Summary
Overview
Work History
Education
Skills
Certification
Professional Development
Presentations
Accomplishments
Timeline
Generic

Shaun Garcia

Summary

As a forward-thinking healthcare executive, I proactively harness foresight and a deep understanding of the evolving landscape of healthcare delivery. My transformative leadership style guides organizations from traditional models to innovative, value-based care, ensuring operational excellence and growth. By strategically integrating clinical operations with population health, data, and financial acumen, I lead not just by adapting to change but by anticipating and shaping the future of healthcare, in a culture where diversity and psychological safety drive innovation and success.


A committed lifelong learner, I continuously absorb new knowledge and apply it to refine organizational strategy, optimize partnerships, and maximize resources and revenue streams. My proficiency in forging robust relationships with payors and effectively representing organizational interests has consistently fostered advantageous alliances across various platforms, securing organizational advancement and sustainability.

Overview

15
15
years of professional experience
1
1
Certification

Work History

Chief Quality Officer

Brevard Health Alliance
11.2020 - Current
  • Provides vision, creating corporate architecture, and performs hands on work to ensure transition from fee for service to value based care.
  • Owns the quality foundations based on population health management, data, operations, and finance.
  • Co-creates clinical operations to match population health initiatives.
  • Transitioned all health plan contracts to VBC contracts.
  • Year one, $1M shared savings on one Medicaid contract.
  • Year two, $2M shared savings on one Medicaid contract.
  • Year three, $3.6M shared savings on Medicaid/Medicare contracts.
  • Drives discussion and contracts across various payers, MSO's, ACO, and health plans toward the organizational VBC goals.
  • Oversees collaborations with venture capital firms seeking to engage with progressive organizations exploring digital health innovations.
  • Accountable for comprehensive electronic health record enhancement, encompassing revenue cycle management, clinical data acquisition, and data analytics implementation.

Advisor

Redesign Health
11.2023 - Current

Leverages extensive healthcare expertise to drive innovation and expand impact within the industry, developing transformative technologies, tools, and insights that lower barriers to change and support the growth of healthcare startups.

Network Member

GLG
05.2022 - Current

As a GLG Network Member, I bring 20 years' of experience in the healthcare industry to help clients solve some of their toughest business challenges.

Executive Healthcare Consultant

Self-employed
09.2019 - 11.2020
  • Consultant who provided operational solutions for an independent primary care practice and an Accountable Care Organization (ACO-MSSP).
    Aligned with Chief Medical Officer (CMO) and Senior Vice President of Analytics (SVP) to evaluate data, identify trends and outliers, informing the strategic direction of quality improvement initiatives via PDSA.
  • Worked with IT in developing proprietary software platform for chronic care and transition care management.
  • Created pre- and post-competency tests and performed seminar training on all aspects of Value Based Care and population health, improving field team test scores from 35-60% to 91-100% after competency training.
  • Improved buy-in from doctors who relied on a transformation field team for information about Pay for Performance health plan measures, CMS, IPA compliance, and ACO regulatory compliance.
  • Developed operational workflows and reignited a critical quality improvement study sponsored by University of California San Francisco after a 1-year hiatus.

Director Clinical Operations And Population Health

Vigilance Health
10.2018 - 08.2019

Developed and lead multiple population health Initiatives focused on rising risk patients. Developed relationships with ACO's, IPA's, Health Plans, FQHC's, and private practice partners. Directed internal chronic care management staff of 25. Ensured strategic alignment with system-wide initiatives, leading to financial sustainability.

  • Consulted with ambulatory clinics and developed business lines integrating payors and providers to reduce risk.
  • Reduced work duplication among partners, streamlined care coordination and capture of HCC codes by practice.
  • Developed new care coordination line for Medicare Advantage patients, resulting in a 10% revenue increase, Improved patient satisfaction and care coordination.
  • Increased corporate contract rates by 5% for population health services by educating leadership on inherent value.
  • Built out a remote workforce program that included the implementation of a workforce and operations management software, added the ability to rapidly scale up the business by hiring remote staff – 200 applicants and 10 hires in just 3 days.
  • Shortened the onboarding process for new care managers from 4 weeks to 2 weeks by creating an online program.
  • Developed a $100 telephone-based Health Risk Assessment (HRA) program that grew revenue by $100K+.
  • Drove the migration of the core revenue generating software platform to one that facilitated operations and successfully passed Medicare audits.
  • Implemented an automatic enrollment retirement plan where 50% of employees immediately enrolled via CalSavers.

