Tammy Hall is a results-driven healthcare professional with extensive experience in health plan operations, specializing in compliance, risk management, and regulatory adherence. With a proven track record in leading comprehensive compliance programs, Tammy has successfully guided health plans through the complexities of CMS guidelines, state, and federal regulations.
Throughout her career, Tammy has excelled in developing and implementing robust compliance frameworks, conducting in-depth risk assessments, and leading audits to ensure operational excellence. Her expertise spans Medicare Advantage and Part D programs, appeals and grievances, delegation oversight, peer-to-peer audits, and corrective action plans. She is adept at managing privacy complaints, handling regulatory submissions, and driving process improvements that enhance productivity and mitigate risk.
Tammy has held pivotal roles at prominent health plans, including KelseyCare Advantage, HealthTeam Advantage, and Blue Cross Blue Shield of North Carolina. In these positions, she led cross-functional teams, streamlined operations, and fostered a culture of ethical conduct. Her leadership in overseeing FDR compliance, preclusion screenings, and fraud, waste, and abuse programs has consistently upheld the highest standards of regulatory compliance.
Known for her collaborative approach, Tammy works seamlessly with internal and external stakeholders to navigate complex regulatory landscapes, ensuring successful audits and investigations. She is also a dedicated mentor and trainer, elevating organizational compliance awareness through education initiatives.
