Tony Joseph

Tony Joseph Email and Phone Number

Principal Program Manager at Blue Shield of California @ Blue Shield of California
oakland, california, united states
Tony Joseph's Location
San Francisco Bay Area, United States
About Tony Joseph

• Experienced healthcare professional with a strong background in healthcare industry regulations, patient care, and operational excellence• Proven ability to drive positive outcomes through strategic planning, effective communication, and cross-functional collaboration• Expertise in clinical quality, risk management, patient safety, compliance, care coordination/utilization management, and leadership• Demonstrated ability to manage complex projects, perform data analysis, and generate meaningful insights that drive operational excellence and positive patient outcomes • Results-driven with a proven track record of delivering successful outcomes through innovative solutions and effective collaboration• Over eight years of experience in retail operations management with a focus on budget management and financial reporting

Tony Joseph's Current Company Details
Blue Shield of California

Blue Shield Of California

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Principal Program Manager at Blue Shield of California
oakland, california, united states
Employees:
6213
Tony Joseph Work Experience Details
  • Blue Shield Of California
    Principal Program Manager - Provider Partnership
    Blue Shield Of California Jun 2023 - Present
    California, United States
  • Dignity Health
    Senior Program Manager
    Dignity Health Aug 2019 - Jun 2023
    Stockton, California Area
    • Manage the special programs designated under the care coordination department including, but not limited to management of the Accountable Care Organization (ACO) Program, Patient Navigator Program, Readmissions, Palliative Care Program, Analytics, Patient Placement Order Pilot Program and other Post-Acute Care related programs• Overseeing daily employee management tasks such as recruitment, payroll, and disciplinary actions• Constantly collaborate with leadership to optimize hospital length of stay and streamline workflows by utilizing data analytics. Additionally, spearhead process improvements to identify avoidable administrative days and implemented strategies to reduce them.• Implemented a new pilot program from scratch to prevent denials and in one year of performance, secured the reimbursement of around $1 million in the lower end by preventing Medicare FFS denials and following the CMS inpatient only procedure guidelines • Implemented strategies to collectively prevent lack of payments (claims denial) by payer for services rendered by the provider• Optimized the readmission assessment workflow process by automating it, resulting in significant improvements in efficiency. Successfully scaled and implemented this streamlined process across multiple facilities and divisions• FY 2022 – National team identified the hospital as a priority site for improving readmissions rates, and through diligent efforts it emerged as the most improved hospital within the system. This achievement resulted in national recognition for our hospital and garnered praise from industry experts. • Implemented and strictly enforced policies that reduced departmental incremental overtime, tardiness, and manual time card punches, resulting in significant improvements in operational efficiency • Successfully fulfilled the responsibilities as a hospital administrator on-call, and actively participate in the daily safety debrief meetings with senior leadership
  • Health Plan Of San Joaquin
    Senior Compliance Consultant
    Health Plan Of San Joaquin Jun 2017 - Aug 2019
    French Camp, California
    • Successfully oversaw the management and submission of DMHC and DHCS reports, quality management data, and provider network data, ensuring strict adherence to regulatory guidelines for initial and ongoing compliance with regulatory agencies. Maintained comprehensive documentation of all processes and outcomes. • Managed to clear a backlog of work related to contracts and regulatory filing that had accumulated over four months due to staff turnover, all while ensuring 100% compliance • Successfully fulfilled the role of Contract Administrator, overseeing the entire lifecycle of contracts from intake to execution using Compliance 360. Ensured compliance with all relevant regulations and requirements throughout the process, while also effectively managing all associated documentation. • Functioned as the Compliance Analyst/Auditor and prepared monthly and quarterly executive reports for the executive leadership • Demonstrated strong leadership skills by co-chairing the policy and procedures committee, overseeing the timely filing of policies with regulatory agencies. Ensured accuracy and thoroughness in all documentation, while also streamlining the process for a faster turnaround time.• Proactively acquired expertise in Tableau through self-directed learning, and subsequently trained other staff members in the development of dashboards and reports. Enabled more efficient data analysis and visualization, contribution to improved decision-making processes.
  • Community Hospice
    Quality Assurance Consultant
    Community Hospice Sep 2015 - Jun 2017
    Modesto, California Area
    • Instrumental in achieving a substantial improvement in HCAHPS survey response rates, increasing from 31% to above 45% for three consecutive quarters. Employed effective strategies and initiatives to engage patients and enhance their willingness to participate in the survey process, ultimately resulting in more accurate and meaningful data for quality improvements efforts. • Played a critical role in ensuring survey readiness by expertly collecting and submitting all required data and reports prior to regulatory agency visits. Thanks to meticulous preparation and attention to detail, the facility achieved its smoothest survey in the agency’s history with no major findings or citations. • Utilized a wide range of data sources to create comprehensive reports for committee meetings and senior leadership. Successfully integrated disparate pieces of information to provide a cohesive and accurate picture of key performance metrics, enabling more informed decision-making and strategic planning.
  • Kaiser Permanente
    Senior Consultant For Ncal Regional Risk And Patient Safety
    Kaiser Permanente Sep 2006 - Apr 2015
    Oakland
    • Successfully managed the NCAL sentinel event management program, which involved coordinating the regional hotline for reporting and preventing never events. Demonstrated strong communication skills and attention to detail in ensuring all stakeholders were informed and engaged in the program. Fostered a culture of safety and accountability, ultimately contributing to the prevention of never events within organization. • Provided expert consultation on regulatory reporting guidelines and requirements for adverse events to 21 medical centers throughout the region. Demonstrated deep knowledge of relevant regulations and guidelines, and effectively communicated this information to stakeholders in a clear and concise manner. • Took a lead role in designing, generating, and presenting actionable reports to support regional performance improvement initiatives. Effectively utilized a range of data sources and analytical tools to develop reports that provided valuable insights into key performance metrics. Successfully presented these reports to committees and senior leadership in a clear and concise manner, enabling informed decision-making and strategic planning. • Demonstrated a strong commitment to maintaining all sentinel and significant event policies and procedures, with a particularly focus on meeting patient notification and regulatory reporting obligations• Successfully transitioned from a specialist position to a senior consultant role, leveraging deep expertise to provide consultative services to 21 medical centers across the NCAL region• Effectively managed the coordination of Quality Council, Medical Executive Committee, and several other meetings, while overseeing Quality Improvement and Patient Safety Program annual revisions, bylaws revisions, and procedures for the entire service area in a specialist capacity.
  • Rite Aid
    Store Manager
    Rite Aid Jun 1998 - Sep 2006
    San Jose, California, United States
    • Directed operations for the second largest retail store in the region, ensuring profitability, cleanliness, and outstanding customer service as a priority• Conducted detailed reviews of profit and loss reports, financial statements, and labor productivity metrics to identify opportunities for optimizing sales and controlling expenses• Championed the development of store-level associates by providing leadership, guidance, and training opportunities to help them reach their full potential• Demonstrated strong leadership in recruiting, hiring, and supervising associates and supervisors instilling a mindset of driving sales through exceptional customer service• Maintained a safety and compliant store environment by following all relevant regulations, policies, and appearance standards with unwavering attention to detail• Fostered a customer-centric environment that consistently achieved and exceeded customer experience goals through a commitment to excellence and innovation• Started as a Cashier/sales floor clerk and progressed through various roles to eventually attain the position of store manager