Operations Manager

Clinicas Del Camino Real, Inc.
03.2017 - 10.2018

Directed a $20M operations portfolio for a leading integrated health system. FQHC parent company, owning a health plan and an MSO. Supervised 5 direct reports overseeing 150 full time employees at multidisciplinary ambulatory care centers with services lines including: medical, dental, optical, behavioral health, plus a central call center and referral center. Set staffing requirements and budgets using clinical and financial performance measures. Managed the growth and development of two new health centers and expansion of a third.

  • Helped the senior management team shift to a more sophisticated value-based care environment.
  • Worked with data analytics team to influenced $110 million+ organization going from silos to integrated health system using population health data analytics.
  • Used data analytics to provide insights on gaps required to improve population health across the integrated health system.
  • Created corporate wide roll out of annual wellness visits for both Medicare and Medicare Advantage patients.
  • Lead the development and operational work flow design to incorporate Medicare annual wellness visit.
  • Used data analytics transformed physician operations from 15 to 30 minutes with no productivity loss.
  • Used data analytics to decreased parent company spend by $150K first year by focused case management on behavioral health patients and primary care sensitive patients.
  • Used data analytics to determined which patients were the highest cost and created program to reduce unnecessary ER visits.
  • Used data analytics to streamline external referrals process decreasing time to get into specialists.

Operations Manager and Clinical Preceptor

Horisons Unlimited Health Care
04.2013 - 03.2017

Managed, supported and directed organizational initiatives for a $10M healthcare portfolio that included eight multi-disciplinary clinics; delivering medical, dental, behavioral health, pain management, house call, and chiropractic services. Ensured the clinic met regulatory and internal standards and participated in regulatory/insurance audits and inspections.

  • Built patient base in three clinics, establishing sustainable revenue 30% above target.
  • Used quality health measures for a variety of diseases to identify gaps in care and drive growth.
  • Increased tenure of primary care clinicians from 4 months to 1.7 years through effective off-site team building.
  • Achieved high staff morale and retention through effective communication, prompt problem resolution, proactive supervisory practices and a supportive work environment.
  • Improved access to care for rural health patients by implementing telemedicine for people 30-60 minutes away.
  • Oriented, taught, and precepted Nurse Practitioners and Physicians Assistants.

House Physician

Dell Children's Medical Center Of Central Texas
01.2010 - 01.2011
  • Performed initial and ongoing assessment of patient's medical, physical, and psychosocial status.
  • Performed history and physical.
  • Developed assessment and treatment plan.
  • Performed rounds. Record progress notes. Order tests, examinations, medications, and therapies.
  • Arranged for discharge and after care.
  • Provided patient education and counseling covering health status, test results, disease processes, and discharge planning.

House Physician

St Vincent's Hospital & Med CTR-NY
01.2009 - 05.2010
  • Performed initial and ongoing assessment of patient's medical, physical, and psychosocial status.
  • Performed history and physical.
  • Developed assessment and treatment plan.
  • Performed rounds. Record progress notes. Order tests, examinations, medications, and therapies.
  • Arranged for discharge and after care.
  • Provided patient education and counseling covering health status, test results, disease processes, and discharge planning.

Education

Master of Science - Health Informatics And Analytics

Tufts University School of Medicine
Medford, MA

Master of Science - Healthcare Delivery Science

Dartmouth College
Hanover, NH

Fifth Pathway - Medicine

New York Medical College
Valhalla, NY

M.D. - Medicine

Universidad Autónoma De Guadalajara
Jalisco, Mexico

No Degree - Master Of Public Health

The University of Texas Health Science Center At Houston
Houston, TX

Bachelor of Arts - Chemistry

Our Lady of The Lake University
San Antonio, TX

Skills

  • Visionary strategic planning and goal-setting
  • Change management and organizational agility
  • Strong communication and interpersonal skills
  • Data-informed decision-making and performance measurement
  • Talent acquisition, development, and retention
  • Stakeholder engagement and relationship building
  • Operations and process optimization
  • Regulatory compliance and industry best practices
  • Technological innovation and digital transformation
  • Resilience and adaptability in dynamic environments
  • Ethics and integrity
  • Project management and program execution

Certification

HBS| Harvard Business School Online

  • Entrepreneurship, 2019

HBS| Harvard Business School Online

  • Leading with Finance, 2018

HBS| Harvard Business School Online

  • Business Analytics, Economics For Managers, Financial Accounting, 2017

Professional Development

National Association of Community Health Centers (NACHC) Center for Community Health Innovation

  • Innovation Advisory Council 2024

Aspen Institute

  • Woody and Gayle Hunt - Aspen Fellow 2023

HBS| Harvard Business School, Institute for Strategy

  • Value Based Healthcare Delivery.

