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Delaware Technical & Community College
Leadership Development Program Participant (2006-present)
 | Served as the Chairperson of the Administrative Retreat Committee to
prepare a two day administrative in-service program. |
Histotechnician Technology Program Coordinator (2004-present)
| Increased the program seats from 1 or 2 students per year to 8. |
| Increased the clinical facilities from 1 to 4 sites. |
| Revised the curriculum and course objectives for all Histotechnician
technology courses. |
| Implemented a summer Internship program in 2005 which is funded by a
NIH INBRE Grant with a purpose to expose undergraduates to biomedical
research. Ten students have participated thru 2007. |
| Achieved a program graduation rate of 84% and board certification pass
rate of 92%. |
| Prepared a NAACLS reaccreditation self study and hosted a successful
site visit in 2006. |
| Chairperson of the Histotechnician Technology Advisory Committee and
Clinical Affiliates Committee. |
DoctorQuality.com, Philadelphia, PA (1999-2001)
A venture capitalist
funded start-up Internet company (www.doctorquality.com) that provides
healthcare quality information to consumers through a Business-to-Business
Model.
Vice President of Government & Channel Partnerships (1999-2001)
| Identified, negotiated, and serviced Federal Healthcare contacts
and agreements, which brought 8 million users to the products. |
| Developed a consumer portal that incorporated a Medical
Knowledgebase and Triage Knowledgebase into our product line. |
| Involved in strategic planning for an Independent Review
Organization (IRO) and project leader to develop the IRO to supervise the review
of HMO denials and Peer Review. |
East Jefferson General Hospital, Metairie, LA (1996-2000)
A 507-bed
tertiary care/teaching medical center/ Integrated Health Care System with annual
revenue $450 million and 2,300 employees. Direct report to the CEO.
Senior Vice President Integrated Physician Network, 1996-2000
| Webmaster for an Internet web site (www.ejgp.org) to address business needs
- archive and communicate information to EJGP providers. |
| Project Team Leader for a new Family Practice Residency Program with
capital and operation budget responsibilities. Successfully developed into an
eighteen resident program. |
| Created and managed East Jefferson Group Practice (EJGP) for risk
contracting and premium management. Developed and promoted a business strategy
that the best utilization management exists when the hospital and physicians
perform delegated functions together and aligns incentives to improve clinical
outcomes. |
| Designed a financial model of low-risk, zero equity, equal governance based
upon zero deficit pools and equal sharing of hospital reserves. |
| Marketed the concept to physicians and achieved 90% contracting rate by
contracting with 167 specialists. |
| Designed EJGP case management by integrating ambulatory guidelines,
successful inpatient clinical pathways, and facility-based care management and
ambulatory case management into a comprehensive continuum of care system for a
model to manage premium without duplication of resources. |
| Started the first Medicare global risk agreement with QI & UM
delegation in 1999. |
As line officer for East Jefferson Physician Network (EJPN) - developed and
presented to administration and EJGH Board of Directors and "sold" a
new business strategy that the employed physicians' productivity and
income/expense should be measured and benchmarked individually. EJPN
provided 156,000 patient encounters for over 81,000 patients with annual
revenues of $20.7 million.
| Managed 200 employees including Central Business Office (CBO) and physician
offices (44 physicians; 10 mid-level providers; & office staff) in 14
sites. |
| Controlled $21.6 million operating expenses 3% better than budget, and
improved the overall net revenue collection percent, for the CBO, to 88%. |
| Planned EJPN to be the foundation to develop Quality Improvement (QI) and
Utilization Management (UM) Programs, which would be incorporated into EJGP
later. Implemented in 1996, these programs are consistent with JCAHO and NCQA
Standards and incorporated HEDIS based guidelines & studies, patient
complaint tracking, patient satisfaction surveys and a morbidity/mortality
reporting system. |
| Created policies and procedures to compliment the QI and UM Programs and
comply with regulatory agencies including HCFA, NCQA, JCAHO, CLIA and OSHA.
Resulted in successful JCAHO reviews for physician office lab surveys (October
96 and October 98) and ambulatory survey (November 97). |
| Identified a strategic partner to implement an Obstetrics Information
System Database and share best practices among physicians through a forum of
bi-weekly Obstetricians and Perinatologist meetings. Resulted in a decrease in
primary (18% to 12%) and total (37% to 29%) C-section rates. |
| Integrated data from hospital Oracle-based Electronic Data Repository and
EJPN financial systems to create an integrated reporting and monitoring of QI/UM
Key Performance Indicators. Resulted in QI/UM Program Evaluation for EJPN and
EJGP. |
| Identified needs for enterprise-wide master person index, common
registration, electronic medical record and rules engines to assist in
corporate compliance, pre-billing coding audits and outcomes monitoring. |
PCA Health Plans of Florida (1994-1996)
North Florida Region
encompassed 37-counties with 80,000 members in Medicaid, Medicare and
commercial products. Annual premium revenue of $128 million. Overall
administrative expenses were 9.5% of revenue.
North Florida Medical Director/Director of Medical Affairs, Jacksonville FL
(1995-1996)
Managed $123 million medical expenses. Responsible for operations management
of 80 staff within Utilization Management, Quality Improvement, Provider
Relations, Claims Reconciliation and Credentialing departments. Managed bed
days: commercial 197 Medicaid 297 and Medicare 1534. Served as instructor for
regional Health Services Paradigm. Served as chairman of State Pharmacy and
Therapeutics Committee. Liaison with state and federal regulatory agencies.
| Maintained the medical loss ratio for all three products less than 1%
variance from budget. |
| Implemented sub-capitation agreements in North Florida one example being
ophthalmology through Premiere Eye Care. Resulted in a $687,000 annual
savings. |
| Developed QI Program for Tallahassee region and assisted in refining QI
Program for North Florida. Resulted in NCQA Accreditation in March of 1996 (PCA). |
| Implemented a system-wide asthma program, "ABC's of Asthma,"
involving Primary Care Physicians, Allergists, Home Health Providers and
patients in the North Florida region in partnership with Metabolic
Consultants. |
| Standardized QI and UM data extraction and reporting from Pensacola,
Gainesville, Tallahassee and Jacksonville in the North Florida region. Worked
to combine the same standardized reporting systems for the three Florida
regions. |
Tallahassee-Pensacola Region Medical Director, Tallahassee FL (1994-1995)
Responsible for Medical Affairs, Quality Improvement, Provider Relations and
Credentialing departments for an 18-county area encompassing 20,000 Medicaid and
commercial members. Reconciled in-patient admissions and length of stays to
centralized computer database; conducted rounds with concurrent review nurses
for daily reports and discharge planning; and reviewed commercial certificates
of coverage and Agency for Health Care Administration Medicaid contract to
create covered benefit summaries for referral coordinators.
| Improved authorization turnarounds by fax to less than eight hours;
telephone answered on first call with 4% abandonment rate; only 5% pending
authorizations. |
| Developed QI Program and wrote 1994 QI Program Evaluation, 1995 QI Program
Description and 1995 QI Work Plan for regional QI Program and coordinated it
with the State QI Department. |
| Performed delegation of Credentialing to IPA's while complying with
regulatory and NCQA requirements. This included site-visits and establishing
corrective actions. |
| Expanded Medicaid and commercial products into three new counties. |
| Implemented Total Quality Management in Tallahassee. |
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