Ajay Barma
Alexandria,VA
Summary
Director, Quality Assurance & Change Management - Profile Analytical and detail-oriented healthcare professional with 18+ years of experience supervising Quality Assurance and Compliance in Government Health settings, Rehabilitation, home care, and nursing facility services. Proven track record of managing regulatory and standards, compliance, quality assurance, quality management, and performance improvement activities, including survey readiness and response to surveys, investigations, and audits. History of collecting and analyzing data related to outcomes and Strategic Planning & Execution Operations Management Financial Management Project Management Case Management Quality Assurance & Review Continuous Quality Improvement Key Performance Indicators (KPIs) QI Reporting & Statistics Regulatory Compliance Risk Management & Analysis Staff Development & Leadership
Overview
17
17
years of professional experience
Work History
Program Manager
District of Columbia Government
02.2023 - Current
- Managed the development and implementation of new programs and innovations in healthcare delivery service and program design
- Directed activities necessary to develop and disseminate various tools and resources that providers and their staff members may use to achieve excellence in the areas of operations, and clinical quality to ensure staff and patient satisfaction
- Developed key performance metrics to monitor the implementation of system deliverables
- Ensured all program requirements were fulfilled and reporting requirements were met in a thorough and comprehensive manner
- Assigned staff and other functional group work based on work distribution and priorities
- Supervised and met regularly with leaders and staff to discuss program progress, share information, provide direction, determine and establish assignments, and solicit staff assessments and observations
- Made decisions on work problems presented by subordinate employees, evaluated work performance of subordinate employees, made and recommended selections for subordinate employee positions, heard and resolved serious employee complaints, reviewed and approved serious disciplinary actions involving non-supervisory subordinate employees
- Collaborated with internal Partners (DGS, OPM, DCHF,DOH,CRT and others) along with external vendors to propose and implement innovative solution to increase efficiency of the program.
Executive Director, Senior Lifestyle
Green Springs Village
Springfield , VA
10.2018 - 02.2023
- Direct and coordinate end-to-end, community/facility-wide financial management operations while meeting budgetary goals
- Plan, initiate, control, and deliver programs while implementing changes
- Ensure a healthy work environment by executing corrective action plans
- Enforce end-to-end compliance controls of all federal, state, and local laws and regulations with the facility operations
- Administer uninterrupted flow of all processes by liaising between the board, staff, and residents while working side-by-side with the community boards
- Exercises discretion and independent judgment in the decision-making process, planning, directing, conserving, and controlling the management of the facility
- Manages the healthcare delivery system and coordinates with the other functions within the institution
- Manages the budget and financial performance of the site
- Submits timely and accurate reports to supervisor and/or corporate office
- Develops and/or supervises the facility’s operational plan
- Directs the activities of the assigned staff
- Manages labor by ensuring the site staffing is in accordance with contractual commitments and supervises staff scheduling
- Coordinates or participates in the interviewing and selection of staff and Independent Contractors
- Ensures orientation of new personnel by conducting or coordinating all initial new hire and annual orientation and training activities
- Ensures site utilization and compliance with all applicable client systems and applications
- Coordinates the Quality Assurance and Medical Audit Committee and facilitates the monthly meetings
- Secure and Maintain Accreditation/inspections as per Federal, State and County Health Departments, Analyze EMR reports and identify trends that impact clinical documentation and billing
- Managed care delivery and billing
- Ensured cost containment for services and reviewed insurance submissions
- Promoted to role of Regional Manager.
Regional Director
Global HealthCare
12.2013 - 10.2018
- Drove results, expanding operations from one rehabilitation clinic to fourteen, including two pediatric facilities
- Supervised full range of therapy services
- Managed regional budget and lead 18 managers and 55 therapists in delivering quality patient care services
- Enforced and ensured regulatory compliance for all applicable state and federal regulations
- Worked with individual clinics to provide optimal quality, customer service, integrity, and performance standards
- Monitored operations for registration, admissions, billing, and collections, and make changes, as needed.
Director of Compliance and Quality
Central Park Nursing Home
Syracuse, New York
12.2011 - 10.2013
- Reviewed KPIs, identify opportunities for performance improvement, and execute changes to enhance productivity and efficiency
- Conducts thorough investigations, writes thorough summaries, and identifies necessary billing corrections and refunds
- Assists with preparing materials for external regulators for compliance investigation disclosure under direction of Compliance Officer and in coordination with Legal
- Manage and oversees auditing and monitoring activities as assigned
- Assists with Compliance Officer with trending reports
- Identifies training opportunities and assists with needed compliance education and training
- Ensured profitability of clients following changes to Medicare and Medicaid reimbursements rates in 2019 by planning, initiating, executing major restructuring initiatives and delegation
- Acted as a change agent to restructure operations and workforce, due to 2019 Medicare and Medicaid reimbursement changes
- Conducted training with staff related to reimbursement changes
- Assurance, Anchor/Flagship Rehabilitation, Location
- Led daily operations for rehabilitation care delivery, including billing and compliance with state and federal regulations
- Managed PPS and G codes compliance for Medicare
- Serve as point of contact for CMS inquiries and surveys, and also serve as liaison with regulatory authorities and business partners to comply with all requirements
- Assisted in interpretation of CMS regulations
- Collaborated with team members and senior management to improve processes
- In order to maintain survey readiness
- Guided team in preparing remediation and corrective action plans in response to audits, investigations, compliance reviews, and self-identified issues
- Reviewed and helped resolve issues from external government agencies, i.e., OSHA, HHS Office of Civil Rights, CMS Medicare Administrative Contractors, and Medicaid agencies
- Worked collaboratively with Legal, Risk Management, Information Systems, Patient Financial Services, Patient Experience, Department Leadership, and Human Resources, to resolve issues and determine further action
- Created materials for, and conducted annual training on, CMS regulations and standards
- Adheres to and enforces all safety and security policies and procedures
- Ensured all annual performance evaluations completed with all staff including peer reviews in a timely fashion
- Ensured PIP (Performance improvement plans) and CAPs (Corrective Action Plans) were complete accurately and timely for submission
- Participated in counselling and discipline employees as warranted by breach of policies and procedures., Led staff of 30 in 350-bed facility
- Managed care delivery and billing
- Collaborated on recruiting and hiring top-tier talent.
