May 26, 2023

Every year, we welcome a new group of interns through Texas Children’s Health Plan’s partnership with Project SEARCH. The program offers young adults with disabilities the opportunity to learn valuable work skills to set them on a path to career success.

As we near graduation for this year’s interns, for Antoine Howard and Deveante Williams, the journey is just beginning as they have secured full-time positions at Texas Children’s. They were both commended and recognized for their superior efforts in attendance, dedication and determination to successfully perform their essential duties. They are currently onboarding and will begin work as unit support assistants in the Facilities department upon graduating from Project SEARCH.

“Project SEARCH taught me I can achieve whatever is placed in front of me,” said Williams. “Sometimes the job seemed hard, but Project SEARCH gave me confidence I needed to work harder to complete my tasks. I will miss every part of the program, but I am thankful that I was offered a job doing something that I’m good at.”

All program participants are immersed in the workplace during the nine-month program and have the same expectations on them as current employees. They work with a team, including a TCHP business liaison, Houston ISD instructor and teacher’s assistant, skills trainer, and local and state agencies to create an employment goal. Guided by department mentors, all interns participate in three internships as they explore a variety of career paths.

Howard and Williams, along with Tommy Dorsey, Mallane Livingston and Spencer Guhl rotated through different areas of the business, including TCHP Centers for Children & Women, Medical Affairs, Administration, and TCH Facilities, Gift Shop and Autism Center. They assisted with administrative duties, such as scanning, sorting, filing, MyChart registration, patient wayfinding, retail tasks within TCH gift shops and data entry.

“The best part of Project SEARCH is witnessing each intern’s progress throughout their internship. We get to assist young adults navigate their first steps into the workforce and individually guide each student to identify their career goals and endless possibilities,” said Shamera Beckham, education and training coordinator, Medical Affairs, TCHP. “Interns not only walk away with employability skills, but leave with increased social skills, self-esteem, independence and confidence.”

The Project SEARCH partnership began at TCHP in 2016 as part of an ongoing cultural competency strategy. We aim to create a healthier future for people with disabilities in our global community by leading in education, care coordination and advocacy through partnerships. The program gives our system access to a new, diverse group of talent with skills that match our labor needs, while also bridging the employment gap for individuals with disabilities.

The program continues to expand across the system, with Texas Children’s Pediatrics and Specialty Clinics scheduled for the 2023-24 school year. If your department is interested in supporting an intern, please contact Shamera Beckham.

August 2, 2022

In an effort to offer better solutions and support for its more than 600,000 plan members, on Aug. 1, the Health Plan launched the Tapestry module in Epic. This new system provides end-to-end integrated operations support by unifying multiple data platforms in one system to improve member and provider experience, revenue cycle and care coordination.

“I’m so excited to launch Tapestry for our members, providers and employees,” said Richelle Montgomery, president of Texas Children’s Health Plan. “This system will transform the way we support our members and providers and will take us to new heights in terms of service, efficiency and operations. I am so proud of the hard work, dedication and resilience of all the Health Plan team members who worked on this multi-year initiative. Thank you to everyone who made this possible!”

Benefits of the new Tapestry module include:

  • Improved compliance: ability to address compliance concerns faster, provides tools and reports necessary for NCQA compliance, simplifies AFRMR reviews.
  • Enriched member and provider support: one integrated database and detailed reports give employees a comprehensive view on how to better serve members, meeting their individual needs.
  • Better portals and information for members: Patient and member portals provide easy and thorough access to benefits and scheduling information.
  • Enhanced technology: consolidates multiple systems into one, automated resource simplifying the claims process and improving data security.
  • Positive business impact: systems consolidation is major cost savings and timing in advance of major state projects.

If you need support with the Epic Tapestry module, there are resources available. Please follow these steps.

  1. Contact your Super User (if you don’t know your Super User, ask your manager)
  2. The Super User will work with the Epic Command Center and open a ticket with the IS Service Desk on your behalf.
  3. After reporting the issue, please attempt to complete your workflow or find a workaround.

