Gordon B. Kuttner, Md, Jd, Mba, Chc, Facog, Facs Email & Phone Number

Boca Raton, FL, US

Provides medical oversight and expertise for appropriateness and medical necessity of healthcare services provided to members,

West Lafayette, IN, US

Yellow Springs, OH, US

• DeLorean Artificial Intelligence (www.deloreanai.com) sentient and semi-sentient systems of intelligence to meet the evolving needs of Fortune 500 companies in the areas of Healthcare, Sales, Financial Services, and.
• Support Delorean’s Real Time Medical Care Management AI (RTMCM AI).
• Advise on managed care organizations’ goals, objectives, and pain points.
• Advise on developing client solutions to identify patient rising risk and specific condition trajectory with evidenced-based interventions to delay progression of the condition and decrease inappropriate utilization.
• Advise on population condition stratifications by rising risk identification allow efficient care management resource allocation.
• Advise on Next Best Care Action, Next Best Healthcare Provider Action, Provider Intervention Recommender, Medical Adherence.

• Partnered with healthcare organizations to provide knowledge and experience in the managed care arena with expertise in federal and state government health programs serving high-risk, vulnerable populations.
• Advised on coordinating biopsychosocial needs of each member through risk stratification, care gap analysis, evidence-based medicine, partnering with community services, appropriate deployment of provider and consumer.
• Delivered innovative program design through data-driven population health analysis.

Long Beach, California, US

Jacksonville, Florida, US

• Hired to build and implement innovative omni-channel patient / physician interactive communication platform leveraging artificial intelligence and automation, delivering high-impact personalized health plan.
• Spearheaded team on development of 375+ system triggers / tasks activated by mining clinical, claims, social determinants of health & other internal and external data consumed by a rules engine to determine optimal.
• Led development of member and provider messaging to ensure personalization and improve engagement.
• Worked with HEDIS measures, STARS ratings, and risk adjustment factors to maximize reimbursement and support total medical expense reduction.
• Delivered multi-million-dollar savings for Health Risk Appraisal implementation by researching external resources and evaluating ROI for new vendors and technologies, and significantly increased response rate for.
• Responsible for developing and medical oversighting case management programs, establishing new telehealth program and implementing automation including IVR (interactive voice response) solution.

Teaneck, New Jersey, US

• Set overall clinical direction of digital healthcare Business Process Services Practice-Health Care Delivery. Guided teams developing solutions, technologies, and global clinical services to enable healthcare.
• Liaised between Cognizant’s US healthcare clients and onshore and offshore clinical delivery healthcare professionals ensuring clinical medical management (UM-CM-DM) quality and compliance; played instrumental role in.
• Advised on knowledge management, knowledge transfer methods, continuous quality improvement, and healthcare medical management clinical operations.
• Coordinated internal compliance and legal teams regarding federal and state regulations for prospective client accounts and accreditation processes.
• Advised Cognizant Healthcare Consulting group on developing client solutions to increase efficiencies and cut cost – by championing transformational thinking and redesign of common processes using automation.
• Cognizant is a multinational company that combines client satisfaction, technology innovation, deep industry and business process expertise and a global, collaborative workforce. Cognizant enables enterprises to.

Hartford, Connecticut, US

• Led strategic medical management activities impacting market performance and promoting quality of care for members. Oversaw development and implementation of medical programs and policies; cultivated and enhanced.
• Supervised administrative staff of five in the Clinical Operations Department.
• Provided clinical and business leadership to support key objectives of business segments & plan sponsors.
• Oversighted Utilization Management, Care Management, Pharmacy, and Quality.
• Performed second level medical and pharmacy reviews.
• Co-led evaluation of quality, care, and service, including activities necessary for NCQA accreditation.

Grand Cayman, Cayman Islands, KY

• Senior academic official responsible for ensuring integrity and seamless operation of third- and fourth-year clerkship rotation sites including evaluation of sites in the US, Canada and the UK.
• Supervised administrative staff of seven in the Clinical Science Department.
• Worked across departments of the Registrar, Billing, Alumni Relations, and Admissions on joint projects.
• Reviewed hospital affiliation agreements and new programs to enhance academic clerkship experience.
• Liaised with students, preceptors and hospitals to improve performance and address any disciplinary issues.

US

• Implemented and led national HFS medical maternity team, partnering with multidisciplinary team of board-certified physician OB/GYNs, obstetrical nurse case managers, social workers, health coaches, pharmacists, data.
• Responsible for oversight of delivery of the highest quality of evidence-based and cost-effective care and eliminating $5 M annual spend on unproven obstetrical outpatient treatments.
• Spearheaded initiatives to improve service and quality of care, provide a consistent member experience, improve birth outcomes, achieve higher overall provider and member satisfaction through effective partnering and.
• Served as subject matter expert (OB/GYN & Reproductive Endocrinology, Fertility); partnered with utilization and care management, medical policy, pharmacy, appeals, provider relations & joint projects across.
• Drove down inappropriate Hospital inpatient admissions by 20%
• Drafted UnitedHealthcare Medical & Drug Policies and Coverage Determination Guidelines regarding 17-Alpha-Hydroxyprogesterone Caproate (Makena® and 17P)

Tampa, Florida, US

• Provided clinical leadership and led care management functions for 1.5 million members in multiple states. Collaborated with Case and Disease Management, Care Management Directors, and senior leadership to implement.
• WellCare is a leading provider of managed care services dedicated to government-sponsored healthcare programs, focusing on Medicare and Medicaid; employs 3,500+ professionals and serves 2.3 million members.

Led start-up efforts for practice. From pro forma to implementation of a full spectrum of assisted reproductive technologies, including IVF, PGD, GIFT, gamete/embryo cryopreservation, intracytoplasmic sperm injection, and 3rd-party parenting. Performed reproductive surgeries, including operative endoscopy encompassing laser laparoscopy and hysteroscopy..

Miami, FL, US

Provided instruction to medical students, residents, faculty, and resident clinical practice. Fostered partnership with local private IVF program while awaiting division funding.

Albany, NY, US

• Head, Division of Reproductive Endocrinology & InfertilityDirector, Undergraduate Medical Education: Department of OB/GYN & Reproductive Sciences Assistant Professor, Obstetrics, Gynecology, and Reproductive.
• Facilitated changes relating to fertility coverage policies through negotiating and lobbying 3rd-party payers regarding contractual language and reimbursements for fertility services; interfaced with insurance.
• Boosted percentage of students applying for OB/GYN match positions 300% over prior year.
• Cultivated and maintained alliances, fostering prompt referrals, through networking with private practice community physicians, including general OB/GYN, family practice, internal medicine, psychology, and urology.
• Transformed clinical clerkship by introducing outpatient experiences and limiting inpatient experience; initiated small group clinical problem solving, limited didactics, implemented live pelvic models, and provided.

Fellow, Reproductive Endocrinology And Fertility

Residency, Obstetrics & Gynecology

Residency, Obstetrics & Gynecology

Md, Medicine

Doctor Of Law (Jd), Law

Ba, Biology

Education record

Education record

Mba, Healthcare