VC University Online, A joint initiative of Startup@BerkeleyLaw and National Venture Capital Association.

  • Venture Capital Finance

CareJourney

  • Value-based Care Analytics Certificate

LinkedIn

  • Ethics in the Age of Generative AI
  • Generative AI: The Evolution of Thoughtful Online Search

Google Cloud Skills Boost

  • Introduction to Generative AI
  • Introduction to Large Language Models
  • Transformer Models and BERT Model

Coursera.org

  • ChatGPT Advanced Data Analysis by Vanderbilt University
  • Prompt Engineering for ChatGPT by Vanderbilt University
  • Managing Data Analysis by Johns Hopkins University
  • Building a Data Science Team by Johns Hopkins University
  • A Crash Course in Data Science by Johns Hopkins University
  • AI For Everyone by deeplearning.ai
  • Digital Transformation by Boston Consulting Group & University of Virginia
  • Health Informatics for Innovation, Value, and Enrichment (Administrative/IT perspective) Columbia University. Topics: Population Health, Care Coordination, Interoperability, Value Based Care, Data Analytics, Patient-Centered Care.

Udemy

  • ISO 31000 – Enterprise Risk Management for the Professional
  • Data Quality Masterclass – The Complete Course
  • The Complete Prompt Engineering for AI Bootcamp
  • Disruptive Innovation Theory & Practice

Presentations

Poster Presentation

  • Sanyal, A., Garcia, S., Featherly, T., Donovan, K., Hawkins, C., Magarik, M.. (December, 2020). MobileShare, a technology based mobile-health tool for chemotherapy toxicity monitoring and COVID-19 screening Poster presented at: 32nd annual Institute for Healthcare Improvement (IHI) National Forum on Quality Improvement in Healthcare; Orlando (Virtual Event), FL, USA.

Select Seminars/Oral Presentations

  • Garcia, Shaun. (January, 2018). Maximizing Integrated Health Systems and The Medicare Annual Wellness Visit. Corporate presentation at: Clinicas del Camino Real, Inc. (Health System)/ Seminar; Camarillo, CA, USA.
  • Garcia, Shaun.(September, 2017). Population Health as a bridge to Value Based Care. Corporate presentation at: Clinicas del Camino Real, Inc. (Health System)/ Seminar; Camarillo, CA, USA.
  • Garcia, Shaun. (August, 2017). What is Value Based Care? Corporate presentation at: Clinicas del Camino Real, Inc. (Health System)/ Seminar; Camarillo, CA, USA.
  • Garcia, Shaun. (July, 2017). What is Population Health? Corporate presentation at: Clinicas del Camino Real, Inc. (Health System)/ Seminar; Camarillo, CA, USA.
  • Garcia, Shaun. (April, 2016). What is managed care? What is a health plan and why does it matter? Oral presentation at: Horisons Unlimited Health Care (Health Centers)/ Seminar; Merced, CA, USA.

Accomplishments

Graduate School Awards

Tufts University School of Medicine

  • Honos Civicus Society

Medical School Awards

New York Medical College

  • Honors: Internal Medicine, Pediatrics, Surgery, Psychiatry

Timeline

Advisor

Redesign Health
11.2023 - Current

Network Member

GLG
05.2022 - Current

Chief Quality Officer

Brevard Health Alliance
11.2020 - Current

Executive Healthcare Consultant

Self-employed
09.2019 - 11.2020

Director Clinical Operations And Population Health

Vigilance Health
10.2018 - 08.2019

Operations Manager

Clinicas Del Camino Real, Inc.
03.2017 - 10.2018

Operations Manager and Clinical Preceptor

Horisons Unlimited Health Care
04.2013 - 03.2017

House Physician

Dell Children's Medical Center Of Central Texas
01.2010 - 01.2011

House Physician

St Vincent's Hospital & Med CTR-NY
01.2009 - 05.2010

Master of Science - Health Informatics And Analytics

Tufts University School of Medicine

Master of Science - Healthcare Delivery Science

Dartmouth College

Fifth Pathway - Medicine

New York Medical College

M.D. - Medicine

Universidad Autónoma De Guadalajara

No Degree - Master Of Public Health

The University of Texas Health Science Center At Houston

Bachelor of Arts - Chemistry

Our Lady of The Lake University
Shaun Garcia