Career Spotlight: Healthcare Administration
This week, Dr. Cameron Ricks sat down with Joseph De Los Santos to talk about his career in Healthcare Administration. We hope this sheds some light onto what a career in healthcare administration could mean for any high school students exploring careers in the medical field.
Tell us a little bit about your job and how long you’ve been there.
I have been a Payment Innovation Program Management Consultant for about a year at Blue Shield of California. I’ve been with Blue Shield for about two and a half years.
In my role, we work with providers to better align incentives focus on quality of care, while also trying to keep costs steady, or see if it's lower. So that comes in a lot of different flavors- it could be primary care, it could be hospital quality, it could be looking at equity across and seeing how we can better incentivize for more equitable care. We do a lot of research and literature review. We work across a variety of teams vet out these payment models to make sure that when we roll it out to the market, that it's something that one meets the needs of patients, but also isn't something that's a pain and deleterious for providers.
In terms of my day to day, usually start with reading papers, reading articles, trying to understand what's going on in the industry, then probably go into meetings where we are designing our models. So working with physicians, PDAs actuary medical informatics, and pressure testing different aspects of the idea, whether that's looking at a care model, or looking at that financial model that is driven by the care mode to make sure that the quality of care is center, and that the payment follows in this incentivize on this specific care model aspects.
What was your career path that landed you where you are today?
I think the cornerstone for me is I wanted to help people, and I wanted to help the most people. In my mind, when I was looking at different opportunities in high school I landed on, I don't know what it was, but I landed on neuroscience. I ended up going to UC Irvine for my undergrad. And at UCI there's a course called Bio 199, where you do their undergraduate research courses, and you can join labs. So during my first quarter, I research the lab and saw that I can do research in this neuroscience lab that's focusing on Alzheimer's disease, even before we officially get to be part of the program.
After being in a lab environment, I didn’t know if it's for me long term. I think I need to do something with more people. I took a healthcare management course, in that course, I learned about the different roles of the whole admin team and support staff that really makes healthcare actually work. I shadowed a leader at a local hospital at Hoag. And he brought me along to a bunch of different meetings, and it was really, really informative. We had a lot of conversations about “what's the future of healthcare look like? What are the roles?” So he was really great. It really like made me think and a lot of the things that he talks about what happened in healthcare over the next 10 years, like actually happened, a lot of care moving outside of the hospital, like going more out to the communities and stuff like that.
Out of college, I ended up working at a pharmacy management company through a temp agency. Here's a consulting company that basically work with hospitals. so that they can optimize their Pharmacy Departments and like to have strategies for funding. So as an executive assistant or the C suite does bass like locally.
After doing that, I transitioned to a role as a clinical research regulatory coordinator back at UCI. I wanted to like work in a hospital because I want to understand what are all these roles in hospitals- I want to work with providers, because they are the engines of the healthcare system. They do so much and kind of see like, what are all those roles.
After doing that for a couple of years, I felt like I was ready for graduate school for a Master's in Health Administration, and went out east to Cornell. In between my first and second year, I interned at Kaiser in the internal consulting group in Northern California and worked on patient experience projects from a population health perspective.
Eventually, I joined the Leadership program at Blue Shield called Shield Emerging Leaders Program. And in that we rotate into different departments every six months, so started in internal audit then moved into this core and small group to future planning, then senior markets, which is more Medicare Advantage, Medicare Supplements, to eligible members and to stretch around that, and then payment innovation. So that really kind of brought me back to that clinical aspect.
I was looking forward to him stuff like bringing that research mind that I have also looking at finances and like how can we properly in line centers well, where we're partnering with providers and not dictating things with providers. So that's where I ended up getting my role where I'm at today, just having different payment models.
What’s your favorite part of your job?
My favorite part of my job is that I do get the opportunity to be creative, like flexibility, where a lot of times sometimes there's these models that are out there that have been done in or have been replicated, but a lot of times. It's something that's new, and we're just figuring it out. It's kind of a double edged sword. Sometimes, it's a good thing, and sometimes the worst thing. It's like, Where do I even go? As I said, earlier, I work with a great team, and work with different kind of parallel teams with me, so we kind of work and figure it out together. I'd say that creative is kind of a little bit of both where it's like, where are we going, but, you know, once you have like, a mind in the path of like, where it's where to move forward to then things start to become clearer and obstacles, you know, start start getting pulled away.
What’s your least favorite part of your job?
As with everything in research, everything takes a long time to do. We're designing these models for sometimes six to 12 months, and then we put it out into the market. And then we see what happens once we have provider partners. It takes a long time to like, get these things done, but that time is really necessary to make sure that you're designing something that's not hurting people or hurting providers, like you really want to do something that's advantageous for folks.
What would you say to a high school student looking at professions in healthcare administration?
If there's any opportunities to shadow with people who work in hospitals, I know that there's something like bridge type programs. In basic science research, there is a lot of like high school summer programs. And those are growing for folks who are interested in healthcare admin health care management. Don't be afraid to reach out to, you know, someone at your local hospital, or it's myself. Definitely open the conversation if you're interested in different careers.
Just be just be curious. I think that's a central thing. That's something that I've tried to be throughout my career, like I have many different interests. And I feel like that curiosity is so important kind of leads you to where you where you should be, ultimately, there's being a doctor and a nurse, like you've been, you've been both in the past is, is great. But there's also these other roles if you want to help people but don’t fancy the sight of blood. And in healthcare, you could do that from a more individual level or, you know, a higher population level, depending on where you go. So, there's a lot of gray and a lot of opportunity for, you know, someone's interested in helping people to join an area of healthcare.
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