Member Board Of Directors

• Jun 2021 - Present

Chief Medical Officer

• Jan 2014 - Present

In charge of managing medical cost outcomes and strategy development for over 280,000 Medicare Advantage and 315,000 Medicaid beneficiaries. Succesfuly cut costs and mantained a zero medical cost trend for over 5 years. Direct supervision and mentoring of 20 medical directors managing inpatient, outpatient, pharmacy, mental health and quality outcomes. Active network management and development of specialist networks, hospitalists and primary care. Expertise in risk managment contracts, capitations and shared savings. Active participation in achieving 4.5 stars in our two MA contracts and only NCQA accredited plans in the market. In charge of expansion, growth and operations of over 15 multispecialty clinics ensuring access, quality, improving patient experience, retention and growth. Show less

Corporate Inpatient Medical Director

• Jan 2011 - Jan 2014

Oversee Inpatient UM Department of the largest NCQA accredited MA Health Plans in Puerto Rico, MMM & PMC, with over 235,000 members. Direct Supervision of Regional Medical Directors. Assist with Hospital Contracting, Renewals, Provider Network Development and IPA Networks. Pioneered and deployed a market wide hospitalist network.

Associate Inpatient Medical Director

• Mar 2008 - Dec 2010

Directed Inpatient Utilization Management of two of the largest regions in Puerto Rico for the largest MA plans in the island, MMM and PMC. Peer to peer case discussion with Hospitalists, Concurrent Review Nurses, and Hospital PA's. Develop stratergies to improve transitions of care, avoid readmissions, coordinate services and provide support to regional IPA's.

Corporate Chief Medical Officer

• Dec 2019 - Jun 2021

Full accountability for Innovacare’s Medical Management Programs in Puerto Rico, Central & South Florida. Integration and Clinical Program development for Orlando Family Physicians a multipayer medical group with over 70 providers, 20 clinics and over 70,000 beneficiaries. In MMM of Florida, a 2018 MA startup with over 3,000 beneficiaries, direct supervision of local market CMO’s clinical programs, medical cost and utilization management as well as pharmacy benefit. Active participation during the diligence and acquisiton process of Innovacare’s Puerto Rico assets by Anthem in 2021. Show less

Chief Medical Officer

• Mar 2018 - Dec 2019

Interim position managing 4 regional IPA’s with over 75,000 Medicare Advantage beneficiaries. Direct supervision of regional medical directors. Responsible for medical cost, coding accuracy strategies and quality/stars outcomes. Interim position managing 4 regional IPA’s with over 75,000 Medicare Advantage beneficiaries. Direct supervision of regional medical directors. Responsible for medical cost, coding accuracy strategies and quality/stars outcomes.

Chief Medical Officer

• Jul 2018 - Feb 2019

Provided support to our expansion of a new Medicare Advantage plan in the South Florida. Provided support to our expansion of a new Medicare Advantage plan in the South Florida.

Board Certified Internal Medicine

• Sep 2005 - Mar 2016

Private inpatient and outpatient practice in the internal medicine field. Private inpatient and outpatient practice in the internal medicine field.

Internal Medicine Residency Faculty Attending Physician

• 2005 - 2008

Mentoring Internal Medicine Residents, oversaw morning reports, daily rounds, inpatient, outpatient clinics and preop clinics.

Chief Resident

• 2004 - 2005

Post-Graduate position supervising internal medicine residents, developing call scehdules, educational activities, conferences, morning reports and mortality reports.