Jentry Hinton

Accomplished Vice President with progressive industry background and decisive leadership style. With 13 years of managed care and healthcare experience, driving transformational change and improved clinical outcomes through effective strategies and business operations. Aligns systems with business requirements, policies, and regulatory requirements. Passionate about applying excellent organization and communication skills to manage and lead teams. Offers strategic planning abilities, background in change management and forward-thinking mindset.

• Vice President of Integrated Clinical Operations and Strategy, Presbyterian Health Plan, 08/23, Present, Responsible for advancing the strategy and integration of clinical operations across all programs in the continuum of care including the management of health services, care coordination, long-term care, behavioral health, clinical informatics, and employer-based health programs for all lines of business., In collaboration with the Chief Medical Officer (CMO), assure that the Presbyterian Health Plan’s mission, goals, and strategies are met., Is accountable for strategic alignment of physical health, behavioral health, and long-term services and supports operations through dynamic leadership, regulatory and accreditation compliance, and fiscal accountability., Oversees new product and/or program implementations and complex initiatives., Accountable for meeting budget targets through processes and technology optimization to enhance business operations., Major contributor to long-term support and services sections of the proposal for New Mexico’s Turquoise Care Medicaid managed care contract and fully engaged in year-long readiness preparation for the contract’s execution.
• Vice President of Clinical & Long-Term Care Operations, Presbyterian Health Plan, 03/22, 08/23, Accountable for all training, reporting, and regulatory compliance for clinical operations., Develop strategies and execute process optimization to support greater efficiencies, improve health outcomes, and support cost reduction/avoidance., Lead the development of new programs in support of state and/or organizational initiatives, focusing on new innovations and best practices., Support other departments and key stakeholders to ensure contract compliance and programmatic success.
• Executive Director of Clinical & Long-Term Care Operations, Presbyterian Health Plan, 12/17, 03/22, Major contributor to long-term support and services section of the proposal for New Mexico’s Centennial Care 2.0 Medicaid managed care contract and fully engaged in year-long readiness preparation for the contract’s execution., Responsible for the overall Presbyterian Health Plan operations and administrative management of health services, care coordination, long term care, utilization management, clinical informatics, population health management, value-based reimbursement, and employer-based health programs across all three lines of business., Coordinate relationships with state agencies, partners (e.g., community-based organizations), participating providers, and plan members and their communities., Direct and ensure that clinical and long-term care operations policies, procedures, and performance results meet nationally recognized standards for accreditation and regulatory compliance., Ensure all annual quality and operational work plans are complete and meet all applicable Medicaid Managed Care standards.
• Director of Long-Term Care Clinical Operations, Presbyterian Health Plan, 01/17, 11/17, Oversee long-term care utilization management and care coordination., Ensure compliance with federal and state regulations., Serve as the long-term care subject matter expert within the organization., Engage with key stakeholders to include the New Mexico’s Human Services Department (HSD) and Department of Health (DOH), Disability Rights New Mexico, and long-term care providers.
• Manager of Care Coordination, Clinical Operations, Presbyterian Health Plan, 06/14, 01/17, Provide guidance and direction to 106 direct and indirect employees., Complete monthly and quarterly audits/reports as required by the NM Human Services Department (HSD)., Support the care coordination department, developing job aids and facilitating training., Participate in quality assurance measures and regulatory audits.
• Supervisor of Care Coordination, Clinical Operations, Presbyterian Health Plan, 01/14, 05/14, Provide direct supervision to 12 care coordinators., Serve as the long-term care subject matter expert within the organization., Support the care coordination department, developing job aids and facilitating training.
• Care Coordinator, Presbyterian Health Plan, 10/13, 12/13, Provide care coordination/case management for a 75-member caseload., Participated in readiness preparation for the execution of New Mexico’s Medicaid managed care contract.

• Ability to lead, direct, and oversee the operations of multiple clinical departments across the health plan to achieve common goals while managing competing priorities.
• Successfully manage both current staffing and forecasting to adhere to budget while meeting performance standards.
• Strong skillset in utilizing data to drive program initiatives, interventions, decrease cost of care and improve member outcomes.
• Lead the implementation of several new system technologies to include Jiva and Health Rules Payor.
• Serve as a subject matter expert and participate in and advise New Mexico’s development of the design and programmatic approach to Medicaid Long-Term Services and Supports.
• Developed various tracking systems and reporting elements, which were implemented across Presbyterian Health Plan as best practices, to monitor program compliance and meet required contractual elements.
• Successfully managed onboarding of 150,000 new members while reducing overall costs and improving efficiencies.

• Gray Clarke, MD, Medical Director, Senior Medical Director, and Chief Medical Officer, Presbyterian Health Plan, 2013-2024, 505-401-1526, gray.clarke@yahoo.com
• Thomas Rothfeld, MD, Medical Director and Chief Medical Officer, Presbyterian Health Plan, 2015-2018, 505-429-7354, Thomas.Rothfeld@optum.com
• Tom MacLean, PhD, Vice President Clinical Operations and Chief Operating Officer, Presbyterian Health Plan, 2016-2019, 505-301-1795, tmaclean@comcast.net