JFM was created in part to honor our fallen soldier - our son, Taylor Camron Veroni. He was awesome. And, he would have wanted us to live our full and passionate lives. So after 30 plus years in corporate America - we decided to quit. We want to be able to find time to have fun, be with our extended family and still provide for our lives, so we created this consulting company. We travel extensively and offer our services to every thing from small companies to large corporations most often for short term engagements where we can find value, offer our services and enjoy the life we are called to live.
I am Julie, and I was in executive positions in both provider and health plan organizations.
Scott was a information officer and self taught data guru.
Together we believe that we can find companies who need assistance during this time of health care reform and provide them with our services. Contact us if we can help you.
AREAS OF EXPERTISE
EMR and HIE Business Oversight
Clinical Innovations for cost saving
Quantifiable measurement of change
PROFESSIONAL EXPERIENCE
▪ Capacity Management ▪ Vendor Relationships ▪ Provider Integration
Consulting:
6 month contract for on site leadership in RBO Southern CA - oversight of Internal audit team, PDR, CSR, Adjustments, Special projects and DMHC Remediation
HNFS for west coast network build
Compliance and back office support for Financial services team
Vice President, Molina Healthcare of Texas
▪ Responsible for Dallas and El Paso Markets for Medicaid, Medicare and Marketplace (ACA) products
▪ Network Development and Management
▪ Provider Services
▪ Community Engagement
Vice President, Network Development, California Health & Wellness ▪ Principle for startup operations of a new Health Plan
o Strategic in the issuance of Knox Keene license
o Built a complete Medi-Cal managed care network of providers in 19 rural counties
o Collaboration and leadership in all aspects of health plan operations
o Business planning and modeling for rate construction for hospitals, physicians, FQHC, RHC, Indian Health, Ancillary, and support services
o Claim and configuration support for the network of 4000 providers
Leadership and management for the ongoing Contract negotiations and network management. Strategic planning for hospitals, medical groups, and ancillary providers.
Director, Managed Care, Sutter Health
▪ Contract negotiations and network management for Northern California system of hospitals, medical groups, ancillary and joint ventures.
▪ Special emphasis on Cost of Health Care, Accountable Care Organization requirements, Shared Savings programs, Covered California and health care reform activities for state programs.
Administrator, Continuum of Care, Kaiser – Morse Avenue Campus
Accountable for Direct leadership in: Outside Services, Eldercare, Continuing Care Outreach, Durable Medical Equipment, licensed hospital based Home Health and Hospice Agency, Palliative Care program for two campuses, Outpatient Dialysis, Advanced Care planning, and several behavior based outpatient service programs for adult day care, mental health and autism.
Focused on Utilization Management, Case Management, Health plan benefit administration and improved quality outcomes for the transition in health care delivery system in and out of Kaiser for 1.2M covered lives
Shared oversight of 394 employees
Budget responsibility $81M (operations and expenses including Claims
Director, Managed Care, Catholic Healthcare West (Dignity Health)
▪ Contract negotiations and network management for hospitals, medical groups, ancillary and joint ventures
▪ Fiscal performance review of strategic service lines with executive reporting
Contract Manager, Health Information Services, WellPoint (Blue Cross of California) Managed all hospital contracts statewide for MediCal Managed care Start up operation.
Manager, Small Group and State Sponsored Business, Blue Cross of California, Performed key role in Operational development and daily management of Business Unit for including Claims, Case Management, Utilization Management, and call center operations.
Hospital based nursing 1980-1989
Master’s, Business Administration 1996 – University of Phoenix Bachelor’s of Science, Nursing 1980 – Harding University
Specific work experience:
Education & Training
Formally trained as a Registered Nurse, license inactive
Staff and Management positions in a hospital environment in the Emergency Room, ICU, CCU, NICU and the medical and surgical floors
Comfortable with multitasking environments and able to prioritize, delegate, and track a wide range of concurrent tasks or projects
Over 20 years working in State Sponsored or Government related Health plan and provider programs, specializing in network development and management
Experienced and proficient in PowerPoint, ABC Flow Charter, Excel, Microsoft Word, Access, CERNER, MS4, Muse, Rubicon, ARTIVA, MIDAS, Bed Tracker technology, phone systems and Mainframe applications
Knowledgeable and accountable to a budget process
Experienced in both California, as well as Federal, regulations on health care. Work experience in Texas, Oklahoma, Virginia, Nevada and Arizona on Non California state sponsored programs
Direct hands on work in Medi-Cal, Medicaid and Medicare including Dual Eligible, Rural demonstration, Medicare Advantage, Medi-Cal Managed Care, Covered California, Pathway to reform and other similar government programs.
o Capitation payment
o Membership
o Network Development o Utilization Management o Vendor Relationships
o Business development
○ Medical Review
○ Physician relationships
○ Hospital Operations
○ Medical Group relationships ○ Database functions
○ Process re-engineering
History of responsibilities that span large geographic areas and the use of technology to be effective and efficient in that arena
Regular interface with Hospital CFO, CNE, COO and Presidents on numerous projects