University of Washington

Reed College

University of California, Irvine - The Paul Merage School of Business

Clinical Operations Executive at L.A. Care Health Plan

Streamline operations to improve clinical outcomes for 2M health plan members through efficient processes that support the provider network.  Report directly to the Chief Medical Officer (CMO) and Chief Operating Officer (COO). Works collaboratively with Health Services and Operations leadership and management across the organization to develop and implement clinical and non-clinical functional standards and processes to ensure end-to-end operational integration. Oversee the planning, organization, direction, staffing and development of Utilization Management, Care Management, and Managed Long Term Services & Supports departments which includes clinical and non-clinical FTEs. Ensure regulatory compliance through oversight of internal and delegates’ UM & CM functions, operations for direct lines of business and/or managed service agreement functions, and interface with external agencies including local governing bodies, Plan Partners and other external organizations. Plan and execute significant outsourcing initiative including development of workflows, business rules, training, oversight and monitoring. Oversee design and implementation of new core clinical software system and tools.

L.A. Care Health Plan

Clinical Operations Executive

Managed departments of Utilization Management, Case Management, Long Term Services & Supports, Behavioral Health, and Program Support, encompassing up to 550 FTE with annual budget over $50M.  Member of senior leadership team; reported to Plan President.  Teams coordinated benefits and services for Medi-Cal, Medicare (Cal MediConnect and Dual Special Needs Plan) and Covered California products and meet complex regulatory requirements in seven counties.

Molina Healthcare of California

Vice President, Health Care Services

Department of 260 FTEs comprised of complex case management, transitions of care and Community Connector (community healthworker/promotora) programs.

Molina Healthcare

Associate Vice President, Case Management

Director Of Case Management

SCAN Health Plan

Director, Compliance Administration

Health Education Specialist

Supervisor, Independent Living Power

Reported directly to physicians and PhD staff with multiple research grants and academic appointments.
•	Project Director, Department of Medicine, UCLA in association with VA Greater Los Angeles: managed national end-of-life educational initiatives for physicians
•	Program Coordinator, Brentwood Biomedical Research Institute (VA Greater LA, UCLA): managed Robert Wood Johnson-funded innovative case management program for veterans with end-stage congestive heart failure, COPD and lung cancer
•	Data Analyst/Research Assistant, Seattle Institute for Biomedical & Clinical Research (VA Puget Sound, University of Washington).  Received Performance Award. 
•	Mental Health Research Associate, VA Medical Center, Portland, OR in association with Oregon Health Sciences University.  Received Performance Award.

Veterans Health Administration

Medical Research (multiple)

Jennifer Rasmussen