Medical Health

GORDON BRUCE KUTTNER MD, JD, MBA, CHC, FACOG, FACS

Boca Raton, FL adikaz@r.postjobfree.com 813-***-**** linkedin.com/in/gordon-b-kuttner

Intrapreneurial healthcare leader with diversified success in medical academia, administration, and healthcare management across startup and multinational corporate environments. Combines expertise in people, process, systems, and regulations to optimize operations, maximize efficiency, drive quality & compliance, and improve healthcare outcomes. Double Board Certified physician leader and innovator in women’s health- obstetrics & gynecology and reproductive endocrinology & infertility. Cross-functional team builder, executive business partner & advisor, and collaborator who mobilizes peak-performance teams through ambitious business goals and across complex national projects. Ethical MD, JD and MBA leveraging unique 360 blend of medical, legal, and business savvy. Exceptional communicator recognized for facilitation, negotiating, training, and stakeholder management skills. Early adopter of emerging healthcare tech. Strategic. Data-Driven. Outcome Oriented. Creative.

AREAS OF EXCELLENCE

Academic Medicine • Clinical Medicine • Managed Care • Healthcare Business Administration • Healthcare Law • Healthcare Compliance • Healthcare Startups • Program Administration • Process / Total Quality Improvement & Management • Team Management • Strategic Planning • Operational Streamlining • Executive Advisory • Client / Patient Relations •Change Management • Health Marketing • Negotiations • Clinical Operations • Care Management • Healthcare Finance • Regulatory Compliance • Policy / Procedure Development • Problem Resolution • Network Development • Social Determinants of Health (SDoH) • Cross-Functional Collaboration • Leadership • Stakeholder Management • Healthcare Informatics & Technology • Teaching & Development • Coaching / Mentoring • Vendor RFP / Selection • Sales

RELEVANT EXPERIENCE & IMPACT

GUIDEWELL CARE SOLUTIONS d/b/a FLORIDA BLUE MEDICARE Florida Nov 2018-Present

Innovative Medicare advantage (startup) company at the leading edge of technology-driven healthcare transformation.

Senior Medical Director, Florida Blue Medicare (Blue Cross / Blue Shield of Florida)

Hired to build and implement innovative omni-channel patient / physician interactive communication platform leveraging artificial intelligence and automation, delivering high-impact personalized health plan communications to providers and 150,000+ Medicare Advantage plan members.

• Spearheaded team on development of 375+ system triggers / tasks activated by mining clinical, claims, social determinants of health & other internal and external data consumed by a rules engine to determine optimal communications and routing to the appropriate stakeholder.

• Led development of member and provider messaging to ensure personalization and improve engagement.

• Worked with HEDIS measures, STARS ratings, and risk adjustment factors to maximize reimbursement and support total medical expense reduction.

• Delivered ~$4.5M savings for Health Risk Appraisal implementation by researching external resources and evaluating ROI for new vendors and technologies, and increased response rate for Appraisal from historic 6.2% to 30% in year 1.

• Responsible for developing and medical oversighting case management programs, establishing new telehealth program and implementing automation including IVR (interactive voice response) solution.

• Oversight of care management program, inclusive of transition of care, complex care management, catastrophic case management, disease management, palliative care, social determinants of health & dual special needs program (DSNP).

• Member of Medical Policy Committee, advisor to Pharmacy Group and contributor to CMS Part D demonstrations.

• Reviewed innovative technology against strategic plans; co-developed virtual health and digital strategies.

• Created and evaluated RFPs for vendors, working closely with legal and compliance departments.

COGNIZANT TECHNOLOGY SOLUTIONS New Jersey Apr 2016-Nov 2018

Multinational digital product & services corporation; one of the world's leading professional services companies.

Chief Medical Officer (CMO), Global Clinical Services, Digital Operations-Healthcare

Set overall clinical direction of digital healthcare Business Process Services Practice-Health Care Delivery. Guided teams developing solutions, technologies, and global clinical services to enable healthcare professionals (payers and providers) to improve healthcare delivery efficiency and reduce expenses.

