCQA, licensed auditors for Medicare and Medicaid, and state Medicaid organizations
• Led team to record HEDIS Stars performance of 4.18 overall domain/4.49 MRR for MY 2017

Bloomfield, CT, US

• Responsible for market strategy and initiatives while leading a team of 11 medical coders focused on:
• Provider education on coding and documentation and Cigna coding initiativesProvided reporting and analytics to the Alabama Operational market (6 states) around:
• Market/Group/Provider completion rates on coding documentation (360s & HMRs) against goals
• Retention of Chronic Conditions YOY and CMS Risk Score/HCCs

Bloomfield, CT, US

• Led a team of 6 medical coders responsible for:
• Intake, processing and coding of provider documentation for both risk adjustment and HEDIS purposes
• Providing feedback to staff to facilitate in provider education and issuing provider payments for documentation

Bloomfield, CT, US

• Led a team of 6 analysts responsible for:
• Reporting and analytics for HEDIS measures and Performance for Quality (P4Q) measures
• Management of Inovalon Certified HEDIS software for in-year reporting and final HEDIS project
• Company-wide rollout and implementation of Inovalon software for P4Q data entry and reporting

Bloomfield, CT, US

• Improve Medicare Star ratings for the Alabama operational market, which includes Alabama, southern Mississippi, and northern Florida with:
• In-depth data analysis of claims and other Stars data sources
• Timely and actionable reporting for various end users
• Data management of yearly HEDIS project
• Sharing of technical Stars expertise as a local subject matter expert
• Creation of Stars resources for staff and external provider use

Bloomfield, CT, US

Rotated through four different departments of the company over the course of a year to learn Medicare and the Cigna model from the ground up. Developed expertise and relationships across all company operations through specific projects and executive interaction.

US

Developed specialized reports for various Southeastern companies looking to expand internationally to facilitate an increase in international trade.

Philadelphia, Pennsylvania, US

Tuscaloosa, Alabama, US

• Marketed the fall 2008 Office Seminar series which included over 12 seminars, through faxes, articles, etc.
• Increased public awareness through my marketing, leading to more revenue and several seminars being sold out
• Wrote at least 7 articles pitching the 2008 Office Seminar series that were published in the local newspaper as well as the Chamber newsletter
• Created faxes and brochures in order to advertise other Chamber events including a meet and greet with a local mayor
• Improved and updated informational brochures on the Tuscaloosa area by making them more visually appealing and easier to read using a combination of graphics and layout adjustments

US

Mba, Global Business Strategy

Bachelors Of Science, Business Management, Spanish