VP Corporate Medical Policy, AmerihealthCaritas
Acting Chief Medical Officer
October 2008 to Present
Delaware Park Wellness Clinic
1999 to Present
Spectrum Health FQHC
2010 to 2015
Avon Grove Charter School
2004 to 2009
Maris Grove/An Erickson Living Community
March 2007 to October 2008
ACTS Retirement-Life Communities, Inc.
Medical Director, Lima Estates, Lima, PA
2003 to 2008
Main Line Health
Chairman, Family Practice Department
2001 to 2008
Riddle Memorial Hospital/Main Line Health
VPMA/Medical Director, Case Management
2001 to 2008
Health Partners Plans
Vice President, Medical Director
2000 to 2002
Durand Academy and Community Services
1994 to 2002
Inspira Health Network
Residency Program Director / Clinical Assistant Professor, Jefferson Medical College
1997 to 2000
HMO of Delaware/Blue Cross Blue Shield of Delaware
Chief Medical Officer, Health Care Center at Christiana
1994 to 1997
US Air Force
Chief Medical Officer (SGH), 651st USAF Clinic
August 1990 to August 1994
Acting Chief Medical Officer, Northern US Division for a national Medicaid/Medicare Health Plan with over 7M members. Supervised Medical Management activities including physician and administrative staff. Chaired Pharmacy and Therapeutics Committee. Coordinated team efforts with Care Coordination, Case Management, Disease Management and Quality. Saved $26M by reorganizing UM department (2013). Saved Pharmacy program $36M over 6 months... Acting Chief Medical Officer, Northern US Division for a national Medicaid/Medicare Health Plan with over 7M members. Supervised Medical Management activities including physician and administrative staff. Chaired Pharmacy and Therapeutics Committee. Coordinated team efforts with Care Coordination, Case Management, Disease Management and Quality. Saved $26M by reorganizing UM department (2013). Saved Pharmacy program $36M over 6 months by redesigning hepatitis C program. Developed and implemented ‘Lose to Win’ program for obese members with type II diabetes, which won URAC’s 2010 Gold Award for national best practices for Health Plans. Coordinated inpatient and outpatient utilization to assure appropriateness and quality of care.
What company does Glenn H. work for?
Glenn H. works for AmeriHealth Caritas
What is Glenn H.'s role at AmeriHealth Caritas?
Glenn H. is Acting Chief Medical Officer
What industry does Glenn H. work in?
Glenn H. works in the Health, Wellness and Fitness industry.
Broad range of experience in Health Care. Board Certified Family Practice educator (former Residency Program Director) with over twenty five years experience in managed care at the executive level for three different companies in the commercial, Medicare and Medicaid lines of business. Currently Senior Medical Director for a national leader in managed Medicaid. Goal is to network within and outside the industry, and to leverage my experience for consulting clients while maintaining my full time activity in the managed care environment. Wish to make a contribution to the rapidly changing health care environment in America, to help bring about effective and efficient health care reform. Established expert in health care change and in managed care. Specialties: Family Practice (Board Certified thru 2019) Accountable Care Organizations Pharmacy Benefits Management Geriatrics Health Promotion/Health Maintenance Preventive Medicine/Immunizations Occupational Medicine Managed Care Medicare and Medicaid Policy HealthCare Policy HealthCare Reform Utilization Management Utilization Review Quality ManagementActing Chief Medical Officer @ Acting Chief Medical Officer, Northern US Division for a national Medicaid/Medicare Health Plan with over 7M members. Supervised Medical Management activities including physician and administrative staff. Chaired Pharmacy and Therapeutics Committee. Coordinated team efforts with Care Coordination, Case Management, Disease Management and Quality. Saved $26M by reorganizing UM department (2013). Saved Pharmacy program $36M over 6 months by redesigning hepatitis C program. Developed and implemented ‘Lose to Win’ program for obese members with type II diabetes, which won URAC’s 2010 Gold Award for national best practices for Health Plans. Coordinated inpatient and outpatient utilization to assure appropriateness and quality of care. From October 2008 to Present (7 years 3 months) Owner @ Proprietor of an Occupational Health Wellness Clinic serving uninsured horsemen and their families. Provided preventive and public health services in cooperation with the Delaware Department of Health and Human Services. From 1999 to Present (16 years) Board Member @ From 2010 to 2015 (5 years) Board Member @ From 2004 to 2009 (5 years) Medical Director @ Physician for a retirement community encompassing independent, assisted living and medical units for over 2000 residents. Developed employee health program through the medical clinic and provided support locally and for corporate initiatives. Provided medical leadership and liaison with Executive Staff and Executive Director at this Erickson facility. From March 2007 to October 2008 (1 year 8 months) Medical Director, Lima Estates, Lima, PA @ Medical Director, working with staff and nursing to assure safety and proper care for residents in this retirement community, which included independent living, assisted living and medical level of care facilities on a single campus. Participated in state and licensing reviews, supervised medical staff and supported community, patient and family relationships. From 2003 to 2008 (5 years) Chairman, Family Practice Department @ Assisted hospital administration with utilization review and length of stay issues, Press Ganey scores and quality