CFE, CMAS, CFCE
Corporate Investigations, Healthcare Fraud
Michael has over 35 years of healthcare operations, regulatory compliance, business process improvement, financial, and investigative experience serving in executive leadership and consulting roles.
As a commissioned US Army Medical Service Corps officer, Michael attended numerous training courses conducted by the at the US Army Medical Department, including the US Army Medical Department Officer Basic and Advanced Courses, the Armed Forces Combat Casualty Care Course, and the US Army Medical Department Health Services Comptroller Internship Program, as well as courses at the US Army Finance School, US Army Logistics College, and US Army Management Engineering College. Highlighted leadership positions include assignments in mid- and senior-level advisory and management positions at hospitals and clinics, as well as the Headquarters, United States Army Health Services Command, where he defined hospital and clinic missions, developed organization and functions manuals, applied manpower staffing standards, planned, programmed, and executed operational budgets in excess of $500 million, conducted regulatory and financial audits, and wrote healthcare standard operating procedures. Subsequently, he was selected to direct and manage financial operations at Keller Army Community Hospital supporting the United States Military Academy, West Point, where he was also designated the Assistant Inspector General for Medical Affairs.
After completing military service, Michael successfully leveraged his education, knowledge, skills, and abilities in the private sector. He has held numerous senior-level management positions and has made numerous contributions to achieving organizational goals at health care organizations across the United States including Physician Corporation of America, Comprehensive Care Corporation, Wellcare Health Plans/Harmony Behavioral Health, BeHealthy America, and Blue Cross Blue Shield of Arizona Advantage. In addition, Michael has worked in various consulting roles as a Subject Matter Expert and Project Manager in business intelligence, competitive analysis, and new business development, strategic planning, financial and operational auditing, business operations and process improvement, regulatory compliance, appeals and grievances, provider network assessment and management, and the prevention, detection, investigation and reporting of suspected fraud, waste, and abuse.
Michael has also performed extensive research and attended continuing professional education courses on regulatory compliance, ethics, healthcare fraud, waste, and abuse, project management, auditing, and relatedsubjects to meet annual certification requirements.
“James and the SunHawk team have been an invaluable resource for our Compliance Office – they are a reliable, well experienced, trusted and knowledgeable team of professionals who at a moment’s notice will take your calls or respond to your emails.
Their advice helped us navigate the ever evolving, highly regulated healthcare industry! Whether it’s discussing report methodology or determining appropriate repayment, SunHawk provides the reassurance and confidence that you are doing the right thing!
We are honored to have partnered with SunHawk and will continue to do so in the future!“
Vice President/Chief Ethics, Compliance and Privacy Officer
Community Health System
“SunHawk’s professionals are leaders in the compliance and risk industries. Over the years I have worked with a number of their professionals on a series of projects/issues and learned SunHawk’s professionals are problem/solution-oriented and great coalition builders.
SunHawk Professionals get the job done and are a pleasure to work with. Commitment, Experience, Professionalism, and Integrity; that’s what SunHawk Professionals brings to the table.”
Vice President/Chief Ethics, Compliance and Privacy Officer
Phoenix Children’s Hospital
“Jim Rough is among the most conscientious professionals I have encountered. When he says he is going to do something — he does it. Jim has a broad range of experience gained over decades in leading organizations.
Now as the founder of his own firm, Jim will be enabled to provide the same high-quality service to his clients in a setting that allows greater customization to his clients’ financial circumstances.”
Frank M. Placenti
Chair, US Corporate Governance & Securities Regulation
Practice, Squire Patton Boggs
“SunHawk Consulting’s HIPAA Check Program provided us with an invaluable third-party review of our HIPAA policies and practices. The tracking tool SunHawk includes with the Program has become an integral part of our continued monitoring for HIPAA compliance.
Jan Elezian’s extensive hands-on compliance experience was evident during site visits and staff interviews as she translated difficult subject matter into practical use scenarios and provided quality feedback. Thank you SunHawk team!”
Vice President, Compliance
Chicanos Por La Causa, Inc.
“SunHawk provides an array of dynamic professionals, each with significant subject matter expertise and a problem-solver approach. Beyond their knowledge and conscientious work ethic, however, is a team of caring individuals who strive to furnish individualized, tailored assistance with a personal touch.
Jim Rough’s dedication to the success of SunHawk clients is evidenced by his strategic and prospective thinking complemented by his ability to truly anticipate the needs of a company in the midst of the complicated compliance climate. I highly recommend SunHawk for companies of any size seeking actionable solutions and measurable results.”
Vice President and Chief Compliance Officer
Paragon 28, Inc.
“Jim is an innovative partner, highly skilled at listening carefully to client objectives and translating those into actionable solutions. Jim has been a trusted colleague for over six years and is a consistently dependable resource for solution-oriented ideas and action plans.
Jim drives teams and projects to produce highly valued results with a flexible approach to meet the needs of the client and his team members. Jim challenges his colleagues to exceed expectations and anticipate hurdles making everyone around him a better, more skilled contributor in the process.”
Kelleen O. Brennan
“Jan Elezian’s Comprehensive Healthcare compliance knowledge base and positive attitude have made is possible for us to complete many compliance projects with tremendous outcomes. If you face complex compliance needs you would be fortunate to work with Jan and SunHawk Consulting.”
Healthcare Revenue Cycle Director
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2550 E Rose Garden Ln.
Phoenix, AZ 85050
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