Tricia Mathis

Senior healthcare operations executive with progressive leadership experience directing multi-site clinical operations, operational performance, workforce effectiveness, healthcare quality, regulatory compliance, and organizational growth. Proven record of translating operational priorities into measurable outcomes, including 500% growth in Medicare Part B visit volume, 180% referral growth, $1.9M+ in savings, and a 68% reduction in therapy utilization. Brings experience building scalable operating processes, strengthening quality assurance and QAPI programs, improving utilization and service delivery, and developing workforce capabilities across complex healthcare environments.

Effective cross-functional leader with experience partnering across executive, clinical, and operational functions to align organizational strategy, operational execution, workforce capacity, compliance, and financial performance.

Vice President, Clinical Operations - InHome Therapy - Remote, United States

(2025-01)

• Led multi-state healthcare operations for 370 therapists, enhancing clinical service delivery, workforce performance, quality, regulatory compliance, and operational execution across multiple markets.
• Drove measurable organizational growth by increasing Medicare Part B visit volume by 500% and referrals by 180%, improving operational workflows and aligning clinical capacity with market demand.
• Established scalable operational performance and quality management processes, developing 25 clinical policies that strengthened QAPI, clinical audits, performance monitoring, and corrective-action practices.
• Partnered with executive and cross-functional leaders to align growth strategy with workforce capacity, clinical quality, compliance, and financial performance, enhancing accountability and operational outcomes.

Director of Quality Assurance & Therapy Services - onehome, a Division of Humana Miramar - United States

(2022-01 - 2025-01)

• Led quality assurance and therapy services across five agencies for 6,000 patients, managed clinical quality analysts, assurance coordinators, and therapists, and enhanced clinical operations and care quality.
• Achieved 100% adherence across 18 compliance audits and maintained 100% Joint Commission quality compliance through QAPI leadership, standardized reporting, policy implementation, performance monitoring, and continuous improvement initiatives; also supported four agencies in achieving or exceeding four-star ratings.
• Delivered more than $1.9M in combined wound-care and therapy savings by implementing therapy utilization and bundled-care programs that improved resource management and operational efficiency.
• Reduced therapy utilization by 3,000 visits (68%) in three months by establishing a structured utilization management process and enhancing clinical review of medical necessity and visit requirements.

Cross-Market Care Coordinator - NaviHealth Nashville - United States

(2021-01 - 2022-01)

• Coordinated cross-market patient care by identifying Medicare coverage gaps, tracking cases, and escalating clinician follow-up to ensure continuity of care and timely resolution of patient needs.
• Streamlined care coordination and documentation compliance by monitoring cases, identifying coverage-related issues, and collaborating with clinical teams to ensure accurate and continuous patient care.
• Reviewed up to eight medical charts daily to assess medical necessity, eligibility requirements, and documentation accuracy, enhancing utilization and compliance processes.
• Identified incomplete or inaccurate documentation in approximately 30% of reviewed records, enabling timely escalation and follow-up to address gaps affecting care coordination and coverage decisions.

Learning & Development Specialist - NaviHealth Nashville - United States

(2019-01 - 2021-01)

• Designed and led a structured two-week onboarding program for 3,500 clinicians across five clinical roles, improving workforce readiness across technology, policies, workflows, proprietary tools, and performance expectations.
• Developed clinician education resources aligned with regulatory requirements, achieving 95% compliance adherence across clinical workforce.
• Assessed clinician competencies and identified knowledge gaps, coordinating targeted remediation to enhance workforce performance and readiness for evolving clinical responsibilities.
• Supported transition to digital training platforms, enhancing scalability and consistency of learning and development for a large clinical population.

Patient Advocate - Utilize Health Nashville - United States

(2018-01 - 2019-01)

• Partnered with clinicians and patients to enhance care-plan accuracy and coordination, ensuring alignment of patient needs, education, and clinical recommendations.
• Developed patient education resources that improved communication around care plans and healthcare needs, supporting a more informed and patient-centered care experience.
• Contributed to national committee initiatives on quality improvement and policy development, reinforcing clinical practices and patient-care standards.
• Supported implementation of a new EMR system by testing workflows, identifying process improvement opportunities, and providing practical user recommendations to improve clinical workflow efficiency and technology adoption.

Owner, CEO & Administrator - Tuscany House Assisted Living Viera - United States

(2012-01 - 2016-01)

• Directed daily operations of assisted living organization, ensuring optimal business performance, high-quality patient care, effective workforce management, and strict regulatory compliance.
• Generated $240,000 in annual profit while maintaining 100% occupancy through effective operational management, strategic marketing, and strong referral partnerships.
• Led and developed team of 25 employees, setting clear performance expectations, enhancing staff education, and ensuring operational accountability and quality standards.
• Maintained 100% compliance with internal, federal, and state requirements through audits, quality assurance programs, employee education, risk mitigation, and ongoing regulatory compliance oversight.

Master of Business Administration - Healthcare Administration - Western Governors University

Master of Science - Physical Therapy - D'Youville College