TJ Shumard

TJ Shumard

Senior Consultant

Nashville, TN

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TJ Shumard has been working in health care for more than 15 years, including work in clinical laboratories and both state and federal governments.  During his career, he spent 11 years working for CMS specializing in managed care quality for all Medicaid and CHIP programs in states and territories.

While at CMS, TJ worked on the 2016 and 2020 Medicaid managed care final rules to improve state oversight and quality within managed care.  He also worked to develop and implement enhanced quality oversight tools.  TJ has extensive expertise in external quality review processes and organizations. He has worked with states undergoing Medicaid expansion or reform to implement their quality oversight programs, as well as performance improvement programs for existing Medicaid programs.

TJ focuses on ensuring taxpayers are receiving great value for their money and that fraud and abuse of Medicaid and CHIP programs are limited.  He searches for cost-effective solution for states, while ensuring the highest quality of care possible.  Having grown up in a rural part of Illinois, TJ has expertise in rural and frontier health care issues and enjoys learning about specific challenges for these communities.

Prior to working at CMS, TJ worked for the State of Maryland Department of Health and Mental Hygiene (DHMH) as a Quality Assurance Manager.  During this time, he worked extensively to implement Money Follows the Person and enroll individuals into home and community-based services (HCBS).  While working at Maryland DHMH, he gained extensive knowledge on Medicaid Management Information Systems (MMIS), billing, fraud, abuse, and neglect of the Long-Term Services and Supports (LTSS) populations.

TJ earned his Master of Public Health from Des Moines University and his bachelor’s degree in biological sciences from Northern Illinois University.

As a fan of aviation, TJ and his son enjoy flying around the country and learning about different historical parts of the country.