Michael Jones Email & Phone Number

Tampa, Florida, Us

Satellite Beach, Florida, Us

Value based care consulting and professional speaking

Bethesda, Maryland, Us

Managed three distinct Accountable Care Organizations (ACO) comprising medical practices from single physician groups to 50+ physician multi-specialty practices, IPAs, and community health centers/ federally qualified health centersGrew our market from 12 practices with 16,000 beneficiaries / lives under management to 32 practices with 36,000 beneficiaries / lives under management - exceeding growth target for three cyclesSuccessfully facilitated and led assisted in the negotiation with four major health plan, adding additional gainshare contracts Led a team of over 15 employees including physicians, clinical team members, field operations and technical specialistsFacilitated addition of hospital automated admissions, discharge, and transfer feeds from less than 5% coverage to greater than 80% coverageServed as chairman of the board for three distinct ACOs, facilitating meetings with physicians, CEOs and stakeholdersLed the legal and compliance policy adherence for all three ACOsLed our ACOs to shared savings in three out of three years; with 2020 leading two of the three ACOs in Alabama to achieve shared savings out of eight in-state ACOsResponsible for leading Alabama ACOs in three years to deliver over $36 million in savings to Medicare / CMS, resulting in distributing over $12 million to Alabama physician practices, resulting in over $7 million in revenue to companyMaintained a Net Promoter Score (NPS) of greater than 86 for three consecutive years, with is top 2% at company, and top 1% industry-wideServed as co-lead and founder of two Employee Resource Groups (ERGs): Veterans and Male Allyship for Women in LeadershipMaintained relationship with Alabama Department of Medicaid and other statewide organizations to deepen relationships and results

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Medicare General Manager for Alabama and Arkansas

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Managed care leader with overall operations responsibility for the state of Alabama for Medicare & Retirement. Broad responsibilities in the following areas:Quality - Responsible for performance of the entire in Medicare Stars and overall quality initiatives. Led a team of quality consultants and clinicians in partnering with providers across the state, hospitals, health systems, and physician groups. Developed and presented incentive programs from traditional quality incentive programs, ACOs / shared savings and shared risk arrangements, and managing clinically integrated networks. Identified opportunities for performance improvement with provider groups and developed plan for quality improvement. Collaborated with licensed pharmacist to work with providers, independent and retail pharmacies, and members in driving medication adherence performance. Drove quality from 2.3 in 2011 to 4.00+ in 2017, trending toward 4.00 in 2018. Growth - Partnered with healthcare economics and product team to develop benefit plans and model expansion to develop robust health plan footprint, with benefits that are rich enough to drive growth, but sustainable in the market. Worked with sales leadership to develop strategy, and worked with individual sales managers and agents to train and coach agents on selling. Media trained through corporate office and did over 20 television and radio appearances across the state. Drove membership from the lowest health plan in the state in 2011 with 34,000 members to the #1 health plan in the state by size in 2018 with over 70,000 members.Affordability - Led inter-departmental team of medical director, clinical staff, and healthcare economics to identify trends and opportunities for medical cost savings through partnerships with health systems, hospitals, physicians and other providers. Led hospital and health system join operating committees, Responsible for achieving average annual cost savings of $11 million per year.

Contracted hospitals and physician practices for a startup Medicare Advantage plan, focusing on value based care and star ratings. Medicare Advantage plan sales

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decision support, financial analysis, benchmarking, reporting and trending

Little Rock, Ar, Us

traditional industrial engineering including time studies, workflow analysis, productivity and efficiency, and reporting to senior managers.

Norfolk, Va, Us

Personnelman 3rd Class - performing general administrative and computer duties. Served on board the USS Antrim, qualified as watchstander, firefighter, and rescue swimmer. Served in MIUWU 209 communications unit.

Mba, Business Administration And Management, General

Bachelor Of Science (B.S.), Operations Research