Experienced Consultant Healthcare and IT

CONSTANCE PHILLIPS-JONES RN, MSN, CCM, CPHQ

* *** *’Huyere

Devon, PA 19333

Home phone: 484. 580.6037

*****@*******.***

QUALIFICATION SUMMARY

Visionary, energetic healthcare executive with demonstrated success in clinical consultations, project and relationship management. Expertise includes:

Strategic Planning

Clinical Study Oversight

Personnel Management

Contract Negotiation

Clinical System Implementation

Population Health Management

Care Management (UM, CM, DM)

Change Management

Continuous Quality Improvement

Regulatory Compliance

Consultation

Training

Public Speaking

PROFESSIONAL EXPERIENCE

TATA Consultancy Services (TCS); Edison, NJ 2015 – present

Global service provider, technology

Director, Clinical Programs

Senior individual contributor role Health Care Practice

Medecision, Inc., Wayne, PA 2008 – 2015

Technology provider for collaborative health care management solutions

Principal, Clinical Consultant

senior individual contributor role

oSubject Matter Expert, provides guidance and oversight to other team members on billable projects

supports other key processes (release management, employee training and sales).

Mentor for new employees

Support Solution Architecture Group in sales process

Provide input to Resource Managers for Performance and Coaching of team members

Act as escalation point for Customer/Project Issues.

Support Director of Professional Services with strategic projects related to Professional Services

Longport, Inc., Glen Mills, PA 2004 – 2008

Ultrasound Technology

Director, Clinical Support

Clinical Support department executive oversight

oMember senior leadership team

Regulatory compliance Class 1 medical device

Developed and implemented company promotion program

oManage company communication plan

Coordinate clinical support program to support distributors and direct sales

Identify and implement opportunities for clinical consultant role

oCommunication plan for healthcare professionals

Direct and implement clinical implementations

oCoordinate publications

Develop and manage training programs

Direct and implement clinical studies

Keystone Mercy Health Plan/Amerihealth Mercy Health Plan, Philadelphia, PA 2002 - 2004

Medicaid HMO with over 250,000 members

Director, Case/Disease Management

Peer Review Organization of New Jersey (PRONJ), East Brunswick, NJ 2001- 2002

Health Care Quality Improvement Organization

Project Leader

Oversight for identification of Medicaid recipients with Mental Health problems

eligible for federal disability coverage.

Amerigroup New Jersey Inc., Edison, NJ 2000 – 2001

Local Medicaid HMO Plan with over 81,000+ members

Associate Vice President, Medical Management

FutureHealth Corporation, Timonium, MD 1999-2000

A national Risk Management Organization and Population Health Risk Management organization serving the Health Benefit/insurance market.

Vice President, Clinical Operations

Trigon Administrators, Richmond, VA 1998-1999

Third Party Administrators for Property and Casualty Risk Management.

Director, Managed Care Services (Interim)

U.S. PHYSICIANS, Ft. Washington, PA 1996-1998

Physicians practice management company and provider organization..

Vice President, Network & Product Development

THE PMA GROUP, Blue Bell, PA 1991-1996

A regional property/casualty insurance company.

Vice President, Managed Care Services 1994-1996

Assistant Vice President, Managed Care Services 1992-1994

Director, Managed Care 1991-1992

Developed start-up managed care approach for workers’ compensation line. Reduced loss ratio average 10% in first – months.

Improved claims process efficiency and eliminated duplicate payments and overpayments reducing medical payments by 10%.

Developed integration of medical case management with disability management improving claims closures by 25% reduction physical therapy expenditures by 35%.

Managed staff of 52 throughout mid-Atlantic region and $1.5MM budget.

Negotiated and managed vendor contracts reducing expenses by 50%.

Developed integrated information systems, which reduced manual reviews by 30%.

Developed information system, which improved management and customer reports to illustrate corporate value and program compliance.

Served as member of insurance Federation Task Force for PA Act 44 cost containment regulations preserving legislative intent.

Developed marketing materials and customer education seminars improving retention.

