Tommi Rivers

About Tommi Rivers

I am a healthcare quality improvement leader with extensive experience helping health plans strengthen performance across HEDIS, Medicare Stars, and Risk Adjustment programs. My passion lies in transforming data into actionable insights that drive compliance, quality outcomes, and sustainable revenue growth across Medicare, Medicaid, and Commercial lines of business.Over the past decade, I’ve led large-scale quality and data operations, building programs that consistently achieve top-tier results. At Centene/WellCare, I directed enterprise HEDIS and supplemental data operations, achieving 99%+ medical record capture rates and supporting multiple health plans in reaching 4-Star and above Medicare ratings. My work bridged analytics, clinical abstraction, and provider engagement to reduce vendor dependency, strengthen data integrity, and improve audit readiness.As a Healthcare Quality Consultant, I now partner with health plans to optimize their quality improvement and HEDIS operations, from data capture and abstraction workflows to Stars strategy and vendor management. I also support RFP development for quality-driven proposals, helping organizations articulate their quality strategy, member engagement models, and value-based care impact.My approach is grounded in collaboration, transparency, and continuous improvement. Whether leading enterprise teams or advising clients, I focus on aligning strategy, operations, and data to achieve measurable quality gains and improve member outcomes.Core Competencies:• HEDIS Program Management & Hybrid Operations• Medicare Stars Performance Optimization• Quality Data Integration & Audit Readiness• Supplemental Data & Chart Retrieval Strategy• Quality Improvement & Population Health Analytics• Leadership, Change Management & Cross-Functional CollaborationAt my core, I believe healthcare quality improvement is about more than meeting measures, it’s about creating systems that empower care teams, close gaps, and meaningfully improve the lives of members.

Experience

1. Vice President, Client Success

   Matrix Medical Network

   Nov 2024 — Present · Tampa, FL, US

   As Vice President, Client Success at Matrix Medical Network, I lead the strategy and execution of client relationship management, ensuring our partners achieve their business and healthcare objectives. I oversee a team responsible for driving client engagement, retention, and growth by delivering innovative in-home and virtual comprehensive health assessments.In this role, I partner on the development and implementation of enterprise-level strategies to expand service offerings, optimize client satisfaction, and foster high-value partnerships. I work closely with executive stakeholders, both internally and externally, to align Matrix’s capabilities with evolving industry needs, ensuring we provide impactful member experiences and deliver meaningful healthcare data to payers and PCPs that improve patient outcomes.By championing cross-functional collaboration and leveraging data-driven insights, I drive continuous improvement in client programs while identifying new opportunities for growth. My focus is on delivering measurable business impact, strengthening strategic relationships, and enhancing the overall client experience.

Education

• University of South Florida

  Public Health Policy

  2012

• University of Central Florida

  Bachelor of Arts (B.A.), Psychology

  1999 — 2005

• University of South Florida

  Graduate Certificate, Translational Research in Adolescent Behavioral Healthcare

• University of Phoenix

  Master of Business Administration - MBA, Health/Health Care Administration/Management

  2018