Chiropractor Expert Witness

Professional Goals

Provide a service to the Healthcare Profession that demonstrates my commitment to ethical treatment practices, focuses on industry trends and economics, including those related to the consumerism of healthcare products and services by leveraging both my clinical and administrative knowledge and experience, and provides an opportunity for professional growth.

Highlights

15 years of professional experience in the complementary healthcare industry, encompassing both clinical practice and healthcare administration.

Strong undergraduate and postgraduate foundation in the biological and clinical sciences.

Excellent communication skills, with a customer service focus both internally and externally.

Education

2006 George Washington University Washington, DC
Masters in Business Administration with an emphasis in Healthcare – Magna Cum Laude

1997 State of California Industrial Medical Council, Los Angeles, CA
Qualified Medical Examiner (QME)

1997 International Chiropractic Association, Los Angeles, CA
Independent Disability Evaluator (IDE)

1993 Palmer College of Chiropractic, Davenport, IA
100 Hr. Postgraduate Course-Radiographic Interpretation

1993 Life Chiropractic College West, San Lorenzo, CA
Doctorate of Chiropractic

1990 University of California- Riverside – Riverside, CA
Bachelor of Science in Biochemistry

Professional Organizations

American Chiropractic Association

American Public Health Association

California Chiropractic Association

Orange County CCA President
(Dates Available upon Request)

Orange County CCA Board of Directors
(Dates Available upon Request)

2004-Present: Legislative Principal Key Doctor (Orange County)

2006: Appointed to Membership Committee

Life Chiropractic College West: Alumni Association

Massachusetts Chiropractic Association

Michigan Chiropractic Society

Ohio State Chiropractic Association

Pennsylvania Chiropractic Association

Virginia Chiropractic Association

Civil Achievements and Scholarships

(Dates Available upon Request.)

Outstanding New Chiropractor, Orange County Chiropractic Society
Who’s Who Among Students in American Colleges and Universities
California Chiropractic Association Academic Scholarship
Student Representative – Life College – World Congress of Chiropractic
Philip Morris International Student Scholarship

Professional Experience

2003 to Present, A Specialty Health Organization – San Diego, CA
Senior Manager, Professional & Governmental Affairs

Responsible for obtaining and analyzing competitor pricing information related to provider reimbursement and prepare recommendations to senior management regarding ASH pricing models.

Appointed to the Leadership Management Team.

Monitor and report trends associated with industry competitors including, but not limited to, pay for performance metrics, accreditation, credentialing processes, reimbursement models, wellness and prevention strategies, health retirement and savings accounts, and new product development.

Support the growth and participation of the consultant network through both written and verbal communications, including the ongoing development of the Professional Affairs Advisory Group.

Manage consultants with respect to project involvement, committee participation and external assistance to.

Assist department head with budget and strategic planning.

Interface with Professional State and National Complementary Healthcare Associations, including association leadership both internally and externally.

Provide inter-departmental back up support to senior management, both clinical and operational, ranging from provider communications to UM-tiering programs.

Assist in fee schedule development and payor summaries.

Developed and manage value added program.

Assist in reviewing State and Federal Legislation pertinent to Managed Care, Worker’s Compensation and Complementary Alternative Medicine.

1996 to 2003, Same company as above, San Diego, CA
Senior Clinical Services Manager- Clinical Care Management

Provided both qualitative and quantitative review using current evidenced based healthcare literature as a benchmark for Chiropractors.

Conducted utilization review of 210,000+ clinical treatment requests.
Served as lead clinician responsible for investigation and resolution of all member clinical grievances and appeals as they relate to standards of care, questionable billing, emergency services and clinical appeals.

Developed official clinical service manager training program and trained new clinical service managers.

Supported senior management in department audits with URAC, NCQA and the California Department of Managed Healthcare.

Oversaw clinical team in identifying and discussing potential health and safety issues.

Lead clinician for all credentialing peer-review of doctors applying to networks, focusing on clinical practice protocols as they pertain to industry standards.

1997 to 2005 Monarch Bay Chiropractic, Dana Point, CA
Chiropractor (Part-time)

Provided high quality level of chiropractic examination and treatment
Continued enhancement of clinical skills

1993 to 1996 Serrins Chiropractic, Mission Viejo, CA
Chiropractor

Provided comprehensive quality chiropractic care.

Taught in-house spinal-care and wellness classes.

1991 to 1992 Life Chiropractic College West, San Lorenzo, CA
Research Assistant

Assisted in data gathering and dissection for a study on Dura Mater Adhesions in the Cervical Spine.

1995 to 1997 Orange County Chiropractic Association, Orange County, CA
President

Managed 8-member Board of Directors, acted as the liaison between CCA and the chapter members.

Developed and implemented a re- licensing seminar for Chiropractors

Contributing author for monthly newsletter to 1100 Chiropractors in Orange County

Additional Relevant Experience

Appointed an expert witness for the California Chiropractic State Board.

Appointed an expert witness for the California Chiropractic State Board.

Investigate and provide peer-review of chiropractors who have been reported to the Board for possible acts of unprofessional conduct, documentation issues and/or billing related concerns.

Appointed to serve on committee responsible for creating California’s Professional Practice and Jurisprudence Examination.

Malpractice Expert Witness: Defense and Plaintiff

Commissioner for National Board of Chiropractic Examinations: Part IV

Lecturer at Life Chiropractic College West, Cleveland College of Chiropractic, Los Angeles and Southern California University of Health Sciences and Palmer Chiropractic College West regarding healthcare economics, standards of care, clinical documentation and UM.

Volunteer: St. Vincent DePaul. Render chiropractic care to the less fortunate

Current State Licenses

(All current and good standing, License Numbers Available Upon Request)

California
Hawaii
Massachusetts
Michigan
Ohio
Pennsylvania
Rhode Island
South Carolina
Vermont
Virginia

References

Available Upon Request