Rajan Viswanathan
Hazleton,PA
Summary
Diligent Vice-President with strong track record of streamlining operations and driving efficiency across multiple departments. Successfully led key initiatives that enhanced productivity and operational excellence. Demonstrated ability to leverage strategic planning and leadership skills to foster team collaboration and achieve operational goals.
Overview
17
17
years of professional experience
Work History
Vice President, Operations
FQHC-LAL / Conynham Primary Clinic
06.2025 - Current
- Provide enterprise governance and operational leadership for quality, compliance, and risk management frameworks, ensuring HRSA, CMS, NCQA, and HIPAA adherence while strengthening internal controls, board oversight, and regulatory readiness
- Own and execute the organizational Quality Management Plan, aligning clinical quality, operational audits, and inter-rater reliability programs to improve UDS clinical performance by 10–25% year-over-year and sustain continuous survey readiness
- Lead Program Integrity and Enterprise Risk Management, developing a risk-based audit and remediation framework that reduced audit findings, compliance incidents, and financial exposure by 40%+
- Strengthen financial and operational risk controls, improving clean claim rates to 95%+, reducing days in A/R by 20–35%, and driving net collections to 98%+ through front-end compliance, coding governance, and workflow standardization
- Direct shared services and enterprise customer experience strategy, improving CAHPS patient satisfaction scores by 10–20% and reducing patient complaints and service recovery escalations by 30%+
- Lead systemwide process improvement and standard work transformation, increasing provider productivity (visits per FTE up 15–25%) and reducing third-next-available appointment wait times by 30–45%
- Oversee enterprise clinical, operational, and product systems, ensuring platform readiness, data integrity, and scalable workflows to support multi-site growth, scope-of-project expansion, and new site activation
- Define and lead the enterprise data, analytics, and reporting strategy, delivering executive dashboards spanning UDS, access, quality, compliance, finance, and patient experience, enabling board-level performance oversight and rapid decision-making
- Serve as a thought leader for High-Value Data and population health analytics, directing the use of predictive insights to improve preventive care measures, chronic disease management, and risk stratification across vulnerable populations
- Partner with clinical, IT, finance, and compliance leaders to align technology roadmaps, operational systems, and regulatory requirements with strategic growth, sustainability, and mission-driven outcomes
- Build and mentor executive and director-level leadership teams, strengthening accountability, succession planning, and cross-functional governance across clinical and administrative operations
Senior Director of Quality and Performance Improvement
Public Health Management Corporation (PHMC)
03.2023 - 06.2024
- Provided strategic leadership across 250+ programs to align QI operations with PHMC’s mission and population health goals.
- Implemented UDS, PCMH, and HEDIS-based frameworks and dashboards by site/provider, ensuring readiness for Joint Commission and HRSA audits.
- Introduced EOS-style accountability frameworks for department heads, promoting continuous improvement and bidirectional communication.
- Directed quality strategy across FQHC centers using SDOH data and staff/patient satisfaction metrics to drive measurable outcomes.
- Established a system-wide QAPI program with governance structures, training, and performance monitoring.
- Championed ERP system adoption and dashboard development to standardize operations and enhance decision-making.
Senior Director of Quality and Performance Improvement
Legacy Community Health
03.2022 - 11.2022
- Led system-wide quality initiatives, aligned VBC strategy with HRSA and Epic EHR optimization.
- Established and scaled a new Quality Department including analytics, HCC coding, outreach, and RN quality teams.
- Implemented a roadmap to improve RAPS/RAF accuracy and streamline HCC coding, increasing revenue and compliance.
- Oversaw population health analytics dashboard development and Epic migration planning.
- Initiated EHR documentation standardization and provider training, improving clinical documentation integrity.
- Established a system-wide quality improvement committee with a legacy community health action plan. Also, created a detailed Quality Plan as required by HRSA for 2022-2025
- Established a Quality Department with a Manager of Analytics, Analytics Associate, HCC Coders, Population Health outreach coordinators, and RN Quality Analyst to help establish metrics tracking and VBC.
- Analyzed RAPS and RAFF scores to ensure MLR for upcoming payor contracts.
- Leased dashboard with an existing vendor to create an in-house population health dashboard, mapped to ensure a smooth move to Epic.
