James Jones

James Jones is an experienced clinical program consultant currently working at Optum since May 2023, where responsibilities include systems and innovation. Previously, James held various roles, including Sr Risk Adjustment Implementation Program Manager and Risk Adjustment Provider Engagement Specialist at Horizon Blue Cross Blue Shield of New Jersey, achieving notable successes such as a 15% increase in medical record retrieval rates within 6 months. At Health Partners Plans, James developed Pennsylvania's first Medicaid quality incentive program for maternity care and created outreach templates that recovered over $2 million in revenue. James’s career began with roles at Qlik, Eli Lilly and Company, Pfizer, and Goldman Sachs, demonstrating a strong background in sales, analysis, and healthcare. James earned a Bachelor's degree in Business Administration and Management from Florida Agricultural and Mechanical University.