Prior Authorization Expert Witnesses
Prior authorization expert witnesses and consultants listed here may be able to form expert opinions, draft expert witness reports, provide expert witness testimony at deposition and/or trial as or serve as consulting (non-testifying) experts on prior authorization. The prior authorization expert witness listings on this page are typically from fields/areas of expertise such as: HMO and Insurance.
James J. McCormick, M.D., M.B.A
Medicare Advantage and Clinical Operations
Yanceyville, North Carolina
HMO, Insurance
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MA, Medicare Advantage, Medicare Operations, Prior Authorization, PA, Appeals, Managed Care, Prior Authorization, Utilization Review, Utilization Management, Senior Care
Edited for Relevant Experiences
National Utilization Committee August 2023 - April 2024
- led the effort to create governance, workflow and procedural requirements to meet CMSS rules changes effective 1/1/2024
- Accountabilities described below and added above responsibility
National Director Medicare Operations March 2022 - April 2024
- Grievances and Appeals
- STARS Appeals performance
- Outpatient Prior Authorization Operations
- Collaborated on national work groups/task forces
Regional VP Mid-Atlantic State March 2019 - March 2022
- Oversight of Prior Authorization and Concurrent Review Operations
- Collaborate on Enterprise Clinical Delivery Models of Care
National reviewing medical Director March 2018 - March 2019
- Reviews prior authorizations for medical necessity
V.P. Integrated Care and Associate CMO Jan 2015 - March 2018
- Multi-state prim...