To celebrate the launch, all Health Plan team members are invited to participate in several fun activities during launch week. Please consult your leader for details.

May 18, 2022

In an effort to offer better solutions and support for its more than 560,000 plan members, the Health Plan began its implementation of the Tapestry module in Epic on May 16 by rolling out the red carpet for the Business Operations team kick off.

The Tapestry module will go live July 1 providing end-to-end integrated operations support by unifying multiple data platforms in one system to improve member and provider experience, revenue cycle and care coordination.

Please click here to watch a video to learn all about the features and benefits not only for plan members, but for providers and team members as well.

The Health Plan team will continue to provide updates and key milestones leading up to the plan-wide launch July 1.

February 3, 2022

Effective February 2, 2022, Texas Children’s Health Plan, the nation’s first health maintenance organization (HMO) created just for children, announced the appointment of Dr. Karen Hill as its new Senior Vice President (SVP) and Chief Medical Officer (CMO).

Dr. Hill is a seasoned health care executive and board-certified Internal Medicine and Pediatrics licensed medical doctor (M.D.). In her new role, she will lead an NCQA-accredited Medicaid plan and the state’s top-rated HMO in Patient Experience, committed to providing its members with dependable health coverage and delivering top-quality patient care.

Dr. Hill will guide clinical and quality initiatives that further position the organization as a leader in patient experience and quality health coverage. She will support efforts that further drive health equity and expand access to top quality care for vulnerable and medically underserved communities.

“I am thrilled to welcome Dr. Hill to the Texas Children’s Health Plan executive team,” said Richelle Fleischer, president of Texas Children’s Health Plan. “Her experience and passion for managed care will be an invaluable asset to the organization, and further enhance the health and well-being of our members and community.”

Dr. Hill has more than 25 years of industry and academic experience, beginning her career as Associate Medical Director for Amerigroup, followed by positions as Senior Medical Director for Cigna, SVP and CMO of Med Affairs for Community Health Choice and CMO for RediClinic. For more than 14 years, she was in private practice as an internal medicine and pediatrics medical doctor and most recently served as Corporate SVP of Programs and Product Management for HealthHelp, a WNS company.

Dr. Hill received her medical degree from the University of Cincinnati College of Medicine, completed her residency at Baylor College of Medicine, and furthered her education with a Master of Business Administration degree from the University of Houston Bauer College of Business.

“I am inspired by the opportunity to play a role in this next phase of Texas Children’s Health Plan, as we continue to improve access to quality healthcare for our members,” said Dr. Hill. “As Chief Medical Officer and collaborative leader, I look forward to working with our community partners to further expand the health plan’s reach and bring quality care to more vulnerable populations across the state.”

Dr. Hill is an active member of multiple professional organizations which support women executive leaders including Chief and IGNITE. She is also a member of several local, regional and national organizations focused on the industry including the American Academy of Pediatrics, Texas Medical Association and the Harris County Medical Society.

Click here to learn more about Texas Children’s Health Plan.

December 21, 2021

As another year at Texas Children’s comes to a close, our team members recently gathered, safely, to take a brief, yet meaningful moment to celebrate the holidays. Over the years, one of our favorite holiday traditions has been Bread & Wassail, but with the changing times, we had to get creative to safely celebrate the season.

Beside our wonderful team members, the stars of this year’s event were delicious Nothing Bundt cakes in six different flavors – red velvet, classic vanilla, lemon, white chocolate raspberry and chocolate chocolate chip, as well as some tasty beverages to wash them down.

The event proved popular among team members across our campuses as we distributed more than 16,000 Nothing Bundt cakes! Even our therapy dogs got in on the fun and were doing everything they could to get a taste.

We look forward to many more fun events on the horizon as we look ahead to building our bright future Tomorrow, Together.

June 22, 2021
Members of the Provider Data Integrity and Quality Assurance teams at Texas Children’s Health Plan gathered this month for a team building session.

