ManuelPubillonesMD

Summary

• Experienced medical professional with over 20 years of clinical and administrative experience. In the administrative settings worked in provider education, policy development, utilization review, evaluation of new technology, claim adjudication, quality of care, waste, abuse and fraud as well as data analysis within the Medicare and Medicaid programs. In the clinical settings, have worked Emergency Room, Acute Care, Liaison/Consultation, In-Patient and Outpatient Psychiatry within the private sector, the state funded services and the VA system. While living in PR was a key player in the implementation of the first step of the Health Care Reform in PR (1990s), as administrator and later, as Medical Director of ASSMCA (SAMHSA equivalent) and the State Psychiatric Hospital. While living in the US have been Medical Director for three CMS contracted companies monitoring the Medicare program nationwide and the Medicaid programs for multiple states.