PROFESSIONAL GOALS
Provide a service to the Healthcare Profession that demonstrates my commitment to ethical treatment practices, focuses on industry trends and economics, including those related to the consumerism of healthcare products and services by leveraging both my clinical and administrative knowledge and experience, and provides an opportunity for professional growth.
HIGHLIGHTS
15 years of professional experience in the complementary healthcare industry, encompassing both clinical practice and healthcare administration.
Strong undergraduate and postgraduate foundation in the biological and clinical sciences.
Excellent communication skills, with a customer service focus both internally and externally.
EDUCATION
2006 George Washington University
Washington, DC
Masters in Business Administration with an emphasis in Healthcare
Magna Cum Laude
1997 State of California
Industrial Medical Council
Los Angeles, CA
Qualified Medical Examiner (QME)
1997 International Chiropractic
Association
Los Angeles, CA
Independent Disability Evaluator (IDE)
1993 Palmer College of Chiropractic
Davenport, IA
100 Hr. Postgraduate Course-Radiographic Interpretation
1993 Life Chiropractic College
West
San Lorenzo, CA
Doctorate of Chiropractic
1990 University of California-
Riverside
Riverside, CA
Bachelor of Science in Biochemistry
PROFESSIONAL ORGANIZATIONS
American Chiropractic Association
American Public Health Association
California Chiropractic Association
Orange County CCA President (Dates Available upon Request)
Orange County CCA Board of Directors (Dates Available upon Request)
2004-Present: Legislative Principal Key Doctor (Orange County)
2006: Appointed to Membership Committee
Life Chiropractic College West: Alumni Association
Massachusetts Chiropractic Association
Michigan Chiropractic Society
Ohio State Chiropractic Association
Pennsylvania Chiropractic Association
Virginia Chiropractic Association
CIVIL ACHIEVEMENTS AND
SCHOLARSHIPS
( Dates Available upon Request.)
Outstanding New Chiropractor, Orange
County Chiropractic Society
Who's Who Among Students in American Colleges and Universities
California Chiropractic Association Academic Scholarship
Student Representative - Life College - World Congress of Chiropractic
Philip Morris International Student Scholarship
PROFESSIONAL EXPERIENCE
2003 to Present, American
Specialty Health (ASH)
San Diego, CA
Senior Manager, Professional & Governmental Affairs
Responsible for obtaining and analyzing competitor pricing information related to provider reimbursement and prepare recommendations to senior management regarding ASH pricing models.
Appointed to the Leadership Management Team.
Monitor and report trends associated with industry competitors including, but not limited to, pay for performance metrics, accreditation, credentialing processes, reimbursement models, wellness and prevention strategies, health retirement and savings accounts, and new product development.
Support the growth and participation of the consultant network through both written and verbal communications, including the ongoing development of the Professional Affairs Advisory Group.
Manage ASH consultants with respect to project involvement, committee participation and external assistance to ASH.
Assist department head with budget and strategic planning.
Interface with Professional State and National Complementary Healthcare Associations, including association leadership both internally and externally.
Provide inter-departmental back up support to senior management, both clinical and operational, ranging from provider communications to UM-tiering programs.
Assist in fee schedule development and payor summaries.
Developed and manage ASH's Value Added Program.
Assist in reviewing State and Federal Legislation pertinent to Managed Care, Worker's Compensation and Complementary Alternative Medicine.
1996 to 2003, American Specialty
Health Plans (ASH Plans)
San Diego, CA
Senior Clinical Services Manager- Clinical Care Management
Provided both qualitative and quantitative review using current evidenced based healthcare literature as a benchmark for Chiropractors.
Conducted utilization review of 210,000+ clinical treatment requests.
Served as lead clinician responsible for investigation and resolution of all member clinical grievances and appeals as they relate to standards of care, questionable billing, emergency services and clinical appeals.
Developed official clinical service manager training program and trained new clinical service managers.
Supported senior management in department audits with URAC, NCQA and the California Department of Managed Healthcare.
Oversaw clinical team in identifying and discussing potential health and safety issues.
Lead clinician for all credentialing peer-review of doctors applying to ASH networks, focusing on clinical practice protocols as they pertain to industry standards.
1997 to 2005 Monarch Bay
Chiropractic
Dana Point, CA
Chiropractor (Part-time)
Provided high quality level of chiropractic examination and treatment.
Continued enhancement of clinical skills.
1993 to 1996 Serrins Chiropractic
Mission Viejo, CA
Chiropractor
Provided comprehensive quality chiropractic care.
Taught in-house spinal-care and wellness classes.
1991 to 1992 Life Chiropractic
College West
San Lorenzo, CA
Research Assistant
Assisted in data gathering and dissection for a study on Dura Mater Adhesions in the Cervical Spine.
1995 to 1997 Orange County
Chiropractic Association
Orange County, CA
President
Managed 8-member Board of Directors, acted as the liaison between CCA and the chapter members.
Developed and implemented a re- licensing seminar for Chiropractors Contributing author for monthly newsletter to 1100 Chiropractors in Orange County
ADDITIONAL RELEVANT EXPERIENCE
Appointed an expert witness for the California Chiropractic State Board.
Appointed an expert witness for the California Chiropractic State Board.
Investigate and provide peer-review of chiropractors who have been reported to the Board for possible acts of unprofessional conduct, documentation issues and/or billing related concerns.
Appointed to serve on committee responsible for creating California's Professional Practice and Jurisprudence Examination.
Malpractice Expert Witness: Defense and Plaintiff
Commissioner for National Board of Chiropractic Examinations: Part IV
Lecturer at Life Chiropractic College West, Cleveland College of Chiropractic, Los Angeles and Southern California University of Health Sciences and Palmer Chiropractic College West regarding healthcare economics, standards of care, clinical documentation and UM.
Volunteer: St. Vincent DePaul. Render chiropractic care to the less fortunate
CURRENT STATE LICENSES
(All current and good standing,
License Numbers Available Upon Request)
California
Hawaii
Massachusetts
Michigan
Ohio
Pennsylvania
Rhode Island
South Carolina
Vermont
Virginia
REFERENCES
Available Upon Request
KEYWORDS
Chiropractic care Expert Witness, Chiropractor Expert Witness