MBA, Business @
Emory University - Goizueta Business School
As a physician executive for over 20 years, I have served as medical director for managed care organizations, a disease management company and a provider owned IPA/PHO. I have also been a senior benefits/health care consultant (with Towers Perrin), working with Fortune 100 employers and large provider-sponsored health plans and systems. In 2010, I implemented the first
As a physician executive for over 20 years, I have served as medical director for managed care organizations, a disease management company and a provider owned IPA/PHO. I have also been a senior benefits/health care consultant (with Towers Perrin), working with Fortune 100 employers and large provider-sponsored health plans and systems. In 2010, I implemented the first PCMH/Collaborative Care project with a large Atlanta health system. I have also implemented medical necessity review/claims management programs, physician performance profiles (report cards) for managed care organizations and also implemented/managed a revolutionary employee benefits program with AT&T in 1995 (through 2004) that provided coverage for select experimental emerging medical treatments/technologies for life-threatening conditions. In 1985, while in medical practice, I implemented an executive wellness/prevention program utilizing a first-generation health risk appraisal and extensive lifestyle evaluation/counseling services. I also provided clinical support to the Georgia Institute of Technology/Coca Cola Co. corporate wellness program.
I am committed to responsible health care reform focusing on accountability of health care decisions and resource use among all constituents – consumers, providers and payers – to promote cost-effective, evidence-based medical practice.
Specialties: Medical cost management, employee benefits.
Medical Director @ I am responsible for patient management activities including UM and CM, medical appeals. I also serve on national Clinical Policy Committee and Medicare Pharmacy coverage committees, as well as employer support and sales activities. I am also responsible for special projects including home infusion and collaborative provider initiatives. From January 2012 to Present (4 years) Greater Atlanta AreaSenior Medical Director @ From December 2010 to January 2012 (1 year 2 months) Greater Atlanta AreaSenior Medical Director @ Responsible for managing medical costs by working with both employer clients and the provider community to identify opportunities to provide cost-effective care. I also helped launch a PCMH/Collaborative Care model with a large health system in the Atlanta area. From August 2006 to January 2011 (4 years 6 months) Senior Medical Director @ Medical cost management initiatives, employer/customer sales and support and the roll out of the Premium Designation program; a provider quality/cost profiling initiative. From December 2004 to July 2006 (1 year 8 months) Medical Director @ Medical management responsibility for statewide business and launched a disease-based quality/cost physician report card. From 1999 to 2001 (2 years) Senior Consultant @ Senior benefits consultant for Fortune 100 companies' health/benefits plans. I launched and managed a unique employer voluntary benefit that provided employees access to select investigational emerging medical treatments/technologies. Worked also in the health plan/provider sector focusing on health plan operations and cost/medical management. From August 1994 to September 1999 (5 years 2 months)
MBA, Business @ Emory University - Goizueta Business School From 1988 to 1989 MD, Medicine @ Chicago Medical School at Rosalind Franklin U-Med & Science From 1972 to 1976 David Epstein is skilled in: Employee Benefits, Managed Care, Disease Management, Utilization Management, Provider Relations, Medicare, Medicaid, Health Policy, HMO, Healthcare Management, Healthcare, Healthcare Consulting, Network Development, Healthcare Information Technology, Credentialing
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