Medical Resume - Physician

MEDICAL RESUME - PHYSICIANMore than (#) years' diverse leadership experience as a physician executive with significant accomplishments in developing managed care strategies, integrating delivery systems, improving quality and utilization management programs and coaching medical staff on health care business and practice issues.A self-directed professional with excellent communication, interpersonal and problem solving skills who builds consensus and promotes teamwork.Professional Experience:SSS Consulting, 1995-1998ConsultantServed as a lead consultant on the recruitment of executives including physicians, chief information officers and administrators for the largest health care retained search firm.Consulted with a multi-hospital system, developed job descriptions and recruited the chief information officer to further the development of an information technology strategy. Helped to create a selection process that involved physician leaders, clinical staff and the executive team.Served as an adviser to a 14-hospital system for the creation and recruitment of a new corporate Chief Medical Officer position to facilitate an integrated physician structure and involvement in the organization's leadership.Health care Managers, 1993-1995Medical DirectorLed the creation and operational set up of an MSO that managed three IPA's with 600 physicians and 60,000 lives located in four counties. Participated on the physician Board of Directors founded in 1993. Oversaw operations with involvement in claims management, authorizations, utilization, provider and health plan relations, and quality management. (HMO capitation contracts were managed for professional, facility and ancillary health care, with full risk and stop loss agreements.) Supervised four clinical case managers.Wrote a business plan for utilization and quality management programs to include report card data elements into a standard reporting system. Expanded scope of quality management beyond Coalition requirements to include database trending of potential quality of care/service issues. Adapted re-credentialing program and a confidential file system of internally generated incident reports.IPAs of SYS, 1988-1993Medical Director (1990-1993)Responsible for utilization review, quality assurance, provider relations, claims problems, and fiscal analysis of provider costs and budgets for an IPA with 200 physicians and 10,000 members. Acted as liaison with the corporate offices of a billion dollar for-profit health care system. Organized and initiated an expansion of the IPA to two additional hospitals and their medical staffs.Board of Directors, Executive Committee, Chairman (1988-1993)Presided over the credentials committee through a provider base expansion from 60 to 180 while patient enrollment doubled in two years.Organized and developed a claims payment system which paid $2 million to providers during a sudden reorganization, facilitating a smooth transition to a new management company.Quality Care, 1992Medical DirectorRecruited as the project director for the development of a potential county-wide EPO product for an organization that provided medical necessity and benefits review for65,000 members.Consulted with self-funded employers, third party administrators and brokers to evaluate new services, including contract analysis, recommendations for benefit packages, claims payors and brokers and the allocation of health care dollars.Hospital, California 1984-1990Chief of Staff (1989-1990) Vice Chief of Staff (1987-1988) Founder, Chairman of Bioethics Committee (1984-1986)Elected as chief of all clinical services of 185-bed, acute care hospital with responsibility for physician quality issues including legal credential challenges.Clinical Experience: - 1981-1993Began and built a two-office solo practice in adult and pediatric allergy, asthma and immunology medicine. Developed pro-formas and established capitation and case rate schedules for IPA and medical groups with 150,000 patients.Education:Fellowship: County Medical Center (Allergy/Immunology), 1980-1981Fellowship: Medical Center (Allergy/Immunology), 1978-1979Residency: Hospital (Pediatrics), 1976-1978University of SYS,Medical Doctor Degree 1976Masters of Science Degree in Molecular Biology, 1972Bachelor of Science Degree in Biological Sciences, 1970Management Training:Medical Informatics, 28 hoursPerspectives in Medical Management, 22 hoursMastering the Art of Power Negotiation, 12 hoursPhysician in Management, Parts 1, 2, 3, 93 hoursHealth Care Finance and Accounting, 14 hoursPerspectives in Medical Management, 18 hoursThe One Minute Manager, 7 hoursLegal Issues in Health Care, 14 hoursCompleted more than 15 management training courses on leadership, quality, information systems and finance.Board Certification and Licensure:Physician and Surgeon, 1976American Board of Medical Management, 1993American Board of Allergy and Immunology, 1982Professional Affiliations:American College of Physician Executives, Member, Advanced StandingAmerican Academy of Pediatrics, FellowAmerican Academy of Allergy and Clinical Immunology, FellowAmerican College of Allergists, Fellow。