Dr. Avishek Kumar, MPH
Executive Director
Mr. Avishek Kumar is a Vice President and Executive Director at The Mihalik Group, LLC, where he brings over fifteen years of extensive experience in Quality Assessment and Improvement, with a focus on compliance with NCQA accreditation standards and HEDIS measures. His career spans various leadership roles in healthcare organizations, where he has led initiatives to prepare and successfully guide entities through NCQA accreditation and reaccreditation processes.
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Mr. Avishek Kumar has played a significant role in the field of Healthcare Effectiveness Data and Information Set (HEDIS), showcasing his expertise as a key presenter at the NCQA HEDIS Best Practices Seminar in both 2008 and 2009. His contributions extend further as the head of the HEDIS Improvement Practice at The Mihalik Group, LLC, where he has led numerous initiatives aimed at enhancing HEDIS performance for various clients. Mr. Kumar's responsibilities have included conducting readiness assessments and developing tailored improvement plans designed to elevate HEDIS scores effectively. His track record demonstrates measurable success in achieving these goals, underscoring his proficiency in leveraging best practices and strategic insights to optimize healthcare quality metrics.
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Mr. Kumar's expertise was highlighted during his tenure as the Director for HEDIS and Stars at Care1st Health Plan, where he played a pivotal role in developing interventions aimed at improving HEDIS performance. His responsibilities included overseeing the Quality Improvement (QI) program, developing work plans, and conducting annual evaluations in alignment with NCQA requirements. He successfully implemented strategies to enhance encounter data collection, resulting in improved HEDIS rates and reduced reliance on medical record reviews.
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As the National Director for Quality and Accreditation at AIDS Healthcare Foundation, Mr. Kumar orchestrated quality improvement and accreditation efforts across multiple departments. His leadership was instrumental in achieving Medicare deemed accreditation status from AAAHC within a year of joining the organization. He meticulously ensured compliance with accreditation standards through rigorous readiness assessments and collaboration with surveyors.
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Mr. Kumar's tenure as the HEDIS Project Lead/Senior Clinical Data Analyst at L.A. Care, a prominent Medicaid health plan in California, further underscored his strategic acumen and leadership in healthcare quality improvement. He directed comprehensive HEDIS reporting activities, managed a diverse team, and spearheaded initiatives that significantly enhanced quality measures. His strategic initiatives included developing multi-year plans for HEDIS goals, fostering collaborative efforts with health plans and medical groups, and implementing real-time data reporting systems to drive performance improvements and cost savings.
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Before relocating to the United States, Mr. Kumar practiced as a licensed physician in India and Nepal, where he provided primary care and supervised intensive care units in hospitals.
Mr. Kumar holds a Bachelor's in Medicine and Bachelor's in Surgery (MBBS) from Manipal College of Medical Sciences in Nepal and a Master's degree in Public Health from the University of California. His technical skills include proficiency in HEDIS software, GEO Networks, Access, SQL, and Lean Sigma Training, underscoring his ability to leverage data-driven insights for healthcare quality enhancement.
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In summary, Mr. Avishek Kumar's career reflects his deep commitment to advancing healthcare quality through strategic leadership, innovative solutions, and compliance excellence in NCQA accreditation and HEDIS reporting. His contributions continue to drive impactful improvements across diverse healthcare settings.