Professional summary
I am a physician (MD) who is board certified in internal medicine. I recently accepted a medical director position in administrative medicine with UnitedHealth Group, who is the largest private payer in the country. Prior to that, I have over 21 years of career experience in administrative medicine as a Medical Consultant for the California Medicaid program (i.e., Medi-Cal), working with various stakeholders.
My areas of experience are in medical review auditing, medical documentation, medical coding, recovery audits, fraud/waste/abuse detection and intervention, quality of care assessment, utilization management, value-based care assessment, medical necessity determinations, multidisciplinary teamwork (with physicians, nurses, pharmacists, Read more
I am a physician (MD) who is board certified in internal medicine. I recently accepted a medical director position in administrative medicine with UnitedHealth Group, who is the largest private payer in the country. Prior to that, I have over 21 years of career experience in administrative medicine as a Medical Consultant for the California Medicaid program (i.e., Medi-Cal), working with various stakeholders.
My areas of experience are in medical review auditing, medical documentation, medical coding, recovery audits, fraud/waste/abuse detection and intervention, quality of care assessment, utilization management, value-based care assessment, medical necessity determinations, multidisciplinary teamwork (with physicians, nurses, pharmacists, administrative management, attorneys, financial auditors, etc.) and program knowledge related to California's Medicaid program. I have worked with lawyers in the Medicaid program advising them on the medical aspects of cases, and have testified before administrative law judges in related matters. I also have worked closely with Medicaid fraud investigators in the review and evaluation of medical fraud/abuse.
I have extensive experience making and defending decisions in the above areas for various types of providers, including physician outpatient/inpatient, laboratory, radiology, other diagnostic, pharmacy, emergency department and inpatient/outpatient hospital. This includes strategy planning meetings, teleconferences, in-person meetings, issue research, online work and written reports of findings.
I am licensed to practice medicine in California. I have past clinical experience in inpatient and outpatient internal medicine at all levels (clinic, urgent care, emergency room, inpatient general and intensive care, clinical consultative medicine and peer review), which coupled with my administrative experience provides a broad perspective with which to integrate issues from wide areas of medical practice.
I received my bachelor's degree and graduated summa cum laude from UCLA, completed my M.D. degree at UC San Diego with a thesis in pediatric cardiology and completed internship/residency at the Cedars-Sinai Medical Center internal medicine program. Prior to my career in administrative medicine, I was appointed to the attending physician staff in the department of internal medicine at Kaiser Permanente.
I am elected into membership of the American College of Physicians, and am a member of both the Los Angeles County and California Medical Associations. I have received the California Department of Health Care Services Superior Accomplishment Award, been listed in the Guide to America's Top Physicians and earned the American Medical Association's Physician Recognition Award multiple times.
