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Deborah Tomba

Director of Care Management

Deborah Tomba is Director of Clinical Analytics and Accreditation at Medical Mutual of Ohio. She is responsible for identifying Care Management initiatives based on predictive modeling tools and claims to decrease corporate pay-out and trend. She oversees clinical performance guarantees and serves as a lead in the accreditation process.

Ms. Tomba is a Registered Nurse who brought extensive hospital clinical experience to Medical Mutual. She held various positions at the Cleveland Clinic Foundation where she specialized in cardiac and critical-care nursing both at a staff level and in management. She also held a supervisory position at Hillcrest Hospital.

Ms. Tomba joined the Company in 1989 and has worked in various areas and progressed through various levels of responsibility in the Care Management department. In her initial role as Utilization Management Nurse Consultant, she reviewed claim requests for authorization of treatment and communicated with hospitals, physicians and subscribers regarding case review determinations. She was promoted to Coordinator for Retrospective Medical Review and went on to be named Supervisor and then Manager of Utilization Management. As Manager, Ms. Tomba was accountable for utilization management programs, including precertification review, concurrent review, retrospective review and discharge planning for the Company’s HMO, POS and PPO products. Prior to her current position and for the last nine years, she served as Director of Care Management, where she oversaw the Company’s case and disease management programs, as well as behavioral health, medical review and medical policy development.

A Licensed Registered Nurse in the State of Ohio, Ms. Tomba received her Diploma in Nursing from St. Elizabeth Medical Center School of Nursing and her bachelor’s degree in Business Administration from Baldwin Wallace College.

Ms. Tomba has been a Diplomat on the American Board of Quality Assurance and Utilization Review Physicians since 1996 and is a Certified Case Manager. She belongs to the Case Management Society of America and the Northeast Ohio Case Management Network.

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