Expert Details

Internal Medicine & Hospital Medicine, Utilization Management & Managed Care, Hospice & Palliative Care, Occupational Medicine & Urgent Care

ID: 740516 Texas, USA

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Expert is a board-certified internal medicine physician with over 13 years of clinical experience across outpatient, inpatient, occupational, telemedicine, and urgent care settings, complemented by extensive administrative experience in insurance credentialing, prior authorization, quality management, coding and billing, clinical documentation, and utilization management. Expert holds a Doctor of Medicine degree and completed residency training in internal medicine, and is currently pursuing a Master of Business Administration degree.

Expert's clinical career has spanned hospital medicine, post-acute care, hospice and palliative care, cardiopulmonary disease management, occupational medicine, and telemedicine-based urgent care and weight-management practice across health systems and organizations in California, Georgia, Texas, and other states, including extensive locum tenens hospitalist assignments during the COVID-19 pandemic. Expert has also held progressively senior utilization management and medical director roles overseeing inpatient, post-acute, and prior-authorization functions for major national managed care organizations.

Expert has founded and managed a private medical practice encompassing primary care, direct primary care, concierge medicine, and aesthetic medicine services, gaining business management experience in billing, insurance credentialing, human resources, and regulatory compliance in addition to clinical duties. Expert is board certified by the American Board of Internal Medicine, holds active medical licensure in numerous U.S. states, and serves as a medical expert witness in addition to clinical and administrative practice.

Education

Year Degree Subject Institution
Year: 2006 Degree: MD Subject: Medicine Institution: Creighton University School of Medicine
Year: 1999 Degree: BS Subject: Biochemistry & Psychology Institution: Loras College

Work History

Years Employer Title Department
Years: 2016 to Present Employer: Undisclosed Title: Founder, CEO Department:
Responsibilities:
Urgent care
Medical weight loss
Non invasive aesthetics
Years Employer Title Department
Years: 2024 to Present Employer: Undisclosed Title: Medical Director Department: National Inpatient Clinical Management Team (West Region)
Responsibilities:
Provides utilization management oversight for inpatient Medicare, Medicaid, and Commercial populations.
Years Employer Title Department
Years: 2023 to 2024 Employer: Humana, Inc. Title: Medical Director, South Central Region Department:
Responsibilities:
Oversaw utilization management functions for post-acute care, prior authorization, and inpatient services.
Years Employer Title Department
Years: 2023 to 2024 Employer: Various Telehealth Companies Title: Physician, Urgent Care/Medical Weight Loss Department:
Responsibilities:
Provided virtual urgent care and medical weight loss consultations.
Years Employer Title Department
Years: 2011 to 2024 Employer: Various Staffing Associations Title: Inpatient Hospitalist Department:
Responsibilities:
Provided inpatient hospital medicine care.

Career Accomplishments

Associations / Societies
• American College of Healthcare Executives — 2023–present
• American Association for Physician Leaders — 2022–present
• Texas Medical Association — 2020–present
• American Medical Student Association (AMSA) — 2018–present (also 2006–2011)
• American Medical Women's Association (AMWA) — 2015–present (also 2006–2011)
• Placer County Medical Society — 2014–2020
• Atlanta Medical Association — 2013–2015
• Georgia Medical Association — 2011–2015
• Society of Hospital Medicine — 2011–present
• Physician Moms Group — 2012–present
• Artemis Medical Society — 2012–present
• American College of Physicians — 2002–present
• American Medical Association — 2001–present
Licenses / Certifications
• American Board of Internal Medicine (ABIM) Certification — 2013–present
• United States Medical Licensing Examination (USMLE) — Steps 1, 2, and 3 (passed)
• Advanced Cardiac Life Support (ACLS)
• Basic Cardiac Life Support (BCLS)
• Active medical licensure in 16 U.S. states: Arizona, California, Florida, Georgia, Idaho, Montana, Nevada, New York, North Carolina, Ohio, Oregon, South Carolina, Texas, Utah, Virginia, and Washington

Fields of Expertise

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