Joyce Grissom
Physician Executive
Clarksburg,MD
Summary
Highly experienced physician executive with expertise in federal health care management. Over 23 years of experience in health plan operations, medical management, patient safety, quality assurance, performance measurement and improvement, credentialing, utilization review, and resource management. Well-versed in bid and proposal development, data analysis, staff development, and engagement. Thrives on challenges and actively seeks opportunities to design and create the patient-centered federal health space of the future.
Overview
30
30
years of professional experience
1
1
Certification
Work History
Chief Medical Officer
Health Net Federal Services
03.2013 - Current
- Led a diverse team of more than 300 medical and administrative professionals responsible for the clinical care provided to 2.8 million military health system beneficiaries in the TRICARE North and TRICARE West regions including utilization management, population health, clinical quality and patient safety
- Planned and successfully executed a first of its kind Managed Care Support Contractor capitated pilot under TRICARE in a West Region Prime Service Area
- Clinically responsible for Veteran’s Administration (VA) Patient Centered Care Program and Veteran’s Choice program in VA Regions 1,2, and 4 (2013-2016)
- Stood up opt-out Fecal Immunochemical Test (FIT) Colorectal screening program for 25K-46K TRICARE beneficiaries; program was recipient of the 2017 Healthcare Quality and Safety Award selected by the DHA Advancement toward High Reliability in Healthcare Award Program
- Clinical lead for the successful T2017 procurement of in the TRICARE West Region
Medical Director
Health Net Federal Services
02.2008 - 03.2013
- Experienced with key medical management and quality oversight processes under the TRICARE program including (1) Quality assurance/performance improvement reviews (2) Record review for potential fraud and/or inappropriate use of controlled substances (3) Second level utilization review, prepayment claims review; and second level appeal review (4) Network provider credentialing as a member of the Credentials Committee
- Collaborated with the American Red Cross and Penn State College of Medicine to provide a one-day training (CME) experience on military TBI and PTSD to civilian primary care and behavioral health providers
- More than 400 providers trained in 4 states in the North Region 2010-2012
- Initiated a structured review and internal communication process for resulted 3rd level (Military Health System) appeal cases to facilitate timely alignment with Military Health System policy interpretations
- Initiated educational clinical briefing for RN’s managing inpatient care to enhance first level reviewer clinical case development of selected high cost/high volume cases
- Verified effective, consistent communication between department heads, medical staff and governing boards through board meeting attendance and synchronization of interdepartmental functions.
Medical Director/Director of Quality
Department of Defense (DoD) - TRICARE Management Activity
07.2003 - 02.2008
- Led the Military Health System (MHS) Clinical Quality Management Program providing oversight to senior quality, safety and risk managers from each military Service, TRICARE Management Activity, and DoD Health Affairs; coordinated clinical quality activities and across the Military Health Service
- Extensive experience with JCAHO Quality and Patient Safety Measures and NCQA HEDIS measures
- Initiated successful pilot of the National Surgical Quality Improvement Program in 3 DoD Medical Centers
- Prepared and coordinated major clinical policy documents for applicable to Military Treatment Facilities and Military Health System purchased care
- Clinical oversight of managed care contracts providing healthcare to 9.1 million Military Health System (TRICARE) beneficiaries worldwide
- Led DoD health promotion campaign featuring a 'family' of initiatives including: a 4-state DoD tobacco quit-line and cessation program; a 4 state multidisciplinary internet/telephone weight management program; an alcohol education program for young enlisted service members, a tobacco and an award-winning alcohol counter-marketing program
Chief Medical Officer
TRICARE Southwest
05.2001 - 06.2003
- Clinical chief for the 4-state (Texas, Arkansas, Oklahoma, Louisiana) integrated Military Health System (TRICARE) Southwest Region including 17 Military Treatment Facilities, and 25,000 providers/facilities
- Clinical oversight for a Managed Care Support Contract and a US Family Health Plan valued at over $500M/year
- Initiated TRICARE telephone disease management programs in diabetes and pediatric asthma
- Led Medical Product Standardization Program for three TRICARE regions with $2.8 million over one year in government savings on equipment/supplies; 40% increase over preceding year
Staff Neurologist
Wilford Hall Medical Center
07.1994 - 06.2001
- Department QA/QI Officer July 1994 - Sep 1996
- Quality QA/QI Officer, Medicine Directorate: 1996 - 2000
- Highly successful Joint Commission on-site accreditation inspection
- Director of the largest botulinum toxin treatment clinic in the Air Force
Education
Medical Degree - Outstanding Medical Student, Alpha Omega Alpha National Medical Honor Society
Uniformed Services University of the Health Sciences
Bethesda, MD01.1986
Bachelor of Science and Bachelor of Arts - Distinguished Graduate; Outstanding Cadet in the Humanities
United States Air Force Academy
Colorado Springs, CO01.1982
Skills
- Strategic leadership and planning developed through 22 year military career and 17 years experience in the federal health sector
- Subject matter expert in Federal Health policy
- Healthcare management
- Beneficiary health education and engagement
- Population health management
- Clinical coverage policy
- Clinical quality, performance measurement and improvement
- Physician relations and provider credentialing
- Excellent oral and written communication; at ease with presentations and media interviews
Certification
- Medical License, Pennsylvania MD04379L
- Neurology Residency: Wilford Hall US Air Force Medical Center, 1988-1991
- Board Certification, American Board of Psychiatry and Neurology in Neurology, Jan 1993 to present
Training
- 2007, Award of Academic Achievement in Medical Management, American College of Physician Executives; completion of Section I curriculum toward MBA
- 2005, CAPSTONE Symposium, Military Health System, Washington D.C.
- 2002, American Association of Health Plans Executive Leadership Program
- 2001, Professional, Academy for Healthcare Management
- 1994, Movement Disorders Fellowship, National Institutes of Health
- 1990, Neurology Residency, Wilford Hall Medical Center
- 1988, Internal Medicine Residency; Wilford Hall Medical Center
Timeline
Chief Medical Officer
Health Net Federal Services
03.2013 - Current
Medical Director
Health Net Federal Services
02.2008 - 03.2013
Medical Director/Director of Quality
Department of Defense (DoD) - TRICARE Management Activity
07.2003 - 02.2008
Chief Medical Officer
TRICARE Southwest
05.2001 - 06.2003
Staff Neurologist
Wilford Hall Medical Center
07.1994 - 06.2001
Bachelor of Science and Bachelor of Arts - Distinguished Graduate; Outstanding Cadet in the Humanities
United States Air Force Academy
Medical Degree - Outstanding Medical Student, Alpha Omega Alpha National Medical Honor Society
Uniformed Services University of the Health Sciences
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