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Lead utilization management medical director team serving the Aetna Better Health Medicaid managed care health plans in Florida, Kentucky, Louisiana ,West Virginia Texas.

Aetna Better Health of Kentucky

Aetna Better Health of Kentucky

Aetna Better Health of Illinois Medicaid managed care lines of business (TANF/ACA, MMAI, ICP, LTSS, MLTSS)Develops, implements, supports and promotes strategies for utilization management, quality management, network management and clinical coverage and policies to drive the delivery of quality healthcare.Oversee utilization review/quality assurance, directing case managementProvide clinical expertise and business direction in support of medical management programs through participation in clinical team activities. Serve as champion for HEDIS child health quality team; lead for neonatal abstinence syndrome program; and as a member on the national health care equity workgroup.Liaise with network providers and facilities to support the effective execution of medical services programs by the clinical teamsMember, Aetna Medicare-Medicaid National Pharmacy & Therapeutics Committee

Selected as inaugural Chief Health Officer, overseeing critical student health and wellness programming within CPS, while collaborating with Chicago Department of Public Health (CDPH) on the city’s first public health agenda - Healthy Chicago. Focused upon creating healthy school environments that positively influence academic performance through health and wellness policy, promotion, education, and direct services. Instituted district accountability measures for student health and wellness. Implemented life-saving epinephrine auto-injectors in all schools to prevent fatal allergic reactions (first large urban school district in the nation), and wellness policies to set standards for nutrition education and physical activity. Introduced new sexual health education policy that promotes age-appropriate health and safety decision-making, as well as a new physical education (PE) policy to ensure that all students receive high-quality PE on a daily basis. Sourced and secured $10MM in multi-year Federal & Local funds to support student health and wellness initiatives.______________________________________________RESEARCH EXPERIENCE:Principal Investigator (2013 to 2015)U.S. Department of Education Carol M. White Physical Education Program GrantFunded: $2.25M over three years Principal Investigator (2012 to 2015)U.S. Centers for Disease Control and Prevention Community Transformation Grant for Small CommunitiesFunded: $3.98M over two years

Medical Director (2007 to 2012)Asthma Van Physician (2001 to 2012)Mobile Care Chicago’s mission is to deliver no-cost medical and preventative care, education, and support to low-income children and families within their communities aboard mobile medical clinics. A not-for-profit organization that uses mobile medical clinics to assist children currently unable to access necessary specialty care for a chronic condition. All services within all programs are offered free of charge to all participants.

Near North Health (NNH), a 501(c)(3) non-profit Federally Qualified Health Center (FQHC), is one of the largest providers of community-based primary health care in Chicago. NNH provides medical services, social services, and nutrition education to medically indigent and uninsured individuals and families.

An acute care community hospital that serves the Chicago community of Austin and the surrounding areas.