Maureen A. O’Mara is a results-driven healthcare executive and consultant with over 40 years of experience in case management, medical management, healthcare operations, and analytics. Throughout her distinguished career, Maureen has been a catalyst for transformational change, recognized for her ability to enhance quality metrics, ensure compliance with regulatory standards, and implement innovative solutions that improve patient outcomes and operational efficiencies.
A strategic leader with a passion for healthcare excellence, Maureen has a proven track record of success across various healthcare sectors, including Medicaid and Medicare programs, managed care, long-term support services, and home healthcare. Her expertise extends to driving operational improvements, spearheading quality initiatives, and aligning clinical and business objectives to achieve measurable results.
Maureen’s career journey reflects her versatility and commitment to making a meaningful impact in healthcare. As Vice President and Market Leader for ComplexCare Solutions, she managed a $3 million Medicare complex case management program, achieving over 95% compliance with coding standards and HEDIS performance guarantees. Her leadership in this role significantly improved CMS Stars ratings and reduced hospital admissions and readmissions, while maintaining a stellar 100% NCQA audit success rate.
In addition to her executive roles, Maureen has served as an independent healthcare consultant and subject matter expert, supporting organizations in navigating complex operational challenges. She has worked with entities such as Centene Corporation, Nascentia Health, and Fidelis Care, where she provided strategic guidance on Medicaid long-term care programs, medical management, and population health initiatives. Her commitment to operational excellence was also evident during her tenure as Director of Patient Services and Compliance Officer for Home Instead, where she led start-up development and interim management for a licensed home care service agency.
Maureen’s academic achievements and certifications further underscore her expertise. She holds a Master of Business Administration in Healthcare Systems Management from The State University of New York at Buffalo, a Bachelor of Science in Nursing from Daemen University, and an RN diploma from Buffalo General Hospital School of Nursing. In addition, she is a Certified Case Manager (CCM) and a Lean Six Sigma Green Belt, bringing advanced analytical and process improvement skills to her roles.
An advocate for innovation and data-driven decision-making, Maureen excels in utilizing analytics, Six Sigma methodology, and project management to solve complex challenges. Her work has consistently led to enhanced HEDIS quality scores, reduced operational costs, increased revenue, and improved regulatory compliance.
Beyond her professional achievements, Maureen is an accomplished author, co-authoring “Challenges in Implementing Fall Prevention Programs for Older Adults: A Comparison of Two Models,” published in the Journal of Managed Care Nursing. Her dedication to advancing healthcare extends to her affiliations with the American College of Healthcare Executives and the Academy of Certified Case Managers.
In her retirement, Maureen remains deeply committed to giving back to the healthcare industry. She is passionate about supporting startups and organizations focused on healthcare innovation and growth. With a mission to drive meaningful change and improve patient care, Maureen continues to offer her wealth of expertise to organizations seeking transformative leadership and strategic guidance.
Character
Maureen A. O’Mara is a results-oriented leader driven by a passion for improving healthcare systems and patient outcomes through innovative and ethical practices.
Knowledge
With over 40 years of expertise, Maureen possesses deep knowledge in home health care, case management, medical management, healthcare operations, and regulatory compliance.
Strategic
Maureen excels in developing and implementing data-driven strategies that enhance quality metrics, reduce costs, and align organizational goals with patient care improvements.
Communication
A skilled communicator, Maureen effectively collaborates across diverse teams, translating complex challenges into actionable solutions to achieve measurable results.
