Teams at Foundation Health Partners

Supports healthcare quality and continuous improvement initiatives across the organization. Evaluates workflows, analyzes clinical and administrative performance data, identifies improvement opportunities, facilitates quality teams, educates staff on improvement methodologies, and oversees performance improvement projects. Collaborates with leaders and process owners to prioritize initiatives and improve clinical and operational outcomes.

Oversees CMS Quality Payment Programs, Alternative Payment Models, and other value-based reimbursement initiatives. Monitors regulatory changes, incentive metrics, financial impacts, and performance dashboards; develops workflows, action plans, education, and cross-functional project plans. Partners with Finance, Quality, Clinical Informatics, IT, providers, and leadership on regulatory submissions, EMR changes, reporting, and strategies to maximize incentives and reduce penalties.

Coordinates patient billing, payment posting, collections, claims research, denials, refunds, payment plans, and accounts receivable activities. Reconciles accounts, researches payment discrepancies, submits appeals and corrections, communicates with payers and provider offices, responds to billing inquiries, documents account activity, and supports reduction of outstanding patient balances while meeting quality and productivity goals.