Michael Starks, MBA, CPMSM

Experience

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  US Army

  Jul 1982 - Jan 2004

  Health Services Specialist

  Administrator for departments of OB/GYN, Orthopedics, Pediatrics, Medicine, Emergency Medicine, and Hospital Planning, Training, Mobilization, and Security. Primarily responsible for analyzing, evaluating and advising leadership regarding operations of the Gastroenterology, Neurology, Dermatology, Internal Medicine, Pulmonary, Cardiology, and Cardiac Catheter Lab Clinics. Supervised the transition of new equipment placement and branch activities for the $250 million dollar New Womack Army Medical Center at Fort Bragg, North Carolina. Emergency Medical Technician-Basic (EMT-B) certified. Served in the Gulf War (Operations Desert Shield and Desert Storm), and Vigilant Warrior in Saudi Arabia as manager for mobile clinics. Developed goals, revised or reviewed policies, procedures, mission objectives, and organization design for all staff. Awarded the Expert Field Medical Badge, two Meritorious Service Medals, four Army Commendation Medals, 4 Army Achievement Medals, and 7 Good Conduct Medals. Show less

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  St. Francis Hospital

  Jan 2004 - Oct 2006

  Resident Service Coordinator

  Assistant Executive Director for a 60-bed assisted living community. Negotiated Long Term Care policies for residents. Conducted assessments, negotiated service plans, developed service schedules, and updated service information as indicated by resident need. Recruited, interviewed, hired, supervised, evaluated and disciplined staff. Coordinated and assisted in administration of wages/benefits for staff. Developed and implemented marketing plans and promotional campaigns within budget. Established and maintained open and effective communications. Participated in continuous quality improvement. Initiated action plans and family conferences for resolving problems Show less

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  Five Star Quality Care

  Oct 2006 - Jul 2007

  Executive Director

  Directed the operations, administration, human resources, and public relations of Morningside, a 40-bed assisted living community. Developed goals, revised or reviewed policies, procedures, mission objectives, and organization design for the staff. Managed budgeting, scheduling, productivity, logistics, strategic planning, and beneficiary satisfaction initiatives for resident services. Ensured timely review, analysis, and adjustment of marketing strategies, plans and programs to meet the needs of the organization and the changing market conditions. Managed the selection, employment, development, control, training and discharge of employees and fostered timely and effective resolution of grievances from residents, families and/or staff. Prepared and presented periodic reports, including: notifications to local, state and federal agencies, operations reports, financial variance reports, monthly and quarterly summary reports. Always available for consult and response to community needs. Show less

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  Emeritus

  Sept 2007 - Aug 2009

  Executive Director

  Directed the daily operations, administration, human resources, and public relations of Emeritus at Lake Ridge, a 107-bed assisted living and memory care community. Licensed as a Residential Care/Assisted Living Administrator in the state of Virginia. Managed seven (7) department managers and 56 line staff employees. Developed goals, reviewed and revised policies, procedures, mission objectives, and organization design for the staff.

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  United States Air Force

  Aug 2009 - Jul 2011

  Director of Quality Services/Risk Manager

  Directed all aspects of the performance improvement program. Air Force Smart Operations for the 21st Century (AFSO21) Green-Belt Certified. Managed the medical treatment facility’s risk management and worked with the Chief Nurse Executive and the Patient Safety Program Manager to ensure focus on identification, mitigation, and prevention of harmful patient events. Managed the medical treatment facility’s external oversight/compliance through liaison with the Air Force’s Inspection Agency (AFIA) and managed the preparation of the medical treatment facility for the 2011 Health Services Inspection (HSI) and Accreditation Association for Ambulatory Health Care (AAAHC) inspection, both resulting in “Outstanding” ratings. Show less

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  Georgetown University Hospital

  Jun 2011 - May 2012

  Manager, Medical Staff Affairs

  Managed the Medical Staff Affairs Department, including physician, non-physician, and allied health appointment and re-appointment, meeting management, flow of information from medical staff committees through the Medical Executive Committee and the Governing Board. Supervises Credentials Coordinators. Works closely with medical staff leaders, hospital administration, and legal counsel with regard to medical staff and bylaws issues.

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  Indiana University Health

  May 2012 - Mar 2013

  Director, Medical Staff Services

  Planned, developed, organized, and directed the daily operations of the Medical Staff Services Department.

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  MDwise Hoosier Alliance

  Nov 2013 - Jun 2015

  Credentials Auditor

  Responsible for maintaining the quality and reliability of the collection and verification of practitioner applicant’s professional qualifications for enrollment in Indiana Medicaid and Market Place products. Completes initial and ongoing quality audits and monitors the performance of Credentialing Representatives, while providing constructive feedback and education to individual associates. Additionally, responsible for data analysis, action plan development and assisting in the establishment and achievement of business objectives. Show less

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  MDwise, Inc.

  Jul 2015 - Aug 2018

  Manager, Credentialing and Delivery Systems

  Created the Credentialing Team and responsible for the implementation of the Visual Cactus credentialing database for credentialing activities at MDwise, Inc. and MDwise Marketplace. Reviews and audits work assignments. Monitors the quality, timeliness, and productivity of work. Performs data management and reporting from credentials database and ancillary systems. Works directly with the Provider Enrollment team by ensuring the credentialing process of providers is completed prior to enrollment into the health plan. Ensures delegated credentialing entities are contracted and responsible for delegation oversight audits of these entities. Prepares files of providers with adverse actions for review by the health plan’s Credentialing Committee. Prepares periodic credentialing reports for the health plan and the state Medicaid office. Updates credentialing policies and procedures annually and/or when there are changes in NCQA, CMS, federal, and/or state policies. Manages the daily activities of the credentialing supervisor/auditor, five (5) credentialing coordinators, and a credentialing technician. The team credentials a monthly average of 750 physicians, advanced practice nurses, and allied health professionals. Received Excellent rating during the 2015 NCQA survey for the credentialing program. Engages in teamwork functions supporting and cooperating with team members in all departments to achieve individual and team goals. As Delivery Systems Manager, directs and implements the strategic activities related to developing and maintaining MDwise contracted delivery systems. Also performs as a consultant to the MDwise credentialing team. Show less

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  The Stylish Grown Man, LLC

  Feb 2018 - Nov 2024

  Image Consultant
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  Community Health Network

  Aug 2018 - Jan 2024

  Credentialing Coordinator
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  Ascension

  Jan 2024 - Jan 2025

  Manager, Medical Affairs

  Serves as a principal resource for ensuring compliance with internal and external standards, including accrediting and regulatory agencies, and for guiding decision-making/dispute resolution processes. Participates as team member and leader in quality improvement activities related to medical staff and medical staff services, including process improvement, development of policies and procedures, andinformation exchange. Manages staff relations including performance management, staff satisfaction and conflict management. Performs and oversees scheduling, recruitment and payroll. Develops and manages the budget and medical staff account, preparing justification for resourceallocation and suggestions for discretionary fund expenditures, including overtime, revenue and expense reports for medical staff, resource management, and dues and fees collections. Serves as a principal resource for ensuring compliance with internal and external standards, including accrediting and regulatory agencies, and for guiding decision-making/dispute resolution processes. Show less