Stephen E. Email & Phone Number

Los Angeles, CA, US

Los Angeles, California, United States

- Support the Independent Review Organization’s (IRO) California Department of Managed Health Care (DMHC) activities- Provide advice and counsel to the DMHC as needed- Address clinical case questions from appeals officers and administrative staff.- Provide clinical advice to legal counsel and internal teams- Clinical panel physician oversight function.

Los Angeles Metropolitan Area

For over 26 years, I’ve had extensive medical writing, analytic, and consulting experience as an administrative healthcare physician. I’ve communicated healthcare information and persuaded readers in many areas of healthcare, ranging from specific medical content to issues involving the healthcare payer system.Writing styles include: - Blog-style projects.

Greater Los Angeles Area

- Medical Director for the startup phase of the new national Community and State (Medicaid) provider reconsideration process (inpatient and outpatient services). - Medical Director for Employer and Individual (Commercial) reconsideration determinations.- Medical Director for Medicaid provider reconsideration determinations.- Medical Director for Medicare.

Greater Los Angeles Area

- On a national basis, was responsible for responding to and resolving appeals, complaints, disputes, and disagreements from physicians, physician groups, laboratories, therapy providers, other ancillary medical providers, and institutions such as hospital networks. - Assessed coverage, coding, payment, benefit determinations, level of care, and medical.

Greater Los Angeles Area

- Obtained physician expertise in the Medi-Cal Program (California's Medicaid Program).- Advised and had oversight functions for medical quality-of-care issues.- Performed extensive medical record auditing against claim and medical policy standards.- Performed extensive medical record reviewing for value-based care assessments. - Participated in detecting.

Greater Los Angeles Area

- Extensive duties and experience in outpatient clinical care.- Extensive duties and experience in inpatient/hospital medicine.- Extensive duties and experience in intensive care unit and critical care medicine.- Extensive duties and experience in urgent care and emergency room medicine.- Extensive duties and experience in consultative medicine, for other.

Completion Of Internal Medicine Residency

Internal Medicine Residency

Doctor Of Medicine (M.D.), Medicine

With thesis in pediatric cardiology.

Bachelor'S Degree, Major In Biology With Minor In Biochemistry

Summa Cum Laude