Goal-oriented, board-certified Internal Medicine physician with 30 years experience in direct patient care, ownership and management of robust medical clinic, and enthusiastic participation in managed care development. Proficient in audits of inpatient and outpatient utilization management, medical necessity, and quality assurance. Accomplished Medical Director utilizing peer to peer reviews and collaboration with nurse reviewers and certified coders to ensure optimal use of resources and superior healthcare. Well-versed in clinical case reviews for long term care and rehabilitation facilities. Evidenced innovation in development of algorithms to improve audit accuracy and efficiency. Valued educator for team members, optimizing consistency in records review process. Experienced in use of Optum InterQual, EncoderPro, Microsoft Word, Excel, Power Point, and Outlook.
Committed to integrating medical necessity awareness, cost containment, and efficiency with compassionate quality health care through multidisciplinary education, collaboration, and monitoring for improvement.
American Medical Association
Medical Association of Georgia
Southern Medical Association
Cobb County Medical Association
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