
Healthcare
Extensive experience in healthcare administration, policies and regulation, and clinical practice, focusing on using healthcare measures to improve performance outcomes and in teaching future medical professionals.
- Serves in multiple positions on professional associations addressing healthcare reform and regulatory issues.
- Serves as an instructor and clinical extern supervisor in a nationally accredited University training program.
- Develops and implements rural healthcare services for historically underserved populations to increase ease of access to care.
Multi-State contracted in-network provider to third-party payors, Medicaid, and all Medicaid Managed Care Organizations.
- Specializes in providing independent and impartial expert evaluations in cases of contested eligibility determinations and differential diagnosis.
- Reviews healthcare data, research, and professionally recognized sources of medical evidence for reliability to support the accuracy of claims and diagnoses and to provide clinically relevant, outcome-driven, evidence-based treatments.
- Strategic planning, development, and implementation of a program to manage claims from various payor sources, design performance reports and measures, and works with providers and payors to correct errors in payments and documentation.
- Supports programs that examine the comparative benefits of a fee-for-service model of care versus a performance-driven reimbursement.
- Supports state-level Medicaid initiative to incentivize provider groups by rewarding quality performance, reduced costs, and improved health and prevention outcome measures.
Contact the Experts in the Field
Delivering superior performance with the highest levels of integrity and professionalism.
