I am a Master’s prepared health professional, a leader who has gone through the mill. I was a medical doctor in my country of origin. I know the nuts and bolts of the business, and have more than a decade of professional experience. I am a soft spoken humble person. I would bring to any position qualities like hard work, reliability, flexibility, and the ability to listen and understand. My career goals incorporate the acquisition of knowledge and skill sets that will help alleviate the sufferings of human populations. Given below are some of my key accomplishments in the various organizations that I have worked for.
PROFESSIONAL CONSULTING POSITIONS:
Dignity Health, Bakersfield Memorial Hospital
As a Director of Quality i created an operational excellence program with key deliverables for the 403 bed hospital and medical group. Futhermore i developed an operational methodology for meeting and maintaining compliance with federal and state regulations.
Shifa Healthcare and Community Services
In my role at Shifa Healthcare in Houston, i lead efforts to improve the quality and operational oversight of the health system. I also developed clinical as well as operational policies & procedures along NCQA and TJC guidelines for the health system.
Woodlands Specialty Hospital
As the Chief Quality Officer & the Chief Operating Officer in Spring, Texas, i corrected all of the deficiencies highlighted on the hospital's first state survey. Laid down operational structure, and developed tracking tools for compliance, safety and infection control. Put in place infrastructure for future TJC accreditation.
Central Care Community Healthcare Services
As the chief operations & Quality officer i had operational responsibility for clinics in six locations in Houston. I was responsible for day to day running of the clinics and regulatory oversight. My duties, included, performance improvement, utilization review, and ensuring compliance with all Federal and State regulations, including HIPAA, OSHA, CLIA, Medicare, Medicaid, and TJC accreditation which the organization was able to retain under my leadership. I was also responsible for ensuring an effective credentialling and peer review process. Developing operational clinic guidelines as well a corporate policies and procedures, and risk management were part of my duties.
Shifa Healthcare and Community Services
In my role at Shifa Healthcare, in Houston i lead efforts and provided leadership, direction and support for HEDIS and CAHPS activities. Facilitated compliance activities, care management, disease management, and helped improve the utilization management process. Assisted in the development of a comprehensive training library for all staff.
Banner Health Services
In my assignment as the Corporate Operations Program director at Banner Medical Group one of my job functions was to help implement strategies in the field to facilitate the organizations transformation to value-based healthcare and population health management. Evaluating, redefining, and helping plan the implementation of patient centered medical homes and physician practice workflows. Assisting the leadership with organizational managed care strategy development, including evaluating new business opportunities, providing guidance on developing collaborations to enhance revenues and strategic partnerships to improve provider relations. Facilitating the implementation of the Medicare & Medicaid Compliance program and streamlining the work processes of the Secondary Professional Activities Committee (SPAC).
CONTRACT EMPLOYMENT:
Legacy Community Health Services
In my role as the corporate senior director Operations & Projects, at Legacy in Houston, I was part of the team providing operations oversight to 10 ambulatory care sites in Houston and the surrounding areas, and 9 school based KIPP clinics.
I helped research, select and implement i2i tracks at Legacy. This is a comprehensive population health management and analytics system. I along with other team members were successful in getting NCQA Level 3 PCMH certification, for several Legacy medical centers. I was part of the core leadership team, which was preparing the health system for the Joint Commission (TJC) accreditation. We implemented in collaboration with the Houston fire department a program to provide clinical care in the most appropriate setting. The compilation of a Corporate Peer Review process, and streamlining of the compliance program, was one of the tasks that was delegated to me and which I successfully completed.
Christus Health
As the Regional Director of Quality Resource Management with oversight of three Christus hospitals in Shreveport-Bossier, Louisiana, i oversaw Quality Assurance, Risk Management, Infection Control, Physician Credentialing, Ongoing Professional Practice Evaluation, Focused Professional Practice Evaluation, and Patient Safety. Working with my team I developed a corporate educational plan on clinical quality indicators for our hospitals. We successfully lead our units in 2012, through a TJC survey, and were reaccredited for another three years. I also coordinated all other regulatory surveys such as CMS, DHH, etc. I was responsible for providing assistance in developing objectives, quality indicators, and goals that related to quality, appropriateness of patient care, and clinical performance in the respective departments.
St. Joseph Medical Center
One of my former roles was of Director-Risk Management, Infection Prevention and Utilization Review at St Joseph Medical Center, in Bellingham, Washington. This included a 252 bed acute care hospital, a large medical group, two foundations, and other health care alliances. I was overall responsible for organization, operation, and personnel management for the three departments. I fulfilled legal, professional, regulatory agency, and institutional responsibilities, and managed the units according to state and federal regulations. In 2011, I led my areas of responsibility through a Joint Commission Accreditation Process with great success. In the fall of 2011, St Joseph Medical Center was one of 9 hospitals recognized by the Washington State Hospital Association, for the “Best Hands on Care Award” for 2011. There were 46 hospitals participating in the program. The award acknowledged excellence in hospital infection prevention measures, hand hygiene, and flu immunization rates.