Developed integrated Disability Management pilot program for PMA employees streamlining process and contributing to new STD, LTD, workers’ compensation product.

For two years, worked management/administrative/clinical assignments while attending full-time graduate school.

PENN HEALTH CORPORATION, Maxicare Subsidiary, Philadelphia, PA 1986-1989

Local Medicaid HIO plan, 100,000+ recipient members.

Director, Utilization Management and Quality Assurance

PHOENIXVILLE HOSPITAL UNIVERSITY of PENNSYLVANIA HEALTH SYSTEM

100+ bed Community Hospital

Part-time (minimum 16 hours/month)

Part-time Nursing Administrative Coordinator 2001-2005

Part-time Case Manager 2006-2009

HOSPITAL, MEDICAL COLLEGE OF PENNSYLVANIA, Philadelphia, PA 1984-1986

300+ bed tertiary acute care hospital.

Manager, Emergency and Trauma Center

TEACHING EXPERIENCE

Immaculata University, College of Lifelong Learning, Immaculata, PA, present. Adjunct faculty

Thomas Jefferson University, School of Nursing. Philadelphia, PA, 2002. Clinical Instructor.

Mercer County Community College, School of Nursing. Trenton, NJ, 2001-2002. Adjunct faculty. Clinical Instructor, all levels.

St Francis University, Joliet, Ill, 2000. Undergraduate School for Healthcare Administration ” Principles of Healthcare Administration”

University of Maryland, Baltimore, MD 1999-2000. Graduate School, College of Nursing Affiliate Professor; Clinical Preceptor.

Villanova University, Villanova, PA, 1993-1994. Graduate School, Education: Instructor: “Medical Management and Cost Containment.”

Villanova University, Villanova, PA 1992-1996. College of Nursing, Graduate Studies, Clinical Preceptor: “Corporate Case Management: Practicum”; Instructor: “Role Theory & Role Development”; Guest Speaker: “Case Management – The Corporate Model”.

Methodist Hospital, School of Nursing, Philadelphia, PA 1981-1984. Instructor: “Leadership and Team Leading”, “Medical-Surgical Nursing”, “Emergency and Critical Care”. Chairperson, Curriculum Committee; Member, Admissions Committee.

EDUCATION

M.S.N. Administration. Villanova University College of Nursing, Villanova, PA

B.S.N. University of Pennsylvania School of Nursing, Philadelphia, PA

Diploma, Professional Nursing. Frankford Hospital School of Nursing, Philadelphia, PA

RN, Pennsylvania (license # 212-302 L), New Jersey (To be provided on request)

Certified Case Manager, CCM, 2001Commission for Case Manager Certification, Rohling Hills, IL

Certified Professional Health Care Quality, CPHQ, 2011 National Association for Healthcare Quality, Glenview, IL

PRESENTATIONS

Webinar, April, 2011. Dorland Publishing: “New Regulations for Medical Loss Ratio: An Opportunity for Case/Care Managers to Demonstrate Outcomes”

Webinar, January, 2012. Dorland Publishing: “Beyond the EHR: Optimizing Care Coordination”

Presentation, June, 2012. Case Management Society of America: “How to implement and use technology to improve outcomes.”

Presentation, September, 2013. Dorland Healthcare Measurement Conference: “Population Analytics: The Turnkey Solution to Accountable Care Delivery”.

PUBLICATION

Phillips-Jones, Connie, Technology and the Medical Home: Back to the Future. Case In Point. September, 2011

Quintavalle, Paul, Connie Phillips-Jones, et al Using High Frequency Ultrasound to detect Pressure Ulcer Pathogenesis. Advances in Skin and Wound Care, April, 2006

PROFESSIONAL AFFILIATIONS

Current, Volunteer, Commission for Case Management Certification (CCMC): Item Writing (certification exam)

Current, Member, Case Management Society of America (CMSA)

Former, Board Member, Philadelphia Chapter, Case Management Society of America

Former, Advisory Board Member, Case Management Program, Graduate School of Nursing, Villanova University -Villanova PA

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