Managed Care and Compliance Administrator
Dominion Health and Fitness
07.2010 - 12.2011
- Delivered excellent outcomes for smooth daily functioning of department and home care services
- Ensured quality care delivery and managed billing functions
- Collaborated on strategic planning, budget development, and financial performance
- Supported sales, when required
- Served as point-of-contact for external service, supply, and equipment vendors
- Provided back-up for clinical and non-clinical positions
- Manage and oversees auditing and monitoring activities as assigned
- Assists with Compliance Officer with trending reports
- Identifies training opportunities and assists with needed compliance education and training
- Develops department-specific training to resolve cases, creating "hot sheet" guidance on targeted areas of non-compliance
- Provides day to day support to Compliance Specialists
- Compiled weekly statistics, and census information.
Director Business Development
Better Health Care, Fulton Commons Nursing Home
, New York
09.2006 - 06.2009
- Structured, negotiated, and closed contracts and acquired Central Park Nursing Home (Syracuse), ), and Birchwood Nursing Home (New York)
- Provided operational direction to 30 staff members while overseeing 350 beds and supervising healthcare delivery, billing, recruiting, hiring, and overall department operations
- Exercises discretion and independent judgment in decision-making process, planning, directing, conserving, and controlling the management of the facility.
Director
Birchwood Nursing Home
New York, New York
- Assisted rehabilitation, in management of care delivery and billing activities
- Promoted to role as Rehabilitation and Billing Manager.
Education
MHA - Budgeting, Long term Care Administration and International Healthcare
University of New Haven
01.2007
Post-Graduate Diploma - Psychology, Behavior Analysis
Institute for Psychotherapy and Management Services
01.2004
Bachelor’s - Physical Therapy
Santosh Medical College, Meerut University
01.2003
Skills
- Operations Management
- Project Management
- Financial Analysis
- Strategic Planning
- Profitability Optimization
- Program Leadership
- Risk Analysis and Management
- Cost Management
- Product Development
- Logistics Operations
- Resource Management
- Monitoring and Evaluation (M&E)
- P&L Management
- Program Performance Analysis
- Project Coordination
- Enterprise Resource Planning
- Policy and Procedure Development
- Effective Negotiations
- Team Development
- Vendor Management
- Process Improvement
- Policy and Procedure Improvements
- OSHA Compliance
- Contract Development
- Project Lifecycle
- Training and Development
- Procurement
- Organizational Performance
- Cultural Sensitivity
- Team Leadership
- Systems Optimization
- Work Delegation
- Data Analysis
- Multi-Operations Management
- Budget Preparation
- Performance Monitoring
- Quality Assurance
- Vendor Sourcing
- Regulatory Compliance
- Strategic Direction
- Team Management
- Critical Thinking
- Change Management
- Quality Control
- Compliance Enforcement
Affiliations
Ensured compliance of therapists and assistants with licensing and CEU requirements of Virginia Board of Physical Therapy, American Physical Therapy Association (APTA), Virginia Board of Medicine, American Occupational Therapy Association (AOTA), Virginia Board of Audiology and Speech, American Speech Language Hearing Association (ASHA), and Behavior Analysis Advisory Board of Virginia.
Timeline
Program Manager
District of Columbia Government
02.2023 - Current
Executive Director, Senior Lifestyle
Green Springs Village
10.2018 - 02.2023
Regional Director
Global HealthCare
12.2013 - 10.2018
Director of Compliance and Quality
Central Park Nursing Home
12.2011 - 10.2013
Managed Care and Compliance Administrator
Dominion Health and Fitness
07.2010 - 12.2011
Director Business Development
Better Health Care, Fulton Commons Nursing Home
09.2006 - 06.2009
Director
Birchwood Nursing Home
MHA - Budgeting, Long term Care Administration and International Healthcare
University of New Haven
Post-Graduate Diploma - Psychology, Behavior Analysis
Institute for Psychotherapy and Management Services
Bachelor’s - Physical Therapy
Santosh Medical College, Meerut University