- Purchased from AHIMA coding classes for 91 Family Medicine providers to improve HCC coding.
- Implemented with IT for adding 120,000 ICD 10 codes to give providers very detailed hierarchical chronic condition coding opportunities: Epic launch team member.
- Trained Population Health Coordinators on Outreach, including language and circle of care.
Director of Risk, Quality and Compliance
Westborough Behavior Health Hospital
03.2021 - 08.2021
- Served on the Executive Committee, led redesign of risk and compliance processes to meet TJC, CMS, and DMH standards.
- Introduced CPI v2 and hands-off protocols, reducing restraint/seclusion incidents by 40% in under two months.
- Instituted executive rounding, mock audits, and daily flash meetings to drive real-time accountability and team alignment.
- Enhanced patient satisfaction from 20% to 83% in 3 months via process redesign and staff engagement.
Project Quality Improvement (QI) / Population Health Manager
The Dimock Center
06.2018 - 04.2020
- Established QI department with CMO; developed standardized workflows and PDSAs aligned with PCMH, HRSA, and MAT compliance.
- Improved ACO, HEDIS, and MassHealth metrics, achieving #1 FQHC in MA with scores rising from 68% to 84%.
- Led opioid grant tracking and patient retention efforts, reducing comorbidity risks by 7%.
QI / Population Health Project Facilitator
UMass Memorial Healthcare
02.2009 - 05.2018
- Led lean improvement projects saving $1M+ in Total Medical Expense.
- Coordinated across 15+ primary care sites to implement standard clinical workflows and improve quality metrics.
- Achieved $23M in shared savings in 2017 through physician engagement, Epic optimization, and care model redesign.
- Worked with CITC (Center for Innovation and Transformational Change) on projects to increase CMG (Community Medical Group) patient count and add millions of dollars to base earnings.
- Improved ACO, HEDIS, and other contracts across all practices; in 2017, achieved $23M in shared savings.
- Educated physicians in Epic to improve patient care; one physician improved from 0.62 to 2.76 / 5 within one year (according to Accountable Care Organization metrics).
Education
Master of Business Administration - Healthcare Administration
University of Massachusetts
AmherstBachelor of Science - Healthcare Management
Northeastern University
Boston, MA05-2020
Project Management Certification - undefined
Boston University
MASkills
- Enterprise Operations & EOS Execution
- Quality Governance & Accreditation (HRSA, HEDIS, NCQA, PCMH, TJC)
- Population Health & Value-Based Care Strategy
- Data & Analytics / Executive Performance Dashboards
- Strategic Planning, Growth & Scope Expansion (FQHC-LAL)
- Regulatory Compliance & Risk Management (CMS, DMH, HIPAA)
- Care Model Redesign & SDOH Integration
- Cross-Functional & Physician Leadership Development
- Equity, Workforce Development & Culture Transformation
- Team leadership
- Decision-making
- Coaching and mentoring
Accomplishments
- Developed strategies to improve patient care by 30-40% basis points and reduce risk on patients with multiple co-morbidities by 7% basis points.
- Masterminded with the CMO and CIO to validate data and create reports for the practice and Board of Directors; validation improved outcomes/performance by 30% within the first six months.
- Improved ACO, HEDIS, and MassHealth measures Year over Year; moved scores from a low of 68% in 2018 to 84% in 2019 and became the # 1 FQHC site in MA; reduced plans to quality work from 16 measures to 2.
Timeline
Vice President, Operations
FQHC-LAL / Conynham Primary Clinic
06.2025 - Current
Senior Director of Quality and Performance Improvement
Public Health Management Corporation (PHMC)
03.2023 - 06.2024
Senior Director of Quality and Performance Improvement
Legacy Community Health
03.2022 - 11.2022
Director of Risk, Quality and Compliance
Westborough Behavior Health Hospital
03.2021 - 08.2021
Project Quality Improvement (QI) / Population Health Manager
The Dimock Center
06.2018 - 04.2020
QI / Population Health Project Facilitator
UMass Memorial Healthcare
02.2009 - 05.2018
Project Management Certification - undefined
Boston University
Master of Business Administration - Healthcare Administration
University of Massachusetts
Bachelor of Science - Healthcare Management
Northeastern University