Max Sungurov Md, Mba Email and Phone Number
Max Sungurov Md, Mba work email
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Max Sungurov Md, Mba personal email
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With over 10 years of experience in healthcare leadership, I am a research-focused and population outcome-driven executive. As the Chief Medical Officer for Medicare Advantage Plans at BlueCross BlueShield of South Carolina, I am responsible for building and managing population health, medical management, medical loss ratio, medical risk adjustment, utilization management, clinical member engagement, policy and compliance, value-based care programs and network management.I have a strong clinical and medical operations background, with a Master of Business Administration degree and a certificate in Business Analytics. I generate ideas and strategies and provide subject matter expertise to teams in combining healthcare innovation, conducting medical research, and creating robust cost-containment solutions. I am proficient at implementing viable strategies and delivering data analytics-driven insights that impact all segments of the population and lines of business. I have developed and executed novel strategies for enhancing member and network provider engagement, targeted population health management, risk adjustment, clinical solutions, health risk assessment surveys and many others that yielded significant ROI. I am passionate about driving continuous process improvement and enhancing revenues and growth for my organization and the healthcare industry.
Bluecross Blueshield Of South Carolina
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Chief Medical Officer, Medicare Advantage PlansBluecross Blueshield Of South Carolina Apr 2023 - PresentColumbia, South Carolina, UsStrategically building and overseeing Population Health initiatives within the Medicare Advantage landscape. Specializing in Medical Loss Ratio (MLR) management, I drive efficient healthcare delivery through targeted strategies. In Medical Risk Adjustment, I lead the strategy and implementation for optimal results.Lead Utilization Management transformations to enhance resource utilization and improve overall healthcare outcomes. My role encompasses fostering Member Engagement through innovative approaches, ensuring a patient-centric focus.Provide clinical oversight for designing and implementing Value-Based Care programs and managing networks for optimal performance. I oversee Medical Management and Utilization Management.I chair Quality and Improvement Committee that shapes and implements robust Medical Policies and Procedures.
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Member Of Editorial BoardPopulation Health Management, Journal Apr 2024 - Present
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Clinical Instructor Of MedicineCooper Medical School Of Rowan University May 2015 - PresentCamden, Nj, Us -
Vp And Enterprise Medical DirectorHighmark Health Jul 2021 - Feb 2023Pittsburgh, Pennsylvania, UsLed the Cost to Value team overseeing 300K Medicare Advantage members, with a strategic focus on driving successful clinical initiatives. Spearheaded the development and execution of innovative strategies for robust risk adjustment and clinical solutions. Provided executive-level support across all management levels and demonstrated clinical leadership in collaboration with cross-functional teams.Coordinated healthcare tech solutions with external partners including Alphabet Verily, League, Gyant, and Google Cloud. -
Medical Director, Medicaid/DualsAmerihealth Caritas Aug 2020 - Jul 2021Philadelphia, Pa, UsLed all facets related to Medicaid and dual Medicaid/Medicare activities as a part of high performing team of Medical Directors.Utilization management reviews and appeals, inpatient DRG validation across multiple states, quality, clinical execution, and Medicaid LTSS programs policy reviews. -
Attending Physician (Division Of Hospital Medicine)Duke University Health System Jan 2019 - Feb 2020Durham, North Carolina, UsDuring this role, I delivered direct patient care, functioned as a lead admission hospitalist and served as a designated clinical instructor and supervisor for medical residents and senior medical students.Additionally I functioned as a leader of the Rapid Response team for the main DukeUniversity Hospital. -
Medical Director In The Division Of Hospital MedicineCooper University Health Care 2017 - 2020Camden, Nj, UsAs the leader of multi-disciplinary teams in Care Coordination, Care Transition, and self-directed reviews for Medicare and Medicaid, I executed and managed diverse review types, including prospective, concurrent, retrospective, and peer-to-peer reviews. -
Hospitalist-Attending Physician In The Division Of Hospital MedicineCooper University Health Care 2010 - 2017Camden, Nj, Us
Max Sungurov Md, Mba Skills
Max Sungurov Md, Mba Education Details
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Haslam College Of Business At The University Of TennesseePhysician Executive -
The Wharton SchoolBusiness Analytics: From Data To Insight
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First Moscow State Medical University Named After I.M. SechenovMedicine
Frequently Asked Questions about Max Sungurov Md, Mba
What company does Max Sungurov Md, Mba work for?
Max Sungurov Md, Mba works for Bluecross Blueshield Of South Carolina
What is Max Sungurov Md, Mba's role at the current company?
Max Sungurov Md, Mba's current role is Chief Medical Officer, Medicare Advantage, BlueCross BlueShield | Expert Population Health, Risk Adjustment and Medical loss management.
What is Max Sungurov Md, Mba's email address?
Max Sungurov Md, Mba's email address is dr****@****ail.com
What schools did Max Sungurov Md, Mba attend?
Max Sungurov Md, Mba attended Haslam College Of Business At The University Of Tennessee, The Wharton School, First Moscow State Medical University Named After I.m. Sechenov.
What skills is Max Sungurov Md, Mba known for?
Max Sungurov Md, Mba has skills like Leadership, Public Speaking, Medicaid And Duals, Medicare, Medical Education, Neurology, Infectious Diseases, Inpatient Care, Physicians, Health Policy, Hospital Operations, Evidence Based Medicine.
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