Meet Your 40 Under 40 Winner - Jessica Rios, Director of Health Equity, Community First Health Plans

Sept. 21, 2023
Congratulations to Jessica Rios for being named to the inaugural Healthcare Innovation 40 Under 40 awards program!

Congratulations to 40 Under 40 Winner: Jessica Rios, Director of Health Equity, Community First Health Plans

Get To Know Jessica:

Why is this candidate a good fit for 40 under 40?

Jessica Rios has dedicated her professional career to creating positive change in the San Antonio community through innovation and collaboration. In her current role as Director, Health Equity, at Community First Health Plans, Inc., (Community First) she builds upon her experience in community collaboration, using innovative approaches to remove barriers to positive health outcomes for all. As Community First’s Director of Health Equity, Jessica’s advocacy is pivotal to the organization’s progress toward National Committee for Quality Assurance (NCQA) Health Equity and Health Equity Plus Accreditation. Through her influence and leadership, Community First is transforming care for its members through the lens of health equity. The resulting outcomes include adopting best practices, realigning policies and procedures, purposefully training a diverse staff and provider network, and examining disease prevalence by race, ethnicity, language, and disability to identify social inequities. Combining this work with meaningful partnerships and investments, Community First is embedding health equity at the heart of providing care to each member. While only in her role for 1 year, and 3 months, Jessica has already established herself as a highly innovative and driven individual.  She serves as a role model within Community First and throughout the community by continuously challenging herself, her organization, and her community to be more innovative and inclusive.  Since joining Community First in 2022, she has immersed herself in increasing her expertise in government affairs and outreach, preventive health and disease management, Texas Health Steps, and the effects of Social Determinants of Health (SDoH) on members in the Community First service area. A self-described data-geek, she specializes in data collection and analytics to identify data points around SDoH (transportation, education, food, housing, health, income in relation to zip codes), HEDIS data (zip codes, gender, race/ethnicity, sexual orientation), patient satisfaction, and member utilization of plans, claims, and other benefits. She was instrumental in rolling out an internal dashboard to keep this data at the forefront of decision-making.

Explain this candidate’s professional accomplishments:

Outcome-oriented, Jessica outlines her goals as Director of Health Equity at Community First on a monthly, annual, and ongoing basis. Her goal achievements include: • Formalizing a Health Equity Council (which she leads) as the driving force of health equity with input from external partners to achieve innovative preventive health and disease management and ground-breaking community outreach. Exhibiting strategic leadership, she works collaboratively with colleagues and executive leadership to develop and advance targeted health equity-focused advocacy strategies.  These strategies influence policy, specifically targeted at members and individuals within the community who are more likely to experience or are experiencing inequity in health care services due to their race, ethnicity, language preference, gender identity, sexual orientation, or disability • Drafting the Council’s charter to guide Community First in inclusiveness, cultural humility, diversity, and equity in all aspects of service to members and the community. Other guiding organizations include University Health, NCQA, and the Texas Health and Human Services Commission (HHSC). • Developing and implementing a plan to leverage social impact, expanding the collaborative community health needs assessments beyond two counties • Sharing her expertise and passion by speaking at local conferences on the digital divide, gaps, and pathways between housing and health, food, and transportation of people 60+ years of age or with disabilities, and how Community First is solving these gaps • Championing Health Equity through an Action Plan- As the leader of the Health Equity Council, Jessica champions innovative member and provider interventions and expansion of existing policies and programs. Through the formation and implementation of a Health Equity Action Plan, the Heath Equity Council assures the model and accountability lines for health equity within Community First remain a priority. She is dedicated to improving health literacy and addressing other factors linked to social disadvantage(s). To enhance health equity within Community First, the organization has engaged in conversations with other community health plans, incorporating data, such as race, ethnicity, and language into its clinical management system and organizational strategy. • Introducing Findhelp.org- Understanding that there are many non-medical barriers to achieving health equity, Jessica has worked diligently with Community First staff members on innovative ways to reduce those barriers. Over the last 12 months, Community First has referred more than 1,200 members to community-based organizations. While FindHelp.org has supported staff in providing a resource tool for our members, Jessica recognizes that there is much more work needed to achieve health equity. For improved tracking and analysis of member referrals.  • Creating and launching member referral forms when referring members to a community-based organization. This allows Community First to identify and quantify connections between its interventions and positive health outcomes among its members.

How does the candidate show commitment to the industry and bettering their professional career?

Jessica continues to follow an upward trajectory in her educational attainment and career achievements. Seeking advanced knowledge, she earned a Bachelor of Science in December 2011 from the University of Texas at San Antonio, a Certificate of Public Health from the University of Texas School of Health in 2013, and a Master’s in Public Health from Purdue Global University in 2022. A life-long learner, Jessica is pursuing NCQA Health Equity and Health Equity Accreditation Plus. This strong foundation in the study of public health has enabled her to think strategically, make persuasive appeals, and advocate for health equity at the highest levels, including Community First’s Board of Directors. Her extensive network throughout the San Antonio region stems from her work experience in a variety of progressively more responsible roles. As a Community Service Learning (CSL) Coordinator at UT Health Science Center, she provided mentorship to student-led programs by managing five free clinics throughout San Antonio, while simultaneously advocating for funding and policy change. In her role as Partnership Manager at SA2020, she identified and assessed capacity-building opportunities with local nonprofits and designed an innovative partner tool kit. To facilitate strategic conversations related to SA2020 metrics, she worked with collaborative groups across San Antonio. In her work as Regional Coordinator for the United Mitochondrial Disease Foundation, Jessica managed key fundraising events in the eight-state central region and led grassroots outreach plans to support program and fundraising goals. Throughout this career progression, she has maintained a focus on working at the grassroots level to build capacity, innovate, and bring about positive change through inclusion. Armed with this depth and breadth of collaborative experience, a passion for change, and perseverance, she continues to be a force for positive health outcomes.  In establishing and growing the Health Equity Council, Jessica sets the bar high, with aspirations and actionable plans to structure this working group as the driving force in health equity for Community First and Bexar County. Her vision is for the Council to be the premier collaborative effort for enhancing health outcomes within the local community, state, and eventually, the nation. To achieve this, she actively recruits individuals to join the Council from organizations who not only desire to create change through innovation but also have a proven track record of doing so.

Sponsored Recommendations

How Digital Co-Pilots for patients help navigate care journeys to lower costs, increase profits, and improve patient outcomes

Discover how digital care journey platforms act as 'co-pilots' for patients, improving outcomes and reducing costs, while boosting profitability and patient satisfaction in this...

5 Strategies to Enhance Population Health with the ACG System

Explore five key ACG System features designed to amplify your population health program. Learn how to apply insights for targeted, effective care, improve overall health outcomes...

A 4-step plan for denial prevention

Denial prevention is a top priority in today’s revenue cycle. It’s also one area where most organizations fall behind. The good news? The technology and tactics to prevent denials...

Healthcare Industry Predictions 2024 and Beyond

The next five years are all about mastering generative AI — is the healthcare industry ready?