• Liaised between Cognizant’s US healthcare clients and onshore and offshore clinical delivery healthcare professionals ensuring clinical medical management (UM-CM-DM) quality and compliance; played instrumental role in achieving URAC Utilization Management accreditation.

• Advised on knowledge management, knowledge transfer methods, continuous quality improvement, and healthcare medical management clinical operations.

• Coordinated internal compliance and legal teams regarding federal and state regulations for prospective client accounts and accreditation processes.

• Advised Cognizant Healthcare Consulting group on developing client solutions to increase efficiencies and cut cost – by championing transformational thinking and redesign of common processes using automation technology, telehealth, patient engagement tools, remote patient monitoring, and artificial intelligence.

HEALTHCARE CONSULTING & SOLUTIONS Florida Dec 2015-Apr 2016

Medical Director

Partnered with healthcare organizations to provide knowledge and experience in the managed care arena with expertise in federal and state government health programs serving high-risk, vulnerable populations.

• Advised on coordinating biopsychosocial needs of each member through risk stratification, care gap analysis, evidence-based medicine, partnering with community services, appropriate deployment of provider and consumer technology, and integration of care delivery model to improve clinical outcomes.

• Delivered innovative program design through data-driven population health analysis.

AETNA’S BETTER HEALTH OF LOUISIANA Louisiana May 2015-Sep 2015

Contracted managed care (startup) health plan for Bayou Health, Louisiana's Medicaid & LaCHIP health care program.

Chief Medical Officer

Led strategic medical management activities impacting market performance and promoting quality of care for members. Oversaw development and implementation of medical programs and policies; cultivated and enhanced relationships with providers and facilities, plan sponsors, and regulatory agencies. Served as key business partner in network development and strategic planning and total quality management.

• Supervised administrative staff of five in the Clinical Operations Department

• Provided clinical and business leadership to support key objectives of business segments & plan sponsors.

• Oversighted Utilization Management, Care Management, Pharmacy, and Quality

• Performed second level medical and pharmacy reviews

• Co-led evaluation of quality, care, and service, including activities necessary for NCQA accreditation.

• Played key role in short/long-range program planning, total quality management and external relationships.

• Designed and implemented medical policies, goals and objectives to meet the needs of each contract/RFP.

• Participated in the development of budgets, staffing plans, assuring the adequate allocation of resources.

• Monitored member & provider medical management satisfaction survey results and made key improvements.

• Used data analysis to identify opportunities for quality improvement, cost reductions, and efficiencies.

• Advised on development and improvement of internal tools to support Aetna's medical management programs.

• Worked collaboratively with other functional areas including provider relations, member services, contracting, benefits and claims management, health care delivery, and national shared medical services.

• Served as critical medical leader for external providers and regulatory & accrediting agencies.

ST. MATTHEW’S UNIVERSITY SCHOOL OF MEDICINE (SMUSOM) Florida June 2013- Nov 2014

Dean of Clinical Sciences

Senior academic official responsible for ensuring integrity and seamless operation of third- and fourth-year clerkship rotation sites including evaluation of sites in the US, Canada and the UK.

• Supervised administrative staff of seven in the Clinical Science Department.

• Worked across departments of the Registrar, Billing, Alumni Relations, and Admissions on joint projects.

• Reviewed hospital affiliation agreements and new programs to enhance academic clerkship experience.

• Liaised with students, preceptors and hospitals to improve performance and address any disciplinary issues.

• Assisted with career counseling, performance evaluations, curriculum development & accreditation efforts.

• Drafted individual Dean’s letters for graduating senior medical students’ applications for residency positions

UNITEDHEALTHCARE - COMMUNITY & STATE / OPTUMHEALTH National Sep 2009-June 2013

UHC-Community & State, a business unit of UnitedHealth Group, at the time served over 2M low-income beneficiaries of state government health care programs in all states and D.C. and is an innovative developer of public sector health care solutions. Optum, a part of UnitedHealth Group, is an international pharmacy benefit manager and care services group

Senior National Medical Director, Healthy First Steps (HFS) – National Prenatal Program

• Implemented and led national HFS medical maternity team, partnering with multidisciplinary team of board-certified physician OB/Gyns, obstetrical nurse case managers, social workers, health coaches, pharmacists, data analytics, and other member advocates to offer state-of-the-art, member-focused quality obstetrical care.

