Janice Fagen

Janice Fagen

Senior Strategic Advisor at Sellers Dorsey

Janice Fagen is a Medicaid and managed care expert with more than 25 years of healthcare leadership experience across commercial, Medicare, and Medicaid programs. A former Vice President of Medicaid Operations at Blue Cross and Blue Shield of Texas and current Senior Strategic Advisor at Sellers Dorsey, she contributes expert insight to Lifeline on Medicaid policy, aging-in-place technology, remote patient monitoring, and value-based care delivery for older adults and vulnerable populations.

About Janice Fagen

Janice Fagen is one of the most experienced Medicaid and managed care executives in the United States. Over a career spanning more than 25 years, she has led health plan operations, shaped state regulatory relationships, and driven quality and financial outcomes across some of the country’s largest Medicaid programs.

She currently serves as Senior Strategic Advisor at Sellers Dorsey, a national Medicaid consulting firm, where she works with managed care organizations, state agencies, and healthcare solution providers on procurement strategy, RFP development, operational assessments, and program planning.

Janice contributes expert perspectives to Lifeline on topics at the intersection of Medicaid policy, aging-in-place care models, remote patient monitoring, and the use of technology to support vulnerable populations living at home. Her background in state regulatory relationships and managed care operations gives her a unique vantage point on how connected health solutions can be integrated into Medicaid and value-based care frameworks.

Her career includes senior leadership roles at Blue Cross and Blue Shield of Texas, UniCare and Wellpoint (now Anthem), Cigna, WellCare of Texas, and Gorman Health Group, as well as more than a decade in hospital administration at Memorial Hermann Healthcare System.

Areas of Expertise

Janice contributes insight and analysis on topics including:

  • Medicaid managed care policy and state procurement strategy
  • Value-based care models and Medicaid program design
  • Aging-in-place technology and remote patient monitoring in Medicaid
  • Provider network development and contracting across commercial and government programs
  • Social determinants of health and care delivery innovation
  • State regulatory relations and Health and Human Services Commission engagement
  • Healthcare operations: P and L, member engagement, medical management, quality programs
  • RFP strategy, solicitation support, and managed care contract development

Career Highlights

Sellers Dorsey

May 2020 to Present

Senior Strategic Advisor

Advises managed care organizations, state Medicaid agencies, and healthcare solution providers on strategy, operations, and business development. Work includes Medicaid procurement readiness, RFP development, operational assessments, and program planning.

Blue Cross and Blue Shield of Texas

March 2012 to March 2020

Vice President, Texas Medicaid Operations

Led all aspects of the Texas Medicaid contract with the Texas Health and Human Services Commission (HHSC), including financial performance, customer service, marketing, provider networks, medical management, pharmacy benefits, quality programs, and regulatory compliance. Key outcomes include achieving program profitability in 2019, reducing corrective action plans by 90 percent within one year, and overseeing a medical management system implementation approved by regulators without required changes.

UniCare, a Wellpoint Company

2010 to 2012

Chief Executive Officer

Led the Medicaid managed care organization and served as the primary executive representative on all matters related to the Medicaid contract. Oversaw operations, network development, community outreach, medical management, and quality programs. Helped develop a Blue Alliance Agreement between Anthem Blue Cross and Health Care Service Corporation to pursue Medicaid opportunities in Texas.

WellCare of Texas

2008 to 2009

Executive Director

Oversaw sales, marketing, and provider contracting in the Dallas service area. Managed physician, hospital, and ancillary provider relationships. Exceeded enrollment targets for the 2008 period.

Gorman Health Group

2009 to 2010

Senior Consultant

Supported network development for a Medicare Advantage client.

Cigna Insurance Services / Great West Healthcare

2005 to 2008

President, Southwest Region

Led regional operations across Texas, Arkansas, Mississippi, Oklahoma, and New Mexico, including PPO network development, contracting, and medical management for commercial health plans.

UniCare Insurance, a Wellpoint Company

1995 to 2003

Vice President, Network Development

Built and maintained provider networks for HMO and PPO plans across all 254 counties in Texas.

Memorial Hermann Healthcare System

1984 to 1995

Assistant Hospital Administrator

More than a decade managing business and admissions operations, care negotiations, and multiple departments within one of Texas' leading health systems.

Speaking and Thought Leadership

Janice is an active voice in national conversations on Medicaid policy, aging-in-place technology, and care delivery innovation. Her speaking engagements and panel participation include:

  • Moderator, North Texas State of Reform Health Policy Conference (September 2021): Session titled Putting a Business Model Around the Social Determinants, focused on SDOH and care delivery approaches.
  • Panelist, Medicaid Health Plans of America (MHPA) and Sellers Dorsey Webinar (April 2022): Preparing for the End of the Public Health Emergency, addressing Medicaid eligibility redeterminations and the impact on states, managed care organizations, and stakeholders.
  • Panelist, Connected Health and Safety Association (MAMA): AI and Aging-in-Place: How Smart Technology is Redefining Senior Care, exploring remote patient monitoring and personal emergency response systems in healthcare delivery.

Education

Alliant International University, California School of Professional Psychology

Master of Arts (MA), Psychology

University of California, Los Angeles (UCLA)

Bachelor of Arts (BA), Psychology