James T. Kerr, Consortium Administrator, 212-616-2205

Carol Maloof, (Acting) Regional Administrator for New York and Boston, 617-565-1188
Nancy O'Connor, Regional Administrator for Philadelphia, 215-861-4140
Carol Maloof, Deputy Regional Administrator, Boston, 617-565-1188
Gilbert Kunken, Deputy Regional Administrator, New York, 212-616-2205
Roseanne Egan, Deputy Regional Administrator, Philadelphia, 215-861-4796

Thomas Devins, Associate Regional Administrator, Boston Division of Medicare Health Plans Operations, 617-565-1321
Reginald Slaten, Associate Regional Administrator, New York Division of Medicare Health Plans Operations, 212-616-2300
James McCaslin, Associate Regional Administrator, Philadelphia Division of Medicare Health Plans Operations, 215-861-4156
Gloria Parker, Associate Regional Administrator, Atlanta Division of Medicare Health Plans Operations, 404-562-7361
Candace Arnold, Associate Regional Administrator, Chicago Division of Medicare Health Plans Operations, 312-353-1777
Julie Kennedy, Associate Regional Administrator, Dallas Division of Medicare Health Plans Operations, 214-767-6420
Kathryn Coleman, Associate Regional Administrator, Kansas City Division of Medicare Health Plans Operations, 816-426-6518
Tod Anderson, Associate Regional Administrator, Denver Division of Medicare Health Plans Operations, 303-844-2126
Barbara Weller, (Acting) Associate Regional Administrator, San Francisco Division of Medicare Health Plans Operations, 415-744-3622
Cathy Smerker, Associate Regional Administrator, Seattle Division of Medicare Health Plans Operations, 206-615-2371

Functional Statement

• Serves as the Field focal point for all interactions with managed health care organizations, Medicare Advantage Plans, Medicare Prescription Drug Plans and Medicare Advantage Prescription Drug (Part D) plans for issues relating to Agency programs, policy and operations.

• Serves as the Field's focal point for all Agency interactions with employers, employees, retirees and others operating on their behalf pertaining to issues related to Agency policies and operations concerning employer sponsored prescription drug coverage for their retirees.

• Serves as the Field focal point for all interactions with beneficiaries, their families, care givers, health care providers, and others operating on their behalf concerning improving beneficiary's ability to make informed decisions about their health and about program benefits administered by the Agency. These activities include strategic and implementation planning, execution, assessment and communications.

• Implements national policy for Medicare Parts C and D beneficiary eligibility; enrollment; entitlement; premium billing and collection; coordination of benefits; rights and protections; dispute resolution process; as well as policy for managed care enrollment and disenrollment to assure the effective administration of the Medicare program.

• Participates in the development of national policies and procedures related to the development, qualification and compliance of health maintenance organizations, competitive medical plans and other health care delivery systems and purchasing arrangements (such as prospective pay, case management, differential payment, selective contracting, etc.) necessary to assure the effective administration of the Agency's programs, including the development of statutory proposals.

• In conjunction with CPC handles all phases of contracts with managed health care organizations eligible to provide care to Medicare beneficiaries.

• Responds to inquiries regarding Parts C and D coverage and payment policies.

• Implements national policies and procedures to support and assure appropriate State implementation of the rules and processes governing group and individual health insurance markets and the sale of health insurance policies that supplement Medicare coverage.

• In conjunction with the CPC, implements regulations, guidelines, and instructions required for the dissemination of appeals policies to Medicare beneficiaries, Medicare Advantage (MA) plans, Prescription Drug Plans (PDPs), CMS regional offices, beneficiary advocacy groups and others interested parties.

• Assures, in coordination with other Consortium Administrators, Central Office Centers and Offices, the activities of Medicare managed care plans, agents, and State Agencies meet the Agency's requirements on matters concerning beneficiaries and other consumers.

• In partnership with appropriate Central Office Offices, administers the contracts and grants related to beneficiary and customer service, including the State Health Insurance Assistance Program grants.

• Participates in the formulation of strategies to advance overall beneficiary communications goals and coordinates the Field implementation of all beneficiary-centered information, education, and service initiatives.

• Builds a range of partnerships with other national organizations for effective consumer outreach, awareness, and education efforts in support of Agency programs.

• Serves as the Consortium focal point for emergency preparedness for the field.

• Provides oversight in the areas of human resource procurement and logistics.

• Ensures the effective management of the Agency's information technology, and information systems and resources in the field.

• Implements the privacy and confidentiality policies pertaining to the collection, use, and release of individually identifiable data.

• Proactively establishes, manages, and fosters partnerships within the region with State and local governments, providers and provider associations, beneficiaries and their representatives, and the media that are focused on CMS' goals and objectives.

• Serves as the primary point of contact to appropriate members of Congress, State Governors, Federal, State, and local officials and tribal governments on matters concerning the Medicare and Medicaid programs.

• Oversees the coordination and integration of CMS activities with other Federal, state, local, and private health care agencies and organizations.

• Counsels, advises, and collaborates with top Agency officials on policy matters and major considerations in developing, implementing, and coordinating CMS' programs as they interrelate in addressing national and regional strategies.

• Advises the Office of the Administrator (OA) on special programs as they relate to national initiatives and as they impact major constituents or their key representatives.

• Promotes accountability, communication, coordination and facilitation of cooperative corporate decision-making among CMS top senior staff on management, operational and programmatic issues cross-cutting organizational components with diverse functions and activities.

Functional Statement for the Office of the Regional Administrator

• Serves as the principal office for Regional operations of the Centers for Medicare & Medicaid Services.

• Serves as focal point among Regional Office components for special initiatives and broad cross-cutting issues.

• Develops and implements a media relations plan to market CMS programs to the diverse populations of the region.

• Coordinates environmental scanning and strategic planning for the region. Pursues activities which enable regional office staff to become knowledgeable regarding developments and trends in health care delivery within the region.

• Effectively implements CMS special initiatives at the regional level.

• Monitors the Regional administrative budget, including oversight of the Regional travel funding allocation.

• Manages procurement and contracting activities, and personnel administration for the region.

• Oversees facilities and property management, labor-management relations, EEO and staff training for the region.

• Initiates and directs the implementation of special regional projects.

• Assures effective relationships within the region with State and local governments.

• Fully coordinates with the DHHS Regional Director to assure effective relationships with Congressional representatives and other DHHS components.

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Page Last Modified: 01/14/2009 11:26:49 AM
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