• Responsible for oversight of delivery of the highest quality of evidence-based and cost-effective care and eliminating $5 M annual spend on unproven obstetrical outpatient treatments.

• Spearheaded initiatives to improve service and quality of care, provide a consistent member experience, improve birth outcomes, achieve higher overall provider and member satisfaction through effective partnering and drive higher overall business performance across state Medicaid plans.

• Served as subject matter expert (OB/GYN & Reproductive Endocrinology, Fertility); partnered with utilization and care management, medical policy, pharmacy, appeals, provider relations & joint projects across UnitedHealth Group.

• Drove down inappropriate Hospital inpatient admissions by 20%

• Drafted UnitedHealthcare Medical & Drug Policies and Coverage Determination Guidelines regarding 17-Alpha-Hydroxyprogesterone Caproate (Makena® and 17P)

WELLCARE HEALTH PLANS, INC. Florida June 2006-June 2008

Leading provider of managed care services dedicated to government-sponsored healthcare programs, focusing on Medicare and Medicaid; employs 3,500+ professionals and serves 2.3 million members.

Medical Director, Corporate Care Management

Provided clinical leadership and led care management functions for 1.5 million members in multiple states. Collaborated with Case and Disease Management, Care Management Directors, and senior leadership to implement clinical programs to support and meet organizational goals. Performed daily clinical evaluations of care and services; collaborated with network and community providers, hospital leaders, and vendors. Liaised between home health care solutions and home therapy products company.

• Led 12 Inpatient Review Nurses in assessment activities and external communication with network MDs & providers.

• Ensured compliance to state & federal audit regulations.

• Member of Appeals & Grievances Committee. Participated in process improvement & quality committees, peer reviews, credentialing, and privileging.

• Developed collaborative intervention plans and influenced practice patterns through facilitating Care Management review and discussion, performing on-site visits, and sharing best medical practices and guidelines related to quality and cost-effective healthcare delivery.

• Identified unnecessary delays in healthcare, led discharge planning, and created follow-up action plans to address care management issues with Care Management team.

• Ideated and instituted clinical criteria guidelines based on evidence-based medicine and latest research of clinical practices, technology, and treatment protocols; shared best practices with leadership.

• Created & executed successful neonatal intensive care unit (NICU) admission & stay reduction pilot program.

• Played integral role in streamlining corporate processes for inpatient and prior authorization utilization.

CENTER FOR ADVANCED REPRODUCTION, ENDOCRINOLOGY, & SURGERY, PA North Carolina 2001-2006

Private medical practice (startup) providing advanced reproductive procedures and solutions.

Founder / Medical Director

Led start-up efforts for practice. From pro forma to implementation of a full spectrum of assisted reproductive technologies, including IVF, PGD, GIFT, gamete/embryo cryopreservation, intracytoplasmic sperm injection, and 3rd-party parenting. Performed reproductive surgeries, including operative endoscopy encompassing laser laparoscopy and hysteroscopy. Administered treatment efforts for fertility, menopause, reproductive endocrinopathies, and pelvic structural anomalies. Created marketing and educational campaigns for print, radio, and TV media targeting patients and referring physicians. Ensured adherence to OSHA, HIPAA and all state and federal regulations. Negotiated personnel issues, insurance contracts, vendor agreements, constructions, and joint ventures with other practices and academic programs.

• Developed practice from ground up, employing 5 professionals and generating $1M in revenues in 3 years.

• Grew practice to well-respected, uniquely patient-focused healthcare provider vs. “have it our way” competitors.

UNIVERSITY OF MIAMI, MILLER SCHOOL OF MEDICINE Florida 2000-2001

Academic medical center providing education, research, patient care & community service to 1M patients annually.

Director & Asst. Professor, Division of Reproductive Endocrinology, Surgery, & Fertility: Dept. of OB/GYN

Provided instruction to medical students, residents, faculty, and resident clinical practice. Fostered partnership with local private IVF program while awaiting division funding.

