Michael Fopiano's Email & Phone Number
Health care executive; Experienced operations specialist; Staff optimizer; Innovative problem-solver
Michael Fopiano's Work Experience
Director, Member and Provider Services
July 2013 to Present
Director, Customer Service
January 2001 to January 2010
New England Memorial Hospital
Assistant Director of Pharmacy
May 1988 to October 1993
Michael Fopiano's Education
Bentley University - McCallum Graduate School of Business
January 1995 to January 1999
Massachusetts College of Pharmacy and Health Sciences
January 1982 to January 1984
January 1978 to January 1982
Michael Fopiano's Professional Skills Radar Chart
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Michael Fopiano's Estimated Salary Range
About Michael Fopiano's Current CompanyTufts Health Plan
Frequently Asked Questions about Michael Fopiano
What company does Michael Fopiano work for?
Michael Fopiano works for Tufts Health Plan
What is Michael Fopiano's role at Tufts Health Plan?
Michael Fopiano is Director, Member and Provider Services
What is Michael Fopiano's Phone Number?
Michael Fopiano's phone (413) ***-*132
What industry does Michael Fopiano work in?
Michael Fopiano works in the Insurance industry.
About Michael Fopiano
💼 Past Experience
Michael Fopiano is currently a Director, Member and Provider Services at Tufts Health Plan in Watertown, Massachusetts. Operations Manager, Member Services at Harvard Pilgrim Health Care from 1995 to 2001 (6 years). Planned, organized and provided oversight to all operations to two Member Services Call Centers, which received over 750,000 calls annually. Responsible for all long-range and strategic planning; design, development, and implementation of quality improvement initiatives targeted at service improvement; staff productivity, and staff satisfaction. Managed a performance evaluation program that effectively combined qualitative and quantitative measurements for all call center staff members. Pharmacy Program Coordinator at Harvard Pilgrim Health Care from 1993 to 1995 (2 years). Responsible for coordinating the issues surrounding the pharmacy benefit as it pertains to the impact on various departments within Pilgrim Health Care. Developed pharmacy/physician-based specialty reports to promote Preferred Drug List and Formulary to physicians. developed and implemented more restrictive Formulary. Promoted the Preferred Drug List and Formulary within the pharmacy network. Director, Appeals, Grievances & Quality Assurance at Harvard Pilgrim Health Care from December 2010 to July 2013 (2 years 8 months). Oversee the full investigation, documentation, and resolution of member appeals in full compliance with all state, federal, DOL, NCQA, and CMS requirements ensuring the highest possible accreditation results. Promoter of the Preferred Drug List and Formulary within the pharmacy network. Director, Customer Service at Harvard Pilgrim Health Care from 2001 to 2010 (9 years). Led all aspects of customer relationship management for members, employers, brokers, and prospective members by understanding all aspects of service delivery and represented the voice of the customer in all internal activities. Responsible for the formulation of the organization’s near term and long-range customer goals and objectives, and the plans and programs directed toward their achievement. Responsible for all regulatory and NCQA standards for customer service. led operations of more than 140 staff members. Successfully managed annual budget of over $9 million. Also, responsible for developing business plans to support specific strategies and goals to ensure high quality and efficient interactions with members via the telephone, the internet, walk-in and IVR applications that will positively influence membership retention and grow membership. Provided oversight and leadership to contact centers, including performance management, quality management, internal and external communications, and training. Established all policies, procedures, work processes, and governance of departmental operations. Grew and expanded the member service centers into a best-in-class operation by improving access, expanding service channels, and improving member satisfaction. Maintained senior management focus on member service results. Responsible for Alliance relationships with United Health Care & Optum Behavioral Health. Assistant Director of Pharmacy at New England Memorial Hospital from May 1988 to October 1993 (5 years 6 months). Provided oversight of pharmacist assignments, performance evaluations, and recommendations for merit increases and promotions. Coordinated continuing education programs, purchasing and inventory control, Quality Assurance programs. Prepared
Michael Fopiano has a Bachelor of Science degree in Pharmacy from Massachusetts College of Pharmacy and Health Sciences, which he obtained in 1982. Afterwards, he completed a Master of Business Administration degree from Bentley University in 1995. From there, he continued his education by studying at the McCallum Graduate School of Business at the University of Tennessee in 1999. There, he obtained a Master of Business Administration degree in Business Administration from the University of Tennessee in 1999. Additionally, Fopiano has also completed coursework in addition to his formal education in Biology at Boston College as a B.S. in 1978. In total, Michael Fopiano has completed a total of 36 colleges and universities inside of the United States and outside of the United States.
💡 Technical & Interpersonal Skills
Michael Fopiano’s work experience has experts in many different areas and it has not been reported that he has any particular specialty. He has worked in many different positions in health care and has plenty of experience withoperated services and problem-solving. Fopiano also has experience with customer service, health care administration, and relationships with other businesses.Michael Fopiano is currently a Director, Member and Provider Services at Tufts Health Plan in Watertown, Massachusetts. He has been responsible for all operations,I assessed and managed the organization’s performance, and led operations of more than 140 staff members. Fopiano has been with Tufts Health Plan for over 10 years, and has been responsible for developing, implementing, and monitoring quality management systems and Quality Assurance programs.Michael Fopiano is also a Pharmacy Program Coordinator at Harvard Pilgrim Health Care from 1993 to 1995. He was also responsible for coordinate the issues surrounding the pharmacy benefit as it pertains to the impact on various departments within Pilgrim Health Care. From 2001 to 2010, he was also responsible for all aspects of customer service, and represented the voice of the customer in all internal activities. He also developed and implemented a more restrictive Formulary, and promoted the Preferred Drug List and Formulary within the pharmacy network.Michael Fopiano is currently a Director, Appeals, Grievances & Quality Assurance at Harvard Pilgrim Health Care from December 2010 to July 2013. He was responsible for the full investigation, documentation, and resolution of member Appeals in full compliance with all state, federal, DOL, NCQA, and CMS requirements ensuring the highest possible accreditation results. Fopiano is also a primary contact for all escalated member issues for all state regulatory agencies, including, MA, ME, and NH Divisions/Bureaus of Insurance. buttocks white
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In a nutshell
Michael Fopiano's Ranking
Ranked #155 out of 3,104 for Director, Member and Provider Services in Massachusetts
Michael Fopiano's Personality Type
Extraversion (E), Sensing (S), Feeling (F), Judging (J)
2 year(s), 0 month(s)
Michael Fopiano's Willingness to Change Jobs
Open to opportunity?
There's 72% chance that Michael Fopiano is seeking for new opportunities