CarlaJane(Huitt-Corcoran)HuittMD

Summary

• Proven leadership, problem solving and ability to manage multiple priorities. With strategic focus on institutional policies/procedures, government regulations, organizational goals, and clinically evidenced-based best practices with integration of utilization management.
  
  A Board-Certified Physician in Occupational & Environmental Medicine is a broad real-life experience in clinical and administrative practice. A Master’s in Public Health (MPH) with a focus on health facility administration and understanding of population health, budgets, staffing and equipment depreciation.
  Performed Utilization Management reviews in a Medicaid/Medicare Management Care Organization (MCO), State Medicaid plans and a commercial health insurance plan. Utilization reviews consistent with State/Federal regulations, medical experience and use of national evidence-based review guidelines (InterQual). Participated in appeals Peer to Peer calls, Grievance Hearings and Fair Hearings. Roles with State Medicaid and Social Security Disability evaluations involved Fraud Waste and Abuse reviews. The administrative experience includes expertise in rule and regulation development. Subject matter expert in development and maintenance of prior authorization payment policies and the criteria necessary for coverage of services in a MCO. In addition, was the Chairperson for the Quality Management Committee and Utilization Management Committee. Supported staff in the Quality Improvement (QI) and Performance Improvement Projects (PIP) to facilitate STAR ratings. Skilled at obtaining participation and consensus in committee settings. Subject matter expert in treatment guidelines and trained physicians and advanced practice providers (APP) in the use of treatment guidelines and pharmacy formulary. Have provided testimony to Legislative subcommittees and state medical board regarding issues of opioid treatment guidelines.