Utilization Management Expert Witnesses

Family Medicine, Geriatrics - family medicine, primary care, general medicine, general medicine, urgent care, managed care, utilization management

I have vast experience providing medical legal expertise for both medical defense as well as plaintiff counsels. I also serve as an expert for the medical board of California. I have been in clinical practice for 34 years in the Los Angeles area, 21 years in private/group practice and 13 years in outpatient family medicine in a community practice affiliated with UCLA. I also serve as medical director for the UCLA primary care network, and am involved in clinical operations as well as quality improvement activities for the primary care physicians. The network includes primary care offices as well as urgent care locations and also incorporates telehealth services. While I no longer provide inpatient care, I do maintain hospital privileges at 2 community hospitals and follow my patients closely upon hospital discharge. I have vast experience in managed care, providing utilization review for health plan beneficiaries under HMO insurance. My clinical practice includes pediatrics, ad...

Internal Medicine, Occupational Medicine - Correctional Healthcare, Independent Medical Examination, Worker's Compensation, Medical necessity determinations, Disability assessments, Medical file chart review, and utilization management,

Nkiruka Ndu, MD, FACP, QME, is the Medical Director of Just Law Medical Services, a medical-legal consulting firm that provides medical-legal evaluations in internal medicine. She is a Qualified Medical Examiner in the state of California, She evaluates injured workers and personal injury cases. She performs medical necessity determinations for Independent Review Organizations. for medical necessity determinations and appropriateness of care. She is knowledgeable in the National Commission of Correctional Healthcare Standards.

Infectious Diseases, Hospital Administration - Long term care, nursing homes, skilled nursing facilities, Patient safety, Quality of care, Hospital accreditation, immunocompromised patient, medical staff protocols, antibiotic stewardship, infection prevention, infection control, transition of care, utilization management, wound care

Andres Romero is an infectious diseases physician with specialized training in treating immunocompromised patients, having completed his training at Memorial Sloan Kettering Cancer Center. He has built a career providing services in acute care hospital, outpatient facilities including wound care and post-acute care settings (long-term care hospital, skilled nursing facilities and nursing homes). Dr. Romero currently serves as Chief Health Officer at an acute care hospital. In this role, he leads initiatives in utilization management and process optimization, ensuring quality care standards are met throughout the hospital and its affiliated facilities. His notable contributions include refining peer review procedures for medical professionals and implementing workflows to facilitate safe patient transitions within the hospital. Dr. Romero actively streamlines patient safety protocols and workflows across acute and post-acute care facilities. His leadership skills, cultivated throug...

Addiction Medicine, Family Medicine - Opioids, opiate, methamphetamine, overdose, alcohol, hallucinogens, cocaine, cannabis, club, drugs, illicit, drug rehabilitation, utilization management, drug policy, alcohol and drug treatment, drug intoxication, drug withdrawal, detoxification, drug testing appropriateness, pain

Dr. San Bartolome is board certified in addiction medicine and family medicine. He has extensive experience as a medical director at all levels of care in addiction treatment including detoxification. As a medical director, Dr. San Bartolome has been involved in policy making, setting protocols, utilization management and direct patient care in addiction medicine. Due to the nature of addiction, Dr. San Bartolome is experienced in pain management, mental health and use of psychotropic medications, and in other co-morbidities involving addiction. Dr. San Bartolome is a national expert, serving on committees for the American Society of Addiction Medicine and on the board of the California Society of Addiction Medicine. His experience in addiction medicine spans settings like hospitals, psychiatric units, emergency departments, outpatient clinics and as an administrative medical director of substance use disorders for a large health plan. In all of these settings and at various medical...