Each of the millions of lines of data managed by Business Operations at Texas Children’s Health Plan are tied to a member or provider – representing a claim or contract processed, a service delivered or a woman or child who received care.

With a real person and real story behind every number, ensuring the files are both accurate and reliable is the first priority for the Provider Data Integrity (PDI) team that recently launched as a joint venture of Business Operations, Contracting and Provider Relations.

Knowing their work touches families and children that need it most keeps the team motivated to master multiple systems, dig into the statistics and use them to paint a bigger picture for our providers, state agencies and other key constituents.

“We are here to take care of our members, to be their voice and to go to bat for them,” said Kellie Malone, director of Business Operations at the Health Plan. “We give everything we have, we’re all in and we’re passionate about what we do.”

Serving on the PDI team is about more than pulling data and compiling reports. These analysts are a critical link between Health Plan members and providers, and a bridge between technically-minded Information Services professionals and businesses that need clear-cut data to function at their best.

What sets PDI team members apart is their skill for seeing data from a different perspective. They are able to draw meaningful conclusions and practical solutions from the numbers, helping to drive smarter decision-making.

“There is a need within operations to be more analytical and connect the dots,” said Jennifer Sima, manager of Provider Experience at the Health Plan, who is also leading the PDI team.

She likens the Health Plan’s function to an insurance company that solely administers Texas Medicaid. Automating processes, maintaining the data in our files and handling claims efficiently all make it easier for our members to access care.

“Making sure our systems are smooth is so important because it directly impacts our members’ lives,” Sima said. “We think about the need, problem-solve and then develop that solution in full. It’s telling the story and telling it logically.”

Though PDI has been initially focused on cleansing the data and building regular controls to ensure it remains trustworthy moving forward, the team will build from that foundation by using the data to track, trend and forecast possible outcomes for Health Plan members. They also plan to conduct more high-level audits and find ways to insert themselves into other areas where their unique approach to data can be useful.

“Our team members take one small bite of data at a time, but with each bite they understand the essence of what we’re doing and how to add value,” Malone said. “We make sure each new person knows that at Texas Children’s and Texas Children’s Health Plan, it’s not about having a job; it’s about having an impact. Everything you do daily makes a difference.”

March 30, 2021

Texas Children’s own Dr. Lisa Hollier recently traveled to the Texas State Capitol to testify on behalf of a proposed bill that would extend Medicaid coverage for low-income mothers across the state, providing them with more access to lifesaving care.

Hollier delivered her testimony to lawmakers on March 23 during a House Committee on Human Services hearing on House Bill 133, which was authored and filed by State Rep. Toni Rose.

In addition to her role as Chief Medical Officer and Sr. Vice President of Texas Children’s Health Plan, Hollier is also chairwoman of the Texas Maternal Mortality and Morbidity Review Committee. The committee released a report late last year that noted that most pregnancy-related deaths in Texas are preventable.

To help reduce the incidence of pregnancy-related deaths and maternal morbidity in the state, the committee recommended increasing access to comprehensive health services not only during pregnancy – but also in the year after pregnancy, and throughout the preconception and interpregnancy periods.

Hollier and other advocates of HB 133 agree that lengthening insurance coverage would go a long way toward saving the lives of new mothers who experience pregnancy-related complications within a year of giving birth. Currently, coverage drops off after 60 days.

“By extending Medicaid with a more comprehensive set of services, we would be able to reach more women and address their needs,” Hollier told legislators, as quoted in an article in the San Antonio Express-News.

A board-certified OB-GYN and leading expert in maternal health, Hollier is the immediate past president of the American College of Obstetricians and Gynecologists (ACOG). She was elected to the post in 2018 and immediately pledged to focus on reducing preventable maternal mortality during her term.

Hollier was also selected to receive the 2019 Mark A. Wallace Catalyst Leadership Award.

If you’re a Texas Children’s team member who has been asked by an advocacy group, legislative staff member or other organization/entity to provide public support or testimony on legislation, please contact Government Relations before responding or taking any additional action. You can reach the team by phone at 832-828-1021.