Medical Quality Assurance
Resume:
Michael S. Fruchter M.D.
Crestview, Florida 32536
acrk89@r.postjobfree.com
Professional Experience
Private Practice
Medical Director / Department Head 2009-2010
Department of Defense United States Navy
Cherry Point, NC
Naval Clinic Marine Corps Air Station (MCAS)
Responsibilities included but were not limited to:
-Supervision of department and staff.
-Coordination of care with TriCare for service members.
-Utilization Management, Peer to Peer reviews and Quality Assurance.
-Coordination of care for service members locally at clinic.
-Provide direct care to service members for emergency and non-emergency care.
National Medical Director Medicare, Behavioral Health 2007-2009
LifeSynch (formerly Corphealth) / Humana
Fort Worth, Texas
Implemented an original custom training program for CM's in properly managing UM cases.
Asked to travel to other offices nationwide to conduct training sessions for
CM's in their offices locally.
We surpassed earnings by $10 million dollars after one year of implementing this program company-wide.
Responsibilities include but are not limited to:
-Peer to Peer reviews with practitioners such as Physicians, APNPs, RNs, LCSWs,
MSWs, LMHC's and LPCs.
-Supervise clinical staff in the process of routine daily work.
-Represent this Managed Care Organization on a national basis.
-Found accounting/billing discrepencies and recouped $750,000 dollars
for the health plan.
-Trained professional staff in properly utilizing UM and CM.
-Chaired and co-chaired committees such as Credentialing, Pharmacy and Therapeutics,
and Quality Assurance.
Medical Director, Behavioral Health 2006-2007
Magellan Health Services
Parsippany, New Jersey
Medical Director for Medicare, Medicaid and Commercial Accounts
Responsibilities included but were not limited to:
-Chaired and co-chaired committees such as Credentialing, Pharmacy and Therapeutics,
and Quality Assurance.
-Peer to Peer reviews with practitioners such as Physicians, APNPs, RNs, LCSWs,
MSWs,LMHC's and LPCs.
-Supervise clinical staff in the process of routine daily work activities.
-Represent this Managed Care Organization on a national basis.
Medical Director, Behavioral Health 2004-2006
Delaware Physicians Care Inc., / Schaller Anderson (now Aetna)
Newark, Delaware
Medical Director for Medicaid and Commercial Accounts
Responsibilities included but were not limited to:
-Chairing and co-chairing committees such as Credentialing, Pharmacy and Therapeutics,
and Quality Assurance.
-Peer to Peer reviews with practitioners such as Physicians, APNPs, RNs, LCSWs, MSWs,
LMHC's and LPCs.
-Supervise clinical staff in the process of routine daily work activities.
-Represent this Managed Care Organization on a national basis.
Medical Director
2003-2004
United Behavioral Health, a division of United Healthcare
Coral Gables, Florida
Medical Director for Medicare, Medicaid and Commercial Accounts
Responsibilities included but were not limited to:
-Chairing and co-chairing committees such as Credentialing, Pharmacy and Therapeutics,
and Quality Assurance.
-Peer to Peer reviews with practitioners such as Physicians, APNPs, RNs, LCSWs, MSWs, LMHC's and LPCs.
-Supervise clinical staff in the process of routine daily work activities.
-Represent this Managed Care Organization on a national basis.
Consulting Forensic Psychiatrist/ Medical Director
2001-2004
Orange County Jail/ Emergency Services
Goshen, New York
-Provided psychiatric evaluations and treatments to incarcerated patients.
-Included emergency on-call, after hours and weekends.
Consulting Geriatric Psychiatrist
2000-2005
Achieve Rehabilitation and Nursing Facility
Liberty, New York
Provided supervisory psychiatric evaluations and treatments to geriatric population.
Medical Director/Owner 1999-2007
Catskill Emergency Services
Monticello, New York
Owned and ran emergency on call psychiatric service which was put out for bid and won by our service for several years before being taken in house by a state facility.
Consulting Geriatric Psychiatrist
1999-2003
Sullivan County Adult Care Center
Liberty, New York
Provided supervisory psychiatric evaluations and treatments to Geriatric population.
Forensic Specialist/Consulting Psychiatrist/ Psycho-Pharmacologist
1997-2001
New York State Office of Mental Health
Department of Corrections Facilities
(Attica, Woodbourne, Sullivan and Eastern)
-Provided psychiatric and psycho-pharmacological services to the inmate population
for the State of New York.
-Provided medical and psychiatric guidance to interdisciplinary team members.
Medical Director
1988-1999
Catskill Emergency Services
Monticello, New York
Ran emergency on call service for Sullivan County.
Forensic Specialist/Consulting Psychiatrist/Psycho-Pharmacologist 1988-2007
Sullivan County Department of Community Services
Sullivan County, New York
-Provided psychiatric evaluation and treatment for psychiatric patients
in Sullivan County.
-Sullivan County ACT team Psychiatrist.
Medical Director
1988-2010
The Center for Better Living
Middletown, New York
Private practice in Hudson Valley New York. Office was open full or part time depending on other jobs at the time.
Attending Physician/Psychiatrist/Psychiatry & Addiction Medicine 1988-1993
Middletown Psychiatric Center
Middletown, New York
Inpatient admission and addiction/forensic services.
Residency
Psychiatry Residency
1985-1988
Norwich Hospital
Norwich, Connecticut
Middletown Psychiatric Center
Middletown, New York
Internship
Family Practice Internship 1984-1985
John F. Kennedy Medical Center
Edison, New Jersey
Education
Medical Doctor Degree
Ross University School of Medicine 1981-1983
Edison, New Jersey
Universidad Autonoma de Guadalajara
1979-1981
Guadalajara, Mexico
Bachelor of Arts in Biology
1975-1979
City of New York Herbert H. Lehman College
Bronx, New York
Medical Licenses/Diplomat Status
Arizona, California, Connecticut, Delaware, Florida, Georgia, Maryland, New York, New Jersey, North Carolina, Pennsylvania, Wisconsin (pending)
Diplomat American Board of Forensic Medicine
Languages Spoken
English, Spanish
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