Candidate Information Name Available: Register for Free Title Medical Director Officer Target Location US-PA-Bryn Mawr Email Available with paid plan Phone Available with paid plan	20,000+ Fresh Resumes Monthly     View Phone Numbers     Receive Resume E-mail Alerts     Post Jobs Free     Link your Free Jobs Page     ... and much more Register on Jobvertise Free
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Candidate's Name , MDStreet Address  Glenwyd Rd.Bryn Mawr, PA Street Address
PHONE NUMBER AVAILABLEEMAIL AVAILABLEADMINISTRATIVE EXPERIENCE2018-present Chief Clinical OfficerMultiplan1. Supervise physician team working on payment integrity and fraud waste andabuse.2. Providing clinical expertise to all departments of Multiplan.2012-2018 National Medical Director/Chief Medical OfficerMedical Auditing and Review Solutions West Chester, PA1. Contracted Medical Director for Health Partners, Philadelphia, PA 20122. Recovery Audit Contractor for Iowa Medicaid:Chief Medical Officer for the program.3. Chief Medical Officer for Aetna Medicare Advantage for the state of Arizona.4. Fraud and abuse audits for the Department of Justice2012 Senior Medical Director of Regulatory AffairsExecutive Health Resources Newtown Square, PAI was responsible for educating the company on any regulatory issues andchanges in regulatory guidance. I traveled throughout the country to lecture to hospitals on the CMS audit and appeals process. I presented a webinar with the American Hospital Association on the CMS audits and the appeal process. I was frequently asked to do media interviews to clarify CMS regulatory guidance.2008-2012 Senior Medical Director of Medicare AppealsExecutive Health Resources Newtown Square, PAAll levels of Medicare appeals from the Rebuttals through the hearings with the Administrative Law Judge, representing hospitals nationwide. I was director of the department overseeing the work of over 50 physicians and 15 nurses. I also collaborated with the attorneys and researched and wrote appeal arguments. Utilized hospital screening tools such as Interqual Level of Care and Milliman Care Guidelines.2007-2008 Senior Medical DirectorExecutive Health Resources Newtown Square, PADirector of a team of four physicians, a nurse and an Administrative Assistant. Worked with hospitals on Medicare compliance program2005-2007 Physician AdvisorExecutive Health Resources Newtown Square, PAWorked with hospitals on their Medicare compliance program and appealed commercial denials.Clinical Appointments:2005.Healthcare CommitteeColorado Chamber of CommerceDenver, Colorado2005.Physician Advocacy CommitteeColorado Medical SocietyDenver, Colorado2001.Utilization Management CommitteeJohn Muir Hospital IPAWalnut Creek, California2001.Provider ManagerMuir Primary CareAlamo, California2001.Ethics CommitteeAlameda/Contra Costa CountyMedical AssociationOakland, CaliforniaCLINICAL EXPERIENCE2005.InternistSummit Medical GroupAurora, Colorado2004.InternistRocky Mountain Kaiser PermanenteLittleton, Colorado2001.InternistMuir Primary CareAlamo, California1991. Medical Director of Civilian Physicians/InternistOakland Naval HospitalOakland, California1990.InternistPalo Alto Medical ClinicFremont, California1989.InternistAccess Medical GroupMarina Del Rey, California1987.Resident, Internal Medicine1985. Intern, Internal MedicineDepartment of MedicineLos Angeles County/University of SouthernCalifornia HospitalLos Angeles, CaliforniaEDUCATIONAmerican College of Physican Executives Courses, 2005Ethics in MedicinePhysician in ManagementFinanceHealth LawBoard Certified, 1987American Board of Internal MedicineM.D., June 1984University of Cincinnati, College of MedicineCincinnati, OhioB.A. with honors, Physiology, June 1978University of California, BerkeleyBerkeley, CaliforniaPUBLICATIONSPollack,Evan, Nathan Stephens, Adam Naider, Inpatient versus observation status: the Medicare Dilemma, ACP Hospitalist: October, 2012.Chan PH, Pollack, EJ and Fishman RA: Differential effects of hypertonic mannitol and glycerol on rat brain metabolism and amino acids: Brain Research, 225PHONE NUMBER AVAILABLEChan PH, Fishman RA, Lee JL and Pollack EJ: Effects on excitatory Neurotransmitter amino acids on brain edema. Trans Am Soc Neurochem 10: 195,1979Schmidt, James, Candidate's Name  and Herbert Srebnick, Effects of Gonadectomy and estrogen treatment on serum FSH and LH Concentration in female protein deficient rats; abstract in AAAConference 1978.Interview:ACP Advocate: April 17, 2015, Panel seeks to Change the Rule on Short-term Hospital Admissions.Report on Medicare Compliance: June 18, 2012, Site of Service for Cardiovascular Surgery Tops RAC Findings of OverpaymentSOCIETIES, AWARDS and APPOINTMENTS:Selected to be a delegate to the AMA from the state of Pennsylvania 2014-2022Awarded the Robert Pressman award by the American College of PhysiciansFellow of the American College of PhysiciansFormer Chairman of the Pa ACPs Leadership DayFormer Chairman of the Health and Public Policy committee of the American College of PhysiciansMember of the Political Advocacy Executive Council of the Pennsylvania Medical Society.Appointed member to the House of Delegates of the Pennsylvania Medical Society2011 Key Contact award from the American College of Phyicians.Appointed to the Pennsylvania Medicaid Peer Review Committee.Named to the Specialty Leadership Council of the Pennsylvania Medical SocietyNamed to the expert panel on hospital policy in the American College of Physicians.Selected as the ACPs representative for the Editorial Advisory Board of the AHAs Coding Clinic.Contractors Advisory Committee for NovitasCoding and Policy Subcommittee for ACP