ADDITIONAL ROLES

Lynn University Adjunct Faculty (P/T) Scheduled for Jan 2021

Course: BUS 372 – The Legal Environment of Business

Albany Medical College New York

One of nation’s oldest medical schools and national leader in curriculum development.

Head, Division of Reproductive Endocrinology & Infertility

Director, Undergraduate Medical Education: Department of OB/GYN & Reproductive Sciences

Assistant Professor, Obstetrics, Gynecology, and Reproductive Sciences

Taught medical students and residents as Undergraduate Medical Education Clerkship Director for OB/GYN Department; instructed faculty and resident clinical practice, research, and IVF. Supervised 1 medical doctor, 3 nurses, 2 administrators, and 3 lab technicians within clinical practice; oversaw one academic administrator.

• Facilitated changes relating to fertility coverage policies through negotiating and lobbying 3rd-party payers regarding contractual language and reimbursements for fertility services; interfaced with insurance companies concerning cost-effective reproductive technologies.

• Boosted percentage of students applying for OB/GYM match positions to 300% over prior year.

• Cultivated alliances, fostering prompt referrals, through networking with private practice community physicians, including general OB/GYN, family practice, internal medicine, psychology, and urology.

• Transformed and elevated clinical clerkship by introducing outpatient experiences and limiting inpatient experience; initiated small group clinical problem solving, limited didactics, implemented live pelvic models, and provided realistic expectations of the clerkship and real-world clinical practice.

The George Washington University - School of Business Facilitator, Health Care Policy Course

University of Central Florida College of Medicine Asst. Professor, OB/GYN - Volunteer faculty

University of South Florida College of Medicine Clinical Asst. Professor, OB/GYN - Volunteer faculty

UCLA Medical Center, UCLA School of Medicine Clinical Instructor, OB/GYN - Volunteer faculty

Pacific Fertility Medical Centers of California, Inc. Associate Medical Director

Harvard Community Health Plan Staff Physician, Department of OB/GYN

Massachusetts Institute of Technology Health Services Staff Physician, Department of OB/GYN

Planned Parenthood of Los Angeles OB/GYN Consultant

Kaiser Permanente Medical Care Program Staff Physician, Department of OB/GYN

Los Angeles Free Clinic/Valley Community Clinic OB/GYN Consultant

NYS Task Force on Life and the Law-Advisory Group on Assisted Reproductive Technologies Committee Member

ACADEMIC CREDENTIALS

Juris Doctor, Cum Laude Florida A&M University College of Law

Master of Business Administration, Healthcare The George Washington University School of Business

Fellowship, Clinical Fellow Dept. of OB/GYN, Division of Reproductive Endocrinology & Fertility Brigham & Women’s Hospital, Harvard Medical School

Residency, Obstetrics & Gynecology Beth Israel Medical Center, Mount Sinai School of Medicine and Cedars-Sinai Medical Center, University of California School of Medicine at Los Angeles

Medical Doctor New York Medical College

Bachelor of Arts, Arts & Sciences, Cum Laude Washington University

PROFESSIONAL DEVELOPMENT

Marketing • Power & Influence • Management • Effective Communication • Healthcare Finance • Negotiating • Meta Leadership • The Power to Change Anything • American College of Physician Executives • American Board of Quality Assurance & Utilization Review Physicians

Clinical Coverage Guidelines/Medical & Drug Policies: OB Ultrasounds • Hyperemesis • Preterm Labor • HUAM • Terbutaline Pumps • Antiemetic Pumps • Infertility • Progesterone and Preterm Birth

Domestic Violence • Medical Error Prevention & Root Cause Analysis • HIV/AIDS: Epidemic Update • Pain Management, Palliative Care & Treatment of Terminally Ill • Opioid Epidemic • Continuing Education: Medical, Mediation, and Compliance

LICENSURE & CERTIFICATIONS

Active Licenses

California License #G066211 • Louisiana License# MD208204 • Florida License #ME80104

Arizona License #37251 • Hawaii License #MD-13532 • Tennessee License #MD46403

New York License#175371 • South Carolina License #TL33103

Inactive Licenses

North Carolina License #2001-00160 • Georgia License #059264 • Washington License #MD00045585

Nevada License #6979 • Massachusetts License #73962

The American Board of Obstetrics & Gynecology, Inc.: Board Certified Obstetrics & Gynecology and Special Qualification in Reproductive Endocrinology & Infertility

Diplomat of The American Board of Obstetrics & Gynecology, Inc.