Yakima Valley Farm Workers Clinic
In my position as the Corporate Director of Quality and Accreditation at Yakima Valley Farm Workers clinic (YVFWC) in Washington, I had a multitude of responsibilities, as it is the second largest community based health care system in the United States. I provided leadership and direction for the Joint Commission accreditation process, and assisted YVFWC to successfully retain Accreditation in 2009. My team developed a training DVD on the Joint commission findings, which was used as an educational tool for our staff in all of our medical centers. In my leadership role I oversaw, infection control, employee health, patient safety, the compliance program, ethics, and risk management, and also sat on the credentialing committee. I chaired several high level committees, and put together a peer review process for the corporation.
PERMANENT EMPLOYMENT:
UNITED OUTSTANDING PHYSICIANS
In my job as Director of Clinical Improvement at United Outstanding Physicians (UOP) one of the largest physician organization in Michigan, I successfully worked with the physicians, the customers, the insurance companies, and the patients to make them recognize that their economic security was linked. I vigorously pursued educational programs focused on sharing both burdens and rewards. According to a 2007 report published by Blue Cross, UOP demonstrated the highest generic dispensing rate percentage point improvement as compared to the group average of all of the physician organizations in Michigan in that year. It was the only physician organization in the state that based on my direction, organized Continuing Medical Education programs on a quarterly basis in 2007. I facilitated The Joint Commission accreditation process at Oakwood Hospital main, a 623 bed, contractually affiliated teaching hospital in Dearborn, Michigan. By virtue of being a certified national trainer for acute care inpatient clinical criteria, I coached the hospital physicians in writing clear notes, so that the hospital would be better prepared for the Medicare, Recovery Audit contractors (RAC) audits.
I served on the steering committee of the Greater Detroit Area Health Council (GDAHC), a non-profit organization that focused on improving health care quality, access and cost through partnership and collaboration. There were thirty three organizations represented, including, the State of Michigan that was represented by the Surgeon General, Executives from Blue Cross Blue Shield of Michigan, Health Alliance Plan, employer groups, and physician organizations.
I along with executives from two other physician organizations, helped launch a state wide Blue Cross Blue Shield of Michigan sponsored patient centered medical home initiative. This is the nation’s largest PCMH program today and has saved $155 million in the first 3 years following its implementation
CARE CHOICES HMO
I have been privileged in having had an opportunity to work in Care Choices HMO, a member of Trinity Health. In the time frame that I was employed there, I was instrumental in developing and setting up a new company department, Clinical Audit and Medical Policy that I led. Among other responsibilities I shared oversight of the call center and provided clinical training, and mentoring to the staff. I and my team were entrusted with the task of writing new medical and administrative policies and revising old ones. We composed a mission statement for our business unit made up of two words. “Standardization & Simplification” The Consumer and News Report named Care Choices HMO and its constituent business units, 12th best in the nation for 2005 and 2006, and named it number 1 in Michigan. The Care Choices call center received a 5 star rating. I also served on the Care Choices Management team that provided oversight of the NCQA accreditation process for that HMO.
BLUE CROSS BLUE SHIELD OF MICHIGAN
I held the solo position of corporate lead clinical criteria in the National Clinical Criteria Program for Blue Cross Blue Shield of Michigan (BCBSM) for almost five years and served as the clinical criteria expert for BCBSM. During my tenure I was responsible for developing training videos and accompanying text for all levels of care, that were distributed to the participating hospitals, rehab centers, skilled nursing facilities, and home health care agencies in Michigan. Such an educational / compliance initiative by a health insurance company was an industry first in the state. These training materials were highly acclaimed by the provider community, in particular by the Michigan Hospital Association and the Michigan Home Health Association, both of whom sent written accolades to BCBSM.
I served on the core group that had oversight of the URAC accreditation process for BCBSM, and co-lead the organization through two consecutive reaccreditation’s successfully. I was part of a team that compiled medical policies for BCBSM and Blue Care Network (BCN). I facilitated the NCQA accreditation process for BCN. I was responsible for developing an annual educational plan for interQual criteria application for BCBSM. I had shared oversight of the operations call center which functioned 24/7. My responsibilities included providing training on compliance, clinical criteria, policies and procedures, and operational guidelines. As a corporate ambassador for BCBSM, and by virtue of being a certified national McKesson interQual trainer for all levels of care, I have trained several thousand, physicians, nurses, and other health professionals, all of diverse backgrounds, on clinical criteria application and existing BCBSM policies. As a professional auditor for Blue Cross Blue Shield of Michigan (BCBSM) I have conducted acute care inpatient hospital audits and inpatient rehab audits.
I feel I would bring a unique set of skills, and experience to the management position that you have open. I look forward to hearing from you.
Sincerely
Altaf Ibrahim