Tony Joseph Skills

Healthcare Public Health Auditing Retail Business Strategy Business Management Customer Relations Databases Data Analysis Financial Analysis Html Inventory Management Logistics Lotus Notes Microsoft Office Non Profits New Business Development Social Networking Newsletters Operations Management Quality Assurance Qualitative Research Quantitative Market Research Sql Visio Powerpoint Process Improvement Supervisory Skills Problem Solving Compliance Management Customer Service Training Hospitals Strategic Planning Healthcare Information Technology Healthcare Management Time Management Quality Improvement Clinical Research Ehr Hipaa Epic Systems Software Documentation Emr Nursing Informatics Performance Improvement Electronic Medical Record

Tony Joseph Education Details

Frequently Asked Questions about Tony Joseph

What company does Tony Joseph work for?

Tony Joseph works for Blue Shield Of California

What is Tony Joseph's role at the current company?

Tony Joseph's current role is Principal Program Manager at Blue Shield of California.

What is Tony Joseph's email address?

Tony Joseph's email address is tj****@****ail.com

What is Tony Joseph's direct phone number?

Tony Joseph's direct phone number is +151039*****

What schools did Tony Joseph attend?

Tony Joseph attended California State University-East Bay, California State University - East Bay.

What skills is Tony Joseph known for?

Tony Joseph has skills like Healthcare, Public Health, Auditing, Retail, Business Strategy, Business Management, Customer Relations, Databases, Data Analysis, Financial Analysis, Html, Inventory Management.

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