Seeking Clinical Leadership Role in Medical Clinical Operations in Health Services, Health Plan, Hospital, Pharmaceutical, Long Term Care settings. Rich experience in managing: Health Plans, Health Care Enterprises, Physician/Provider Networks, Regulatory and Accrediting Agencies, Benefit Expense Trends, Clinical Mitigation Strategies. Have developed and managed: effective and efficient Health Care Delivery System protocols; Population Health Management Programs; Medical-Behavioral Condition Case Management Programs; Quality and Affordability Initiatives; Evidence Based Medicine Standards; Compliance and Regulatory Affairs.

Physician Executive managing medical clinical programs administered by Optum with Independent Health Plans, in this Fortune 50 Company.• Physician expert on Innovation Team that developed and managed seminal Medical Behavioral Integration program that improved quality and efficiency of care, in addition to sustaining and obtaining Independent Health Plan contracts. Program impacted 10 M members.• Established clinical management programs with Accountable Care Organizations, Medical Groups and Health Care Enterprises resulting in wholistic health care and improved clinical outcomes. Reduced all cause Readmission Rates by 5%, improved patient engagement by 15%.• Represented Independent Health Plans in State Government Legislative Committees, Task Forces and Health Plan Association forums addressing effective delivery of Health Care Services to state-wide insured members. Improved Access to Care for all state-wide insured populations: Children and Adolescents; Substance Use Disorders; Medical Emergency Management. • Managed performance of Clinical and Quality Management Programs along with developing and managing mitigation strategies to improve outcomes for contracted Independent Health Plans. • Developed longitudinal care management programs for High Risk Populations which resulted in improved engagement in treatment, improved continuity of care, and greater clinical stability. • Supported improved performance for Centers for Medicare & Medicaid Services (CMS) Star metrics and National Committee for Quality Assurance (NCQA) metrics by developing and managing clinical operational processes to improve engagement through all levels of care.

Physician Executive managing Optum’s California licensed health plan business unit inclusive of clinical operations, quality management, customer service, claims, finance, network contracting, regulatory affairs, compliance affairs and Board of Directors.• Effectively managed all functional business units noted above to the delight of primary customer Blue Shield of California, an $80M dollar contract.• Directly supported and maintained excellent accreditation ratings with California Department of Managed Health Care, National Committee on Quality Assurance and Utilization Review Accreditation Commission.• Developed unique clinical programs that supported population health management needs for condition case management programs, high risk populations and integrated care management needs. Improved Follow Up After Hospitalization metric up to 90th percentile performance per NCQA Quality Compass ranking.• Directly supported market audit needs for business unit related to all functional units noted above.

Managed Health Service company. Directed, developed and maintained clinical management programs for Serious and Persistently Mentally Ill and Substance Use Disordered populations in Partial Hospitalization, Intensive Outpatient and Medication Clinic settings.