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Tamara Matos

Vice President Stars & Risk Adjustment at Capital BlueCross

Tamara Matos has extensive work experience in the healthcare industry, particularly in roles related to Stars and Quality Ratings. Tamara is currently working as the Stars & Risk Adjustment Sr. Director at Capital Blue Cross since 2023. Prior to that, they worked as the Director of Stars and Quality-Government Business at Capital Blue Cross from 2022 to 2023.

Before joining Capital Blue Cross, Tamara worked at Cigna Healthcare from 2017 to 2022, where they held the position of Star Ratings Operations Director at Cigna HealthSpring of Florida. In this role, they were responsible for developing and managing the Stars Operations strategy, leading cross-functional teams, and achieving 5 Stars for four consecutive years.

From 2015 to 2017, Tamara worked at BlueCross BlueShield of Tennessee as a Star Ratings Operations-Provider Quality Engagement Manager. Their responsibilities included guiding providers and staff in auditing and calculating provider Stars, analyzing and reporting financial impact, and executing Quality and Risk Adjustment interventions.

Prior to that, Tamara worked at First Medical Health Plan, Inc. from 2012 to 2014 as the Star Ratings, CAHPS/HOS, and QI Operations Manager. In this role, they led the implementation, monitoring, and evaluation of the Star Rating Program and acted as the subject matter expert.

Tamara's earliest work experience in the healthcare industry was at MCS Puerto Rico, where they worked as the Quality Improvement Manager-Special Needs Plan (SNP) Model of Care from 2006 to 2012. Their duties included designing and ensuring compliance of the Model of Care and Care Management Programs, implementing quality controls, and coordinating with operational areas.

Tamara Matos has a Master of Business Administration (MBA) with a focus in Quality Management from Universidad del Turabo. Tamara also holds a Bachelor's degree in Biology, General from Inter American University.

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