Ted Vana, DO, MBA
Utilization Review Medical Director at EnvisionRxOptions- Claim this Profile
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Bio
Credentials
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Board Certified Family Medicine
The American Board of Family MedicineJul, 1997- Nov, 2024 -
Florida Medical License
Board of MedicineNov, 2008- Nov, 2024
Experience
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Utilization Review Medical Director
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Aug 2018 - Present
EnvisionRx Options August 2018 – PresentMedical Director reviewer for this pharmacy benefit management company. Responsibilities include:• PBM Part D and Commercial Appeal Reviewo Using PaHub, EPSROI, and Pharmscreens• Process improvement and Quality Improvement leadership o Clinical lead ona project using a formal Kaizan Process to overhaul the medical Director and clinical pharmacist Medicare Part D appeal review process.o Successful launch on February 1, 2019… EnvisionRx Options August 2018 – PresentMedical Director reviewer for this pharmacy benefit management company. Responsibilities include:• PBM Part D and Commercial Appeal Reviewo Using PaHub, EPSROI, and Pharmscreens• Process improvement and Quality Improvement leadership o Clinical lead ona project using a formal Kaizan Process to overhaul the medical Director and clinical pharmacist Medicare Part D appeal review process.o Successful launch on February 1, 2019 with a 67% reduction in Maximus overturns in medical directors utilizing the process.o Transitional period of change management for medical director’s not currently engaged with the new process. Show more Show less
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Travel and Job Search
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May 2018 - Jul 2018
Tokyo, Panama, Australia, Mexico City
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Senior Regional Medical Director
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Jul 2014 - Apr 2018
Leveraging my extensive background in healthcare, I held full accountability for providing sound leadership to 17 centers in Tampa, Orlando, and Daytona along with 44 clinicians. It was my job to manage a $300M budget while overseeing and reviewing clinical processes and procedures. Some of my other main responsibilities involved leading efforts to continuously improve healthcare and operational workflows, policies, and communication with key stakeholders while also making analytical decisions… Leveraging my extensive background in healthcare, I held full accountability for providing sound leadership to 17 centers in Tampa, Orlando, and Daytona along with 44 clinicians. It was my job to manage a $300M budget while overseeing and reviewing clinical processes and procedures. Some of my other main responsibilities involved leading efforts to continuously improve healthcare and operational workflows, policies, and communication with key stakeholders while also making analytical decisions and delivering efficient solutions for complex care and administrative issues.Key Contributions:● Spearheaded a complete financial turnaround that resulted in Tampa centers becoming profitable.- Led the reconfiguration of referral processes resulting in $1M in overall cost savings and a 50% reduction in physical therapy costs.- Oversaw a change in pain management referrals; led to a bending of the pain management expense curve.● Successfully improved patient satisfaction scores and grew membership; achieved a 4-star HEDIS rating in all offices with some ratings reaching as high as 4.5.● Mentored and guided the career development of five clinicians who went on to become market/regional leaders.● Took the initiative to devise a Heat Map scorecard for clinicians and operations to better understand how centers and teams performed.● Fully accountable for implementing several treatment-enhancing and cost saving initiatives.- Lowered per case treatment cost by working with specialists to institute step therapy in the treatment of wet age-related macular degeneration.- Lowered overall treatment cost for hyaluonic acid injectable therapy by limiting/prohibiting off label/experimental use.- Improved Ambulatory Care Sensitive Case (ACSC) management by focusing on improved treatment programs or patients with COPD, CHF, and/or a propensity for UTI have emergency kits to help avoid ER visits or hospitalization. Show more Show less
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Executive Medical Director
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Jun 2011 - Jul 2014
During my time with Walgreens I orchestrated day-to-day operations, performance improvements, and process transformation initiatives for health outcomes, clinical management, and patient care. A critical part of my position involved working with Walt Disney World Parks and Resorts’ senior leaders to devise and establish policies and procedures for healthcare processes and procedures. I also led efforts to implement operational improvements, participate in community events, and drive continuous… During my time with Walgreens I orchestrated day-to-day operations, performance improvements, and process transformation initiatives for health outcomes, clinical management, and patient care. A critical part of my position involved working with Walt Disney World Parks and Resorts’ senior leaders to devise and establish policies and procedures for healthcare processes and procedures. I also led efforts to implement operational improvements, participate in community events, and drive continuous improvement projects using process identification to maximize productivity, throughput, quality, and consistency specifications. Key Contributions:● Commended by the Florida Health Care Coalition for successfully devising and establishing a program to engage clinicians and patients while overcoming clinical inertia to change the behavior in the treatment of diabetes, hypertension, and lipids.● Decreased opioid prescriptions by changing a long-standing practice of treating non-malignant pain.● Slashed the amount of inappropriate antibiotics use by creating a heat map scorecard that allowed caregivers to appreciate their prescribing patterns. Show more Show less
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Corporate Medical Director
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Nov 2008 - Mar 2011
As the Corporate Care Director for the Jackson Health System, I utilized my entrepreneurial spirt, creative drive, and sound leadership skills to supervise daily operations and lead process improvement activities that provided efficiency and consistency for Occupational and Employee Health Clinics. I also continuously sought out innovative integration improvements for absence management, family medical leave, and overall employee health and well-being. Key Contributions:● Collaborated… As the Corporate Care Director for the Jackson Health System, I utilized my entrepreneurial spirt, creative drive, and sound leadership skills to supervise daily operations and lead process improvement activities that provided efficiency and consistency for Occupational and Employee Health Clinics. I also continuously sought out innovative integration improvements for absence management, family medical leave, and overall employee health and well-being. Key Contributions:● Collaborated with the University of Miami to make the Jackson Health System and the college smoke-free.● Orchestrated an influenza vaccine program increasing employee influenza vaccination rate by more than 50%. Show more Show less
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Medical Director of Health Promotion and Wellness
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Oct 1998 - Nov 2008
Earlier in my career I was directly responsible for day-to-day and long-term clinical operations along with devising strategic business plans. It was on me to enhance the organizational structure, improve communications, and manage efforts to improve Health and Population Management.Key Contributions:● Collaborated with various medical directors develop work-streams focused on engaging team members involved in Transitional Return to Work Programs, Short Term Disability, Workers’… Earlier in my career I was directly responsible for day-to-day and long-term clinical operations along with devising strategic business plans. It was on me to enhance the organizational structure, improve communications, and manage efforts to improve Health and Population Management.Key Contributions:● Collaborated with various medical directors develop work-streams focused on engaging team members involved in Transitional Return to Work Programs, Short Term Disability, Workers’ Compensation, FMLA, and ADA programs. Show more Show less
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Education
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Philadelphia College of Osteopathic Medicine
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Saint Joseph's University
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Elizabethtown College
Community
