Thomas Glodek

Background

About Thomas Glodek

Chief Medical Information Officer and Senior Healthcare Executive Board Certified in Healthcare Quality and Management with sub-specialty Board Certification as a Physician Advisor by ABQAURP. • Provides clinical guidance, education, and support across multiple functions in the development, organization, and governance of the health plan market. • Responsible for providing change management expertise & guiding the improvement of clinical, quality, and financial outcomes for the operating partnerships (i.e, health systems, provider organizations, physician practices, etc.) • Collaborates cross-functionally to implement, improve, and support the care model. Works broadly across internal teams and directly with clinically networks of physicians and 1:1 with physicians. • Participates in the alignment of physician incentives, quality measures, and value-based contracts. • Builds and fosters strong relationships with internal and external clinical partnerships. • Directs and monitors medical management activities and quality management programs as needed to maintain compliance with CMS, NCQA and other accrediting bodies. • Directs and ensures implementation of the clinical direction of the health plan and ensure compliance with all regulatory requirements. • Develops strategic goals and provides guidance and oversight of Medical Management Committees that are responsible for the development, approval, and implementation of all clinical work plans such as Utilization Management, Case Management and Quality Improvement. • Acts as a consultant and works collaboratively on the development/integration/implementation of all clinical programs and special projects. • Participates in ongoing product development and content development. • Participates in business development meetings with clients and supports the delivery of the value propositions to drive ROI. • Provides timely communications and progress reports to all key partners regarding internal activities and external client status. • Contributes to the clinical thought leadership of the organization through presentations and case studies. • Ample experience in population health or managed care experience with a solid understanding of population health management strategies • Knowledge of healthcare financing and the relation to various managed care products (HMO, PPO, Indemnity, and Medicare Advantage)