Senior Care Expert Witnesses

White Lake, Michigan

Health Informatics, Nurse - EHR, Medical Record, Health Record, EMR, Health Information Technology, Assisted Living, Non-Skilled Home Care, Legal Nurse, Senior Care, Medical Malpractice, Nursing Malpractice, Hospitals, Healthcare, Nursing, Record Review, Standards of Care, Investigation, Analysis, Evaluation

I am a Registered Nurse with over 18 years of healthcare informatics/technology (2006) & over 25 years of healthcare experience (1999). I held healthcare roles as a bedside RN, in clinical management, as an electronic health record (EHR) analyst & project manager, and in executive-level positions within the health information technology profession. I have a Bachelor of Science in Nursing and a Master of Science in Health Informatics. I am extremely versed in overall healthcare and can look at cases with various healthcare lenses because of my strong, diverse background. As a leader, I was asked to review multiple cases to assist with standards of care, defendant identification, EHR standards, documentation, and much more. I have reviewed multiple cases related to clinical standards of care, screening for merit, defendant identification, locating experts, organization & summarization of the medical record, and relevant document recommendations. I have also reviewed over 40 cases rela...

Yanceyville, North Carolina

HMO, Insurance - 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...