James F. Falls

Work History

Queen’s University Medical Group

12.2021 - 02.2025

Implement provider template adjustments to increase RVU and maximize access to care, boosting productivity and service efficiency
Conduct monthly budget meetings with analysts to ensure fiscal responsibility and adherence to budgetary guidelines across four clinics
Ensure compliance with The Joint Commission (TJC) standards through regular tracer checklists, achieving a 73% reduction in deficiencies in 8 months
Write, update, and distribute clinic SOPs to ensure effective training and guidance for new and existing staff
Oversee the successful implementation of the CMS PCF program, ensuring compliance and optimizing program outcomes
Collaborate with COREO to close critical care gaps, driving increased revenue and improving patient care processes
Successfully transitioned three clinics from CMS CPC+ to Primary Care First (PCF), ensuring smooth adaptation to new program standards
Developed and implemented training curriculum for clinic staff, increasing Annual Wellness Visits from 11% to 24%
Designed the framework for the Ambulatory Administrative Patient Discharge Process, enhancing workflow efficiency and compliance
Achieved regulatory compliance by maintaining up-to-date knowledge of industry standards and guidelines.
Overhauled outdated clinic procedures and workflows in four clinics, increasing efficiency and ensuring alignment with current best practices in healthcare management.

United Healthcare, Hawaii

10.2018 - 12.2021

Led the development, implementation, and ongoing management of a clinical program with 4 external stakeholders in eleven locations.
Produced accurate and timely data reports for internal use and clinical performance tracking, driving improvements based on analysis
Trained staff in administering Social Determinants of Health (SDOH) surveys, improving understanding and accuracy of data collected
Managed and supported audits, ensuring compliance with clinical, financial, regulatory, and quality standards
Conducted process mapping and analysis to streamline operations, improve staff efficiency, and reduce workflow disruptions
Developed and delivered SDOH survey training, creating performance reports for clinical partners that identified progress and areas for improvement
Created an evaluation checklist that streamlined site evaluations, eliminating ambiguity and improving operational efficiency
Developed and maintained strong relationships with key stakeholders, ensuring successful collaboration on clinical initiatives.
Presented progress reports and findings at conferences, showcasing the organization's commitment to cutting-edge research and clinical excellence.
Conducted thorough data analysis to identify areas for improvement, driving continuous program enhancements.

U.S. Army – Schofield Barracks, Hawaii

08.2016 - 07.2018

Directed medical operations in support of contingency operations, coordinating the clinical care of Soldiers while supporting the Army’s response force mission
Led a team of 8 officers and 7 enlisted personnel, advising the 25th Infantry Surgeon and ensuring the successful management of clinical operations and template scheduling
Coordinated mandatory training for medical staff, including HIPAA, Joint Commission, ethics, and equal opportunity training
Increased the Medical Simulation Training Center’s efficacy from 89% to 96% by restructuring instructional methods
Achieved a 98% EMT-B license rate among eligible Soldiers through improved training programs

U.S. Army – Schofield Barracks, Hawaii

06.2014 - 08.2016

Supervised a team of 35 personnel responsible for the reception and integration of incoming Soldiers and their families to U.S
Army Hawaii
Worked with over 10 military and civilian agencies to ensure seamless support for Soldiers and their families, including housing, medical, and financial assistance
Managed training and regulatory compliance for new personnel, ensuring all requirements were met before assignment
Expanded the reception and integration program to accommodate all Army personnel assigned to U.S
Army Garrison Hawaii, increasing operational capacity
Developed a swim assessment program, improving safety awareness for Soldiers and leadership
Ensured 100% completion of regulatory requirements for incoming Soldiers, improving compliance tracking and program outcomes