Jim Parker is an experienced operations administrator with a successful track record of implementing reforms to improve health and reduce costs.
He comes to HMA from the State of Illinois Division of Medical Programs, Department of Healthcare and Family Services (DHFS) where he served as the deputy administrator for operations for 14 years and ended his career at the state as acting Medicaid director. In these two roles, he oversaw operations of the $20 billion Medicaid program and was responsible for all aspects of transitioning the Illinois Medicaid program from fee-for-service to managed care.
That transition included development of rate structures, design of new delivery models, establishing performance incentives, contract terms, coverage policies, and enrollment processes/contract monitoring to reduce the growth trend in the Medicaid program while improving health outcomes. Jim started the process of reforming the Medicaid program with the implementation of primary care case management and disease management programs.
In addition to his expertise in managed care, Jim has substantial experience in the area of prescription drugs in Medicaid. He helped develop the first Medicaid Pharmacy Plus waiver prior to the implementation of Medicare Part D. He led efforts that developed one of the first Medicaid Preferred Drugs List in the U.S. and negotiated supplemental rebate agreements that brought hundreds of millions of dollars of new revenue into the state. He also helped develop many unique utilization controls for prescription drugs.
Prior to his work with the Division of Medical Programs, Jim worked in the Office of the General Counsel, DHFS where he served as chief of the Bureau of Administrative Litigation, Chief Administrative Law Judge and administrative law judge. As a judge, Jim initially presided over medical provider appeals and then assumed responsibility for all administrative hearing processes to include Medicaid recipient fair hearings, child support hearings, and medical provider appeals.
Jim previously worked as an attorney in private practice, with an emphasis on first amendment issues. He received his Juris Doctorate from Loyola University of Chicago School of Law and his bachelor’s degree from Marquette University.
Jim has enjoyed coaching his sons in Little League baseball and looks forward to transitioning to spectator as they move to high school baseball.