Nicole “Nicki” Bongiovanni is a quality improvement leader focused on driving health plan quality.
Just as the healthcare landscape continues to change at a rapid pace, so do accreditation requirements. Nicki knows National Committee for Quality Assurance (NCQA) accreditation requirements inside and out. She evaluates Medicaid contract compliance for health plan readiness assessments, collaborating with plans on procurement and accreditation preparation. Recently she led efforts for a nationwide Medicaid health plan to assemble the necessary documentation for its accreditation survey submission.
As someone with health plan roots who has been on the front lines of quality improvement, Nicki meets her health plan clients where they are at – and works shoulder to shoulder with them to assess their needs and tailor solutions that ensure their accreditation success. She has extensive experience helping health plans improve quality and determine the best way to highlight their quality programs and outcomes. Focus on population health outcomes continues to increase, and Nicki has successfully worked with health plans to craft strategies for meeting new NCQA population health compliance requirements.
Prior to joining HMA, Nicki was quality improvement manager for a Michigan health insurance company with Medicaid, commercial and Marketplace lines of business. Her leadership helped the company achieve NCQA accreditation for all three lines of business. She led the HEDIS, Consumer Assessment of Health Plan Provider and Systems (CAHPS), and the Qualified Health Plan (QHP) Enrollee survey projects. Additionally, she worked with her team to conduct an analysis of those performance measures including HEDIS, CAHPS, and QHP Enrollee survey results, while identifying priority areas and implementing an overall improvement strategy. Nicki developed and wrote a population health management strategy for the plan that included quality improvement initiatives for vulnerable populations such as high-risk members, members with health disparities, and members with multiple physical and behavioral health conditions.
Nicki previously served as director of case management for a 380-bed tertiary care center that provides sub-specialty care to patients across the country and from around the world. She directed implementation of a multidisciplinary collaborative approach and visual controls to reduce excess days by seven percent at the center. She also led efforts to sharply focus on transitional assessments of high-risk patients and improving transitional care coordination by partnering with community agencies. These efforts resulted in a significant reduction in the center’s readmission rate.
Nicki was born and raised in Michigan. She is a busy mom of four teenagers. When she has downtime, she enjoys spending it with family and friends in northern Michigan on Lake Michigan.