Diplomat of the National Board of Medical Examiners, Certification #338117

Supreme Court of Florida Certified Circuit Court Mediator #32692 R

Compliance Certification Board: Certified in Healthcare Compliance (CHC)®

AFFILIATIONS & AWARD

Fellow American College of Obstetricians & Gynecologists • Fellow American College of Surgeons • American Society for Reproductive Medicine • Society for Reproductive Endocrinology & Infertility, Inc. • Healthcare Compliance Association

The Berlex Foundation Faculty Development Award: Reproductive Epidemiology and Clinical Trial Design • Cognizant Technology Solutions: Value Stream Mapping Award

RESEARCH

• G Sher M Feinman, C Zouves, G Kuttner, G Maassarani, R Salem, W Matzner, W Ching, P Chong. High fecundity rates following in-vitro fertilization and embryo transfer in antiphospholipid antibody seropositive women treated with heparin and aspirin. Hum Reprod. 1994 Dec;9(12):2278-83.

• Brothers A.J., Sher G., Willman S., Zouves C, Kuttner, G.B., Ulehlova E., Waterhouse K., Huen N., Vaught L.PROD: A gentle enzymatic method for assisted hatching to enhance implantation. The IX World Congress on In Vitro Fertilization and Assisted Reproduction; Vienna, April 3 7, 1995.

• Kuttner, G.B., Horvath P.M., Dias J.A., Mok S.C., Wilson L., Hannay T.J., Alouf C.A., Kellom T.CA-125 Is Not Produced by Human Granulosa Cells Obtained From Patients Undergoing Controlled Ovarian Hyperstimulation (COH) for In-Vitro Fertilization-Embryo Transfer (IVF- ET).American Society for Reproductive Medicine 53rd Annual Meeting; Cincinnati, OH, October 18-22, 1997.

• Alouf C.A., Wilson L., Hannay T.J., Kuttner, G.B. Is Acrobeads Test an Accurate Predictor for Fertilization During IVF? American Society for Reproductive Medicine 54th Annual Meeting; San Francisco, CA, October 4-9, 1998.

SELECT LECTURES

“Holistic Care For The Frail Elderly: Strategic Approaches” Focura Connect Summit • Webinar, August 28, 2020.

“Precision Medical Health: Technology Enabled Medicare Health Plan” BCBS 2019 Information Technology Symposium.” • Boise, ID, September 17, 2019.

“Trying to Have a Baby Without Success?” Seminar • Charlotte, NC, May 8, 2003

“Age & Fertility: How Old Is Too Old?” Ferring Pharmaceutical Nurses’ Seminar • Charlotte, NC, May 20, 2003

NEWSLETTERS & PATIENT GUIDES

• “The use of Progesterone in the Prevention of Preterm Births.” UHC Practice Matters Summer 2012.

• “Insulin Resistance: Effects in Women.” CONCEPTION. 1: 2003.

• “Age & Fertility.” CONCEPTION. 2: 2003

• “Questions & Answers About Infertility and its Treatment,” 2000. New York State Task Force on Life and the Law-Advisory Group on Assisted Reproductive Technologies. http://www.health.state.ny.us/community/reproductive_health/infertility/1128.htm

• “Thinking of Becoming an Egg Donor,” 2000. New York State Task Force on Life and the Law-Advisory Group on Assisted Reproductive Technologies. http://www.health.state.ny.us/community/reproductive_health/infertility/eggdonor.htm

MEDIA RELEASES

Charlotte Observer, Charlotte, NC. Topic: "Family Tree Loses Genetic Defect," June 20, 2005

Enquirer Journal, Monroe, NC. Topic: “Parenthood a Hard Road for Monroe Couple,” May 7, 2003

Infertility Support Group, Charlotte, NC, Topic: "Ask The Doctor," November 5, 2002

* Full list of lectures, newsletters, media releases, patient guides, and abstracts is available upon request. *

Contact this candidate