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Senior Vice President Operations in San Francisco Bay CA Resume Jackie James

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Senior Vice President Operations in San Francisco Bay CA Resume Jackie James Powered By Docstoc
					                                            Jackie L. James
                                            Pacifica, CA. 94044

                         e-Mail: jackie@aemerus.com Telephone: 972-248-1040



                                                Summary

       Executive experience with 20 years of excellence in leadership, leveraging operations,
       marketing, strategy and financing to create winning corporate cultures. Led human resources
       and assumed responsibility for hiring, firing and employee development consistent with
       company values. Built senior management teams, setting strategy and vision. Developed
       budgets and actively formed partnerships to advance profits. Strategic oversight of capital
       allocations to optimize the bottom line. Ensures regulatory compliance.


                                      Professional Experience

AEMERUS Consulting Group – Dallas, Texas
Senior Vice President                                                                    2006 – Present

      Expert in current health reform issues and implementation of solutions to navigate fluid environments.
      Facilitated the development of a software program to detect under and over payments of medical claims.
      Built a Change Management practice based on Six Sigma principles to achieve operational excellence.
      Consulted with large medical practices to effect revenue optimization and OIG compliance.
      Expanded firm’s reach into focused, high performance provider network development.
      Collaborated on the development of advanced medical practice management systems.
      Returned to restructure operations after acting as the CEO for Airway Technologies.


Airway Technologies, LLC – Carrollton, Texas
Chief Executive Officer                                                   2010 - 2011
Vice President Business Development                                       2009

      Formulated financial and operating reporting mechanisms for the Board of Directors.
      Organized and supervised a financial funding team to secure new capital investments.
      Replaced costly and ineffective direct sales model with leveraged distribution model.
      Introduced dental sleep medicine to large self funded employers, MCOs & union welfare trusts.
      Successfully effected a cost based turn- around after prior CEO launched a failed expansion program.
      Created and launched the Dental Institute of Sleep Medicine to generate new revenue sources.
      Negotiated with insurance companies to establish coverage and maximize reimbursement policies.
      Formed a team of external financial and legal experts to facilitate recasting the company’s governance
       structure to be eligible for institutional funding without disrupting the owner’s estate planning.
      Restructured and integrated two companies which yielded an improved cost structure including more
       effective supply chain management.
       Resume of Jackie L. James                                                               Page two

Horizon Health Corporation – Lewisville, Texas
President, Horizon Behavioral Services, Inc.
Senior Vice President Horizon Health Corporation                          2003 – 2006

      Led a diverse organization with 194 employees in 5 large nationwide regional offices.
      Directly responsible for all financial aspects with an annual revenue for FY 2004 of $52.8 million.
      Responsible for EAP and Managed Behavioral Health Organization operating unit of Horizon Health.
      Integrated five operating units secondary to acquisitions by Horizon into a finely tuned single entity.
      Restructured Sales, Account Management and clinical delivery divisions to dramatically improve ROI.
      Reduced company’s total operating budget yielding a $4.4 a four million turn-around in 18 months.


One Health Plans, Division of Great West Life – Glendale, California
President, Western Region
Vice President Great West Life Assurance                                  1997 – 2003

      Developed a provider network consisting of 60,000 HMO providers for the western region.
      Built and implemented licensed HMOs in the complex environment of California and Arizona.
      Assumed corporate responsibility for establishing network development protocol at the national level.
      Directed and was accountable for all operational, financial and medical management aspects of the PPO
       POS, and HMO products of the Great West Life’s Western Region.

Health Net – Woodland Hills, California
Regional Vice President, Network Management
Director, Medicare Operations
Executive Director, Central California
Regional Sales Manager                                                    1992 – 1997

      In charge of a provider network servicing 340,000 commercial and Medicare members.
      Restructured key provider contracts that revitalized and enhanced relationships with those providers.
      Successfully developed a combined contracting approach for expansion into multiple product lines.
      Strategically built teams to expand development, contracting and maintenance of provider members.
      Led day-to-day Medicare operations including CMS compliance and member services.
      Managed and directed all aspects of Medicare member enrollment and membership accounting.
      Built and implemented the Medicare Operations Department to accommodate net membership growth of
       50,000 within one single year with a substantial increase of over 200%.
      Responsible for the integration of five CMS Medicare risk contracts into a concise operational platform
      Lead manager for the complex merger activities between both Health Net and the QualMed entities.
      Accountable for, sales and marketing activities for three large and extremely busy regional offices.
      Increased membership by 10,000 net new members (15% increase) and cultivated member retention.

                                                Education

       Ashford University                   B.A.. Healthcare Administration in progress (Senior)
       MBA Certificate Program              Freeman School of Business Tulane University
       Executive Development Finance        Haas School of Business, University of California Berkeley
       Business Administration              Fresno City College, Fresno, California

				
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Description: Jackie James has executive experience with 20 years of excellence in leadership, leveraging operations, marketing, strategy and financing to create winning corporate cultures. Jackie led human resources and assumed responsibility for hiring, firing and employee development consistent with company values.