StephenEngleMD

Summary

• I am a physician (MD) who is board certified in internal medicine. I am currently self-employed as a medical writer and editor. I have experience as a medical director in administrative medicine with UnitedHealth Group (yes, this is the correct spelling, with a space missing!), which is the largest private payer in the country. Prior to that, I have over 21 years of career experience in administrative medicine as a Medical Consultant for the California Medicaid program (i.e., Medi-Cal), working with various stakeholders.
  
  My areas of experience are in medical review auditing, medical documentation, medical coding, recovery audits, fraud/waste/abuse detection, quality of care assessment, medical necessity, utilization management, value-based care, multidisciplinary teamwork (with physicians, nurses, pharmacists, administrative management, attorneys, financial auditors, etc.) and program knowledge related to California's Medicaid program. I have worked with lawyers in the Medicaid program advising them on the medical aspects of cases, and have testified before administrative law judges. I also have worked with fraud investigators in the review of medical fraud/abuse.
  
  I have extensive experience making and defending decisions in the above areas for various types of providers, including physician outpatient/inpatient, laboratory, radiology, other diagnostic, pharmacy, emergency department and inpatient/outpatient hospital. This includes strategy planning meetings, teleconferences, in-person meetings, issue research, online work and written reports of findings.
  
  I have past clinical experience in inpatient and outpatient internal medicine at all levels (clinic, urgent care, emergency room, inpatient general and intensive care, clinical consultative medicine and peer review), which coupled with my administrative experience provides a broad perspective with which to integrate issues from wide areas of medical practice.