Melanie D. Hunter, Md, Mba Email & Phone Number

United States

Usa - National

Executive operationsPC-Medical Home Champion Consultant to Agape Integrative Health Care CorporationOrganizational Change Analysis/ManagementHelped to implement change in UCLA R. Reagan Neuropsychiatric Hospital - Dietary Dept. with consideration of Agape Integrative Health Care’s – Basic Whole Food Nutritional Blended G-Tube feeds for hospitalized patients. Proprietary Primary Population Care©– active patient engagement, active employee engagement, patient care work plans successfully adopted by MD/RNP offices

National

Oversee the operations of the organization to meet business goals and projectionsCollaborate closely with the chief executive officer and produce reports on company operationsEmpower the operational team with the leadership and resources they need to successfully complete operations initiativesPositively represent the company at all times through a success-oriented and professional demeanorMeasure and report on operational performance and develop plans to improve relevant key performance indicatorsHelped to procure and maintain new Enterprise Resource Planning, (ERP); core software for telephony, accounting, and main business operations.

Remote

Greater Nashville Area, Tn

Provided consulting services related to the Request for Proposal for US State's Departments of Finance/Administration and Divisions of Health Care Finance related to the provision of managed care enrolleesAuthored key sections of the company's written proposals related to Quality Improvement, UM, and Long Term Care Services Provided technical writing and professional editing services Providing consulting services related to the broader opportunities for this Managed Care CompanyHealth Services: PR/UM/UR/Quality/FWA/NetOps/QIC/CMS-MA/Medicaid/BH/Pre-cert

Usa - National

Physician Case Reviews – Medical, Disability, Workman’s CompPC-Medical Home ChampionIntegrative Consultant Reviews

VP, Medical Director – TN HPProvided executive oversight: UM/CM/QM units. Nov. 2011 issue of Consumer Reports: TN HP named best HP in middle TN -highest quality scores per NCQA measure. Amerigroup (AGP) had lowest MLR of all TennCare MCO’s in Tennessee - #1 HP. Total Membership – 240KProvided leadership - development of new programs. Hired and supervised Medical Directors. Direct responsibility: AGP TN performance improvement (PI) achievements: Financial – 2008: 105% of target (61M), 2009: 113% of target (69M), 2010: 215% of target. Met MEI savings goal by 177% (44.2M), & 2011 near years end financial results – on track for exceeding the MEI savings target by 125% (148M). PI: 100% achievement - member/provider satisfaction goals. Chairperson - TN HP QMC: 2010 Q. I. – exceeded all targets for CAPHS and HEDIS measures; 2010 CAPHS award (TN State Bureau). Provided local/national level oversight for physical/behavioral health: UM, UR, CM, DM, NCQA/EQRO accreditation. Credentialed network providers. PC-MH Champion. Designed UM/UR Inpatient Outlier Mgmt Process, Pain Management Review, Obs. vs. inpatient stay mgmt, & expedited MD review: MEI - hit 100% target: saved $2.0M. Decreased Medicare readmission in 2010 by 36%. Provided clinical leadership to corporation committees. Selected by AGP corporate executives for a Sr. Level Leadership Forum: 1 year development process - provided participants the skills to maximize their effectiveness in today’s workplace. It included a formal group action learning project presented to corporate executive team

Medical Director for National UM/UR/Transplant Medical Services and Review. Regional Medical Director IL Care Management Site and Liaison to Chicago Health Plan. Participated in Sales presentations and Finalist Presentations both locally and nationally. Work with Health Plan to achieve Medical Expense Iniatives success.

Provided leadership for the statewide health plan with a mandate to rectify compliance issues, streamline and improve ineffective work process, and improve overall quality and financial results. Demonstrated skills and success with: utilizing medical informatics, program development/implementation, and communication with patients, customers, brokers, physicians, chief executive staff, and regulatory agencies. Participated on National Standard Operating Procedure Committee – drafted language for several policies. Partnered with Market and Network medical leadership to determine and implement strategies that maximized the market’s performance achieving 100% of quality and cost-saving targets. As the Subject Matter Expert for Multiple Sclerosis, redesigned the MS Clinical Interventions Tool for UHG. Provided medical director support for sale presentations to large UHG customers locally and nationally.

Greater Chicago Area

Internal Medicine/Family Medicine in large metropolitan area of Chicago, IL.  Developed expertise with multi-cultural medical delivery systems. Developed and trained a unique provider services department, resulting in non-clinicians successfully influencing clinicians’ clinical behavior. Elected Chair of the American College of Physician Executives Society on Managed Health Care.

Greater Chicago Area

Staff Model Physician - Internal Medicine Practice

Forrest Park, Il

Group Practice - Internal Medicine/ Family Medicine

Greater Chicago Area

Chair Quality Control Committee for Dept. of Family Medicine.Reviewed all internal and external referrals for Quality of Care concerns for Dept. of FMPresented case and root cause analysis with solutions to Dept. Chair and COS

Hyde Park, Il

Private practice - IM and FM

Greater Chicago Area

Clinical Instructor - School of MedicineSupervised Residence in clinicsResearch & Grant Preparation for School of Gerontology (MPH - 1 Yr of course work)

M.D., Medicine

Mba, Executive Business Management

B.S., Engineering/Biological Science

Activities and Societies: Dean's Honor Roll