Dr. James L. Voiland DNP, MBA, MSN, RN, CMCN's Email Addresses & Phone Numbers

📖 Summary

Principled For-Profit and Not-For-Profit Leadership [email protected] As a highly accomplished Healthcare Executive, I possess a time-tested record of progressive experience managing high quality, efficiently run health plan operations in the for-profit and not-for-profit sectors. A well respected team builder, leader, and collaborative business partner, I lead by example, instilling a shared vision that brings people together, and “makes things happen.” Building and Managing Efficiently Run Operations… Catalyst for transformational change and exponential growth with an impressive array of achievements that include building high-performing teams, restructuring underperforming operations, starting up new divisions, and developing/implementing new programs for driving member growth, accelerating revenues, and maximizing profitability. Select accomplishments…  Built the infrastructure and team for a new state-wide medical call center at Amerigroup.  Restructured El Paso First Health services operations after being labeled insolvent by Texas Department of Insurance; restored operational net profit to a positive balance in one month.  Transformed financial performance of multiple health plans through market/product expansion initiatives, operational redesign, and new member programs.  Developed all health service expansion plans for new business initiatives at El Paso First Health; expanded product line beyond core Medicaid population and doubled membership from 45K to 90K+.  Dramatically reduced the MLR at both Amerigroup and El Paso First Health Plans; took Amerigroup from 139% to 79% MLR in three years and El Paso First Health from 130% to high 70% / low 80% level. Expertise that Drives Transformational Change and Growth… Team Building, Development and Retention — Operations Start-up, Expansion and Growth — Fiscal Management and Cost Control — Organizational Development and Restructuring — Strategic Business Development — New Business DevelopmentChief Operations Officer and Medical Operation Director, Regional VP, El Paso @ Direct all aspects of Healthcare Management Services (HCMS) operations in the State of Texas, comprised of 600+ associates across all medical management functions serving ~800,000 members for health maintenance organization (HMO). In addition, oversee all health plan operations in the El Paso service delivery area. Ensure that division meets or exceeds all metrics related to pay-for-quality initiatives. Serve as liaison to the Health Plan President for all nursing and clinical issues. From 2015 to Present (less than a year) El Paso, TXChief Operations Officer, El Paso Health Plan @ Led all operational activities required to start-up the health plan in March, 2012, which manages care of ~20,000 El Paso residents enrolled in the Texas Medicaid STAR+PLUS and Medicare programs. Reporting directly to the President/CEO of Texas, managed all aspects of health plan operations, with full accountability for quality improvement regulatory compliance (local, state, federal), and annual administrative, medical, and capital budget development and management. From 2011 to 2014 (3 years) El Paso, TXSenior Director of Health Services @ Served as key advisor and business partner to the President/CEO and Board of Directors, in addition to continuing to perform all director-level responsibilities of prior position for multi-line, non-profit HMO. Collaborated with senior leadership in the areas of policy development and improvement, preparation of annual budget, and strategic planning and execution. Maintained communications with external stakeholders, including community providers, community organizations, and Texas regulatory authorities. From 2010 to 2011 (1 year) El Paso, TXDirector of Health Services @ Rebuilt the health plan after El Paso First Health Plans was deemed insolvent by the Texas Department of Insurance, and restructured and led the Health Services Department, the largest department in the company with eight units, and multimillion-dollar annual premium revenue. Administratively directed activities of the Quality Improvement, Utilization Management, Case Management, Prior Authorization, Credentialing, Customer Service, and Physician Advisory committees. From 2006 to 2010 (4 years) El Paso, TXManager of Medical Management @ Managed the most efficient Medical Management Department for multi-line HMO in the Centene national network, while consistently maintaining the lowest MLR. Created and implemented state-wide policies and procedures and served on planning committees in establishing national policies and procedures. From 2004 to 2006 (2 years) El Paso, TXPrior experience @ Diverse positions in clinical care management and nursing with Del Sol Medical Center, Superior Health Plans, NurseWise, BMA Dialysis, Sierra Medical Center, and University of Michigan Medical Center. In addition, served in variety of nursing roles as Lieutenant in the US Army. From 1995 to 2004 (9 years) Doctor of Nursing Practice (DNP), Executive Administration @ Texas Tech University Health Sciences CenterMaster of Business Administration (MBA) @ University of Phoenix-New MexicoMaster of Science in Nursing (MSN) @ The University of Texas at El PasoBachelor of Science in Nursing (BSN), Nursing @ University of Michigan-Ann Arbor Dr. James L. Voiland DNP, MBA, MSN, RN, CMCN is skilled in: Healthcare Management, Healthcare, Medicaid, Managed Care, Physician Relations, Healthcare Consulting, Utilization Management, Medicare, HIPAA, Hospitals, Healthcare Information..., Disease Management, Healthcare Industry, Quality Improvement, Revenue Cycle, EHR, EMR, JCAHO, Home Care, Insurance, Provider Relations, Acute Care, Nursing, Case Management, Critical Care, Inpatient, Elder Care, HMO, Management Training and..., Program Development and..., P&L Management and..., Product Line Expansion, Regulatory Compliance, Policies Development..., Revenue and Profit..., Team Building,..., Operations Start-up,..., Fiscal Management and..., Organizational..., Strategic Business..., New Business Development, Operations Management, Health Plan Operations, Not for Profit, Operational Efficiency, Financial Performance, Health Service..., Start-ups Management, Cost Control, Team Leadership