Mary Walter, BS, DPN, RN
Managing Director, Quality and Accreditation
Salt Lake City, UT
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Mary Walter is an accomplished executive leader with more than 30 years of experience in healthcare including extensive work in managed care insurance the past 25 years, quality and oversight of every aspect of health plan operations. She is deeply entrenched in the commercial, Medicare, Medicaid and Marketplace quality space that includes strategy and execution in quality compliance, interventions, population health, HEDIS, Stars, risk adjustment, value-based care and pay for performance, risk management, accreditation, delegation oversight, vendor management, geographical expansion and more.
Mary has worked managing state Medicaid relationships, both commercial and government business, meeting employer group, CMS and state quality regulations, including various accreditation requirements. In addition, she has led health plan quality operations and developed key partnerships to create and execute high quality programs and projects. She has partnered with multi-faceted provider groups including integrated delivery, fee-for-service, and capitated network models as well as accountable care organizations, management services organizations and independent practice associations to carry out upside/downside risk value-based care and pay for performance programs to improve the quality of customer care outcomes.
Before joining HMA, Mary founded and served as president of Healthcare & Integration Solutions, LLC. (HCIS), where she provided her expertise on quality measures including state Medicaid audits, Stars and HEDIS performance, patient safety, and quality compliance. She also supplied insight on strengthening fiscal operations in areas including marketing and sales, budgeting, product and market expansion, and key performance indicators.
Mary has also served as vice president of clinical quality of U.S. Medical with Cigna Medicare and has held several quality leadership roles with the top payers including Coventry, Aetna (now CVS Health), UnitedHealthcare, Anthem, Kaiser Permanente, and Molina Healthcare.
In those positions and experience, she led strategy, execution, and growth of the clinical quality teams, where she elevated population health management strategy and quality compliance oversight. Her leadership resulted in a CMS All Star nomination by passing the CMS audits for organization determinations, appeals and grievances, special needs plan model of care, and supported first-tier, downstream and related clinical entities. In addition, she supported her leadership team to fully pass HEDIS, risk management and NCQA audits with top scores year over year. She also received top regional and national awards for the TeenScreen Depression and Suicide Prevention Program at Kaiser Permanente.
Mary earned a Bachelor of Science degree in exercise physiology, and a minor in health at Iowa State University. In addition, she is a registered nurse, earning a three-year diploma, practical nursing degree at Iowa Methodist School of Nursing in Des Moines. She also holds a certification in process improvement/LEAN six sigma as an Improvement Advisor from KP National Process Improvement Institute.
She volunteers her time serving as a key board member for a non-profit organization that has a national footprint and volunteers in the community Food Share Program assisting families with food insecurities. Mary’s other passions include specialty cooking, entertaining, biking, hiking, raising an organic garden, landscaping, reading, and serving in her local church.