measures. Assured open communication between the medical staff and administration. Served on the hospital’s Medical Executive and Pharmacy and Therapeutics Committees. Provided inpatient and outpatient care for the full range of family practice patients. From 2001 to 2008 (7 years) VPMA/Medical Director, Case Management @ Hospital medical director, liaison between 500 member Medical Staff and Administration for utilization, resource management and patient care issues. Helped save $1M in one year by working with top physician utilizers to decrease LOS. Reduced denials by additional $200K through appeals and by facilitating behavior change amongst top admitters. Helped save $3.4M over two years by work with Case Management to decrease denials and reduce length of stay, decrease ER wait time and time on divert. Worked with P&T Committee and helped implement closed formulary and robotic pharmacy system to save over $200K/yr in unnecessary drug costs. Facilitated Utilization Committee development of direct admission policy to avoid denials of entire hospital admissions. Ad hoc committee on levels of care addressed quality & utilization issues involving patient safety & reimbursement. Provided education to Medical Staff on utilization and third party payor issues, government regulatory requirements and quality/peer review activities. Developed and marketed new hospitalist program to improve quality of care and reduce LOS. Directed house physicians and increased billing activity 75%. From 2001 to 2008 (7 years) Vice President, Medical Director @ Managed $72M pharmaceutical budget for a managed Medical Assistance population, limiting cost increases to 8% vs. industry standard of 20%. Coordinated inpatient utilization to assure appropriateness and quality of care. Oversaw $260M utilization budget, limiting annual cost increases to 2% vs industry benchmark of 10%. Assured compliance with state regulatory agencies for Utilization Review department. Interacted with government agencies at all levels to coordinate care. Liaison between payor and seven major medical centers at operational and senior levels for 125,000 members. Monitored member satisfaction improvement efforts and chaired ad hoc member relations committee. Met with various customers and constituencies to assure positive relations with diverse groups for the company. From 2000 to 2002 (2 years) Board Member @ From 1994 to 2002 (8 years) Residency Program Director / Clinical Assistant Professor, Jefferson Medical College @ Initially Associate Residency Director for a 4-4-4 allopathic family practice residency program, an affiliate of the University of Pennsylvania School of Medicine and Thomas Jefferson University. Directed educational and clinical program for residents and medical students. Responsible for program & faculty development & recruitment for a 300 bed University-affiliated community hospital. Coordinated regulatory and certifying organization (JCAHO and Residency Review Committee of the American Board of Family Practice) reviews and achieved approvals with commendations from these organizations. Responsible for inpatient service, practice management, pediatric service, community medicine and intensive care unit experience, and various other clinical and educational activities. Successfully recruited volunteer faculty and residency candidates. Improved quality of medical education program and quality of candidates enrolling in the residency. From 1997 to 2000 (3 years) Chief Medical Officer, Health Care Center at Christiana @ Medical Director of a 12 physician practice with 13 ancillary providers, full service pharmacy, radiology, lab and specialty clinics. Director of HMO medical operations, utilization and quality, credentialing and regulatory compliance for a 25,000 member closed panel HMO. Developed an incentive program based on productivity for physicians that resulted in increased productivity of up to 25% in 10/12 physicians based on volume of daily office visits. Oversaw $12M budget and services including freestanding laboratory, radiology, and pharmacy services. From 1994 to 1997 (3 years) Chief Medical Officer (SGH), 651st USAF Clinic @ Chief Medical Officer and clincal lead (SGH) of the largest outpatient clinic in the US Air Force. Supervised 22 providers including 12 physicians, Flight Surgery Clinic and the San Antonio Air Logstics Center. Supervised the provision of 22,000 annual patient visits at the SA-ALC, providing Occupational Medicine (including safety inspections and hazmat management) and Flight Surgery Services to tenant organizations including the 433d Reserve (C5) Squadron and the C5 Paint and Maintenance Shop. Provided support for Operation Desert Storm. Supervised radiology, emergency services, laboratory, pharmacy and occupational health services to retired and active duty members and families at the largest outpatient clinic in the US Air Force. Helped develop the Tricare program, which provides retired and dependent members with medical coverage using a managed care insurance model. From August 1990 to August 1994 (4 years 1 month) MD, Medicine @ Jefferson Medical College of Thomas Jefferson University From 1984 to 1987 BA, Microbiology, Economics (double major) @ Rutgers, The State University of New Jersey-New Brunswick From 1979 to 1983 Glenn H. is skilled in: Medical, Medicaid, Medicare, Utilization Management, Managed Care, Healthcare IT, Quality Management, Occupational Health, Medicine, Healthcare Management, Healthcare, Healthcare Information Technology, Employee Benefits, Policy, Case Managment
Introversion (I), Sensing (S), Thinking (T), Perceiving (P)
5 year(s), 8 month(s)
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