Former TennCare Director of Compliance Oversight and Non-Emergency Medical Transportation Tammy Mihm discusses how the organization strengthened accountability, centralized information, and improved compliance management.
TennCare is Tennessee’s Medicaid program, serving millions of residents through a network of managed care organizations and other contracted partners. Like many state Medicaid agencies, TennCare is responsible for monitoring contract performance, reviewing deliverables, ensuring compliance, and maintaining accountability across a complex ecosystem of internal stakeholders and external organizations.
To improve visibility, accountability, and efficiency, TennCare implemented Harmony Healthcare IT’s Managed Care Oversight™ solution. The highly configurable solution was tailored to TennCare’s unique workflows, reporting requirements, and stakeholder needs. The result was a centralized system that helps manage contract deliverables, streamline communication, track reviews and responses, and maintain a comprehensive record of oversight activities.
We spoke with Tammy Mihm, former Director of Compliance Oversight and Non-Emergency Medical Transportation at TennCare, about her 30-year career with the organization and the impact of the solution on accountability, operational efficiency, and long-term program integrity.
Want to learn more? Read the full TennCare case study to see how the organization partnered with Harmony Healthcare IT to modernize managed care processes.
Q: Can you tell us about your background and your role at TennCare?
Tammy Mihm: I spent 30 years with TennCare, working primarily in compliance oversight and non-emergency medical transportation. My responsibilities included overseeing managed care compliance activities, monitoring contract requirements, working with internal and external stakeholders, and helping ensure accountability across the program. During that time, I collaborated with Harmony Healthcare IT to implement Managed Care Oversight™.
Q: How would you describe Managed Care Oversight™?
Tammy Mihm: The solution is an end-to-end platform for managing compliance oversight, contract deliverables, stakeholder communication, and accountability. It supports the review process, communication among stakeholders, and, when necessary, sanctions or corrective actions. Rather than relying on emails, spreadsheets, and manual tracking, everything is managed within a single system.
The solution brings information from multiple stakeholders and business processes together into one centralized, accessible view. Internal and external partners can see the information relevant to them, communicate within the system, and maintain a complete record of activity.
Q: What challenges was TennCare trying to solve before implementing the solution?
Tammy Mihm: Previously, much of our compliance management work was manual. Tracking deliverables, assigning ownership, monitoring deadlines, and documenting responses required significant effort from a very small team. Internal stakeholders didn’t always have visibility into what was expected of them, and there were limited mechanisms for ensuring deliverables were reviewed and addressed on time.
Managed Care Oversight™ helped solve those problems by creating a more structured process and centralizing information that was previously scattered across multiple locations. It reduced the manual effort associated with collecting, validating, and reporting information while providing a more consistent source of data for oversight activities. It also supported TennCare’s broader modernization efforts by creating a stronger foundation for compliance monitoring, reporting, and operational improvement initiatives.
Q: What are the biggest benefits provided by the solution?
Tammy Mihm: The biggest benefit is accountability. Every communication, review, comment, and notification is documented within the solution. Stakeholders can see what actions have been taken, what still needs attention, and who is responsible. That eliminates much of the uncertainty and lack of awareness that can occur when information lives in multiple places.
The system’s role‑based access structure has proven invaluable in providing flexibility when needed. It allows TennCare to grant read‑only access for audit activities or restrict certain information so it is viewable only to internal users, ensuring both transparency and appropriate data protection.
External partners, such as MCOs, also have a high level of trust in the system. When they receive a communication that does not originate within the tool, they proactively notify TennCare and request that it be routed appropriately. Their reporting processes, whether RFP submissions or corporate leadership updates, are fully aligned with and supported by the system.
Another significant benefit is having a centralized source of truth. Instead of searching through emails or piecing together information from multiple systems, users can see everything related to a specific deliverable in one location. Review comments, communications, responses, documentation, and decisions are all connected to the same item. That streamlines communication, improves collaboration, and gives everyone confidence that they are working from the same information.
The automation built into the system is also incredibly valuable. Notifications and reminders are distributed automatically, reducing reliance on manual follow-up and helping stakeholders stay on schedule. There is also greater confidence in the consistency and reliability of data used for reporting and oversight.
Finally, the solution delivers significant efficiency gains. At the time of implementation, our managed care function operated with a team of only two people. Once the solution was in place, we spent far less time managing administrative tasks and gathering information. Instead, we could focus on analyzing data, addressing issues, and supporting other important program priorities. That time savings ultimately allowed us to devote additional attention to non-emergency medical transportation, which is a critical service for Medicaid members.
“The biggest benefit is accountability. Every communication, review, comment, and notification is documented within the system.”
— Tammy Mihm, former Director of Compliance Oversight and Transportation, TennCare
Q: How important was customizing the solution for TennCare?
Tammy Mihm: It was absolutely critical. Our original system was essentially an off-the-shelf product, and we found that it couldn’t fully support our unique processes. What made this different was that it was developed around TennCare’s specific needs.
During the discovery and development process, the Harmony Healthcare IT team took the time to learn our workflows in detail. By the end of the engagement, they understood our processes almost as well as we did. That allowed them to create workflows that worked not only for our compliance team but also for the many departments and external partners involved in the process. The result was a solution designed around our operational requirements rather than forcing us to adapt to the limitations of generic software.
Q: TennCare also partnered with Harmony Healthcare IT for data archiving. Why was that important?
Tammy Mihm: Maintaining historical records was a major requirement for us. When we transitioned from our previous system, we couldn’t risk losing years of compliance and contract data. Harmony Healthcare IT helped archive those records and made them searchable through a link directly within Managed Care Oversight™.
Users can quickly retrieve historical information when needed for audits, investigations, operational reviews, or compliance activities. The solution preserves continuity while eliminating concerns about losing access to important legacy data.
“The information isn’t sitting in a file room somewhere. It’s stored in a way that remains accessible and useful for years to come.”
— Tammy Mihm
Q: What advice would you give other Medicaid agencies evaluating a solution to more effectively monitor managed care?
Tammy Mihm: First, identify your stakeholders and clearly define their responsibilities. A successful Medicaid program depends on accountability, and the right solution should make that accountability visible and measurable.
Second, look for a partner that understands both the technology and the operational realities of your organization. Every organization operates differently, so flexibility and configurability are critical. We spent a great deal of time mapping processes, discussing needs, and determining what mattered most. In the end, that work produced a solution that continues to deliver value years later.
What stood out to me about Harmony Healthcare IT was their willingness to learn our business, collaborate closely with our team, and remain focused on helping us achieve our goals. The result was a solution that improved oversight, simplified access to information, and created a foundation for future initiatives.
Having a solution that can scale and adapt as needs evolve is incredibly important. We initially implemented the solution to support three MCOs and their compliance teams, along with Pharmacy and Dental Program managers and each of TennCare’s program areas. Since then, TennCare has expanded its use to support additional contracts across multiple operational areas.
