Visionera

DME Services: Health Plan Contracting, Rate Negotiation, Strategic Planning, Expansions, Alternative Payment Models / Value-Based Care, Accreditation

President

Dell Medical School at The University of Texas at Austin

Turning University Research into real-world solutions.  Identifying and mentoring promising med tech innovations and propelling them toward real-world impact. Commercialization Strategies. Business Development.

Texas Health Catalyst Advisor

Soundview Medical Supply

Chief Operating Officer

Prospect Medical Systems

Provider Contracting Manager, South California

TenderHeart Health Outcomes

Transformed corporate strategy, introduced large exclusive MCO contracts, and improved revenue cycle. Oversaw 90+ payer relationships and contracts. Played a significant role in PE acquisition.

Capitation
●Exploded patient volume by 62% and increased EBITDA by 50% in 4 years after securing exclusive contracts.
●Negotiated multimillion-dollar contracts with 3 Managed Medicaid Plans. Secured exclusive contracts with 75% of the state’s Medicaid patients, gaining 30% of the Managed Care market.
●Became the only provider with a demonstrated successful capitation model in Texas, capturing twice the market share as the next largest competitor. 
●Reduced hospital readmissions for targeted diagnoses by 59%, saving Managed Care plan $15M annually.
●Became State’s Capitation Standard after testifying as recognized capitation SME.
●Appointed to Capitation Advisory Boards in multiple Managed Medicaid programs.
●Conducted customer onboarding presentations to 900+ nurses at insurance company.

Operational Optimization
●Differentiated company from other providers by optimizing product delivery to better align with payors.
●Inducted 12K new patients during exponential growth phase by hiring new staff and automating the process.
●Reorganized departments and streamlined processes, reducing hold times and customer fulfillment lead times.
●Consolidated operations by closing 9 branches and migrating to drop shipping.

Chief Operations Officer

Promoted to oversee customer and compliance operations impacting 10K home medical supplies customers in Texas monthly. Implemented processes and systems to improve the company’s reputation. Built strong relationships with Managed Care Organizations and the State’s Health and Human Services Commission to get approval to construct first capitation program in Texas.

Capitation
●Pioneered a “value over volume” differentiated capitation payment model that drove meaningful economic savings for managed care organizations (MCO) partners through appropriate product utilization and better patient outcomes.
●Reduced hospital admissions by 43% after creating a program to align managed care payments with clinical outcomes.
●Successfully transitioned 6K patients to capitation from other providers, with less than 1% opting to stay with the previous provider.

Operational Optimization
●Increased collection ratio from 92% to 97% by improving revenue cycle processes and billing and collections.

Vice President of Operations, Patient Care

Manager of Process Improvement

Authorization Manager

Specializing in creating strategic payer partnerships that drive revenue and improve patient outcomes for DME businesses. Experienced in navigating complex reimbursement landscapes, negotiating favorable contracts, and implementing value-based care initiatives. Proven track record of building strong relationships with payers, providers, and regulatory agencies. 

Passionate about transforming healthcare through collaboration and data-driven insights. Let's connect and explore how Visionera can empower your DME business to thrive.

Heather Davis

UnitedHealth Group

Highly-skilled Clinical Leader who recognizes the complexity of the healthcare delivery systems and is dedicated to advocating for improvements. Strong back ground in clinical operations and expertise in long term care.

-Responsible for overall performance accountability for STAR+PLUS line of business, including profit and loss of product performance.
-Direct and drive product performance through forecasts, budgets and long term strategy.
- Report financial results and business initiative progress to Executive Leadership.  
-Responsible for operational oversight of service coordination and contractual requirements.
-Leadership and oversight of programmatic implementations
-Development of strategic planning and innovation for product performance.
-Maintain a working knowledge of product capabilities and competitiveness in the marketplace. 
- Ensure all organization activities and operations are carried out in compliance with local, state and federal regulations and laws governing operations.

Executive Director Star+Plus Medicaid

o	Leader for all clinical programs for STAR, STAR+PLUS, CHIP and United Dual Special Health Needs Plans in Texas. 
o	Directs and oversees team of service coordination and case management for all service areas. 
o	Manages or coordinates all clinical programs to ensure that they are high quality, member focused and fully compliant.

VP Health Services

o	Successful leadership of large team through clinical improvement process
o	Leadership and oversight of over 150 clinical staff
o	Oversight of SPW department ensuring 100% compliance on 5% at risk measure of ISP submission

Director Of Health Services

Health Services Manager

Highly skilled clinical leader who recognizes the complexity of the healthcare delivery systems and is dedicated to advocating for continuous improvements. Demonstrated history of working in a variety of health care settings. Skilled in Medicaid, Managed Care, Healthcare Management, and Data Analysis. Strong background in clinical operations, strategic planning and expertise in LTSS. Strong business development professional with a Master of Science Nursing focused in Nursing Administration, Nursing Leadership, and Nursing Education.

taplio

The Battle

Heather Davis

Julie Garcia

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