PROVIDENCE – Tufts Health Plan is expanding into the Rhode Island Medicaid market with RITogether, relocating its Rhode Island office to the Providence Journal building on Fountain Street, and is bringing in a new team to support the expansion.
Helene Forte, vice president of emerging markets for Tufts Health Plan, sees two challenges in the expansion into the Ocean State’s Medicaid market: Making eligible people aware they can choose Tufts Health Plan, and communicating the value of RITogether.
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“We know we can have an impact on the health and wellness of Rhode Island Medicaid recipients through our innovative, high quality, high-touch, individualized programs, while at the same time providing great value and services and managing costs for the state. We focus on an integration of medical and behavioral health care, as well as social care management. We bring our best practices to our Rhode Island members. We work to provide our members with the resources and tools needed to understand their health plan, care available and better meet their needs – we need to ensure that our members are aware of our quality and our value,” Forte said.
Forte is responsible for leading and managing Tufts Health Plan’s Rhode Island Medicaid entry, which includes strategy and business planning, government and community relations, sales, marketing and operations. The other members of the new R.I. office team are:
Dr. Tilak Verma, senior medical director
Verma is responsible for clinical activities in Rhode Island, including the development and implementation of comprehensive medical programs and ensuring the delivery of high-quality care to members and enhancing relationships with providers, facilities and regulatory agencies. Prior to joining Tufts Health Plan, Verma served as a regional medical director at UnitedHealthcare for nine years.
Deanna Talley, integrated clinical management director
Talley joined Tufts Health Plan in April 2017. Prior to her new role, she was the associate vice president of case management for Molina Healthcare of New Mexico, and previously held senior leadership positions in care management and health care quality in acute care and payer settings, including Medicaid, Medicare and Marketplace experience.
Jason Brown, provider contracting and relations director
Brown has worked at Tufts Health Plan for nearly 10 years in the Massachusetts and Rhode Island markets. In this role, he oversees and directs the contracting efforts and provider-relationship management for hospitals, physician groups, integrated delivery systems, behavioral health and other ancillary providers in Rhode Island. Brown’s earlier experience includes working at CVS/MinuteClinic in payer-contracting and Conduent Inc. (formally Xerox State Healthcare LLC) as a consultant to the Rhode Island Medicaid managed-care program.
Joy Russell, director of Rhode Island Medicaid Operations
Russell is responsible for overseeing operational functions related to the implementation of the Medicaid contract, including eligibility, enrollment and services as a liaison with claims payments, and member and provider services. In addition, she is responsible for ensuring all service-level agreements and will assume a visible leadership role in the products, services and partnerships offered by Tufts Health Plan in support of the Medicaid plan. Before joining Tufts Health Plan, Russell worked at Dell Services in Providence, where she was a client delivery and customer executive consulting for Blue Cross & Blue Shield of Rhode Island.
Rob Borkowski is a PBN staff writer. Email him at Borkowski@PBN.com.
