Summary
Overview
Work History
Education
Skills
Languages
Certification
Timeline
Work Availability
Research
Research
Generic
Bilal R. Rayes

Bilal R. Rayes

Summary

Renowned physician with excellent experience in Internal Medicine, Palliative Care, and Obesity Medicine. Outstanding bedside manner to connect with patients of various ages and circumstances. Lifelong learner of latest healthcare innovations and approaches. Led a diverse team of medical and administrative professionals in improving HAIs ranking to the highest among local hospitals. Established multidisciplinary rounds resulting in improved outcomes in ICU/StepDown/Tele units. Developed evidence-based programs in septic shock, chest pain, STEMI, stroke, severe aortic stenosis, and palliative care.

Overview

17
17
years of professional experience
1
1
Certificate

Work History

Associate Program Director

OPTI-WEST WESTERN UNIVERSITY
UPLAND, California
01.2024 - Current
  • In conjunction with the PD , oversee and ensure the quality of didactic and clinical education in the sites that participate in the program.
  • Collaborated with the PD to prepare and submit all necessary information to the ACGME, ensuring compliance with requirements.
  • Collaborated with PD to develop and enforce policies aligned with institutional and program requirements for resident duty hours, resulting in improved working conditions, including moonlighting opportunities
  • Monitored and ensured provision of back up support systems for patient care during challenging and extended responsibilities.
  • Led the Clinical Competency Committee in conducting semi-annual milestone evaluation meetings to assess resident performance and development.
  • Aid in selection and mentor to the Chief Residents
  • Enhanced projects and facilitated student learning with an annual completion target.

Founder, CMO

Premier Hospitalist Group of California
Upland, CA
07.2009 - Current
  • Founding Partner of a medium sized hospitalist group
  • Led development and implementation of quality improvement initiatives to enhance patient care and service excellence in collaboration with hospital administration.
  • Improved patient outcomes and care delivery through improved clinical quality processes with cost improvement to reflect newest evidence-based medicine.
  • Participate in development and implementation of policies, procedures, and bylaws, including credentialing and privileging medical staff members to ensure clinical excellence.
  • Created an environment that fosters physician alignment with the hospital system.
  • Support physician recruitment and development of new high-profit margin service lines.
  • Recruited, hired and trained staff members to ensure that operational goals were met.
  • Negotiated contracts with vendors and suppliers for optimal pricing structure.
  • Identified potential partnerships to expand the reach of the business.
  • Developed strategic initiatives to increase market share and revenue growth.

PHYSICIAN ADVISOR

SAN ANTONIO REGIONAL HOSPITAL
UPLAND , California
02.2024 - Current
  • Advised senior leadership on issues related to patient safety and regulatory compliance.
  • Ensured compliance with applicable laws, regulations, codes, rules, standards.
  • Participated in hospital committees to improve service delivery.
  • Used performance metrics, patient outcomes and delivery of care analysis to improve clinical quality.
  • Served as a clinical resource and consultant for hospital(s), contributing to the identification, facilitation and resolution of denials.
  • Facilitated collaborative conversations with health plan counterparts regarding denial of inpatient cases.
  • Mentored physicians to enhance understanding of payer requirements.

CHAIRMAN

Utilization Management Committee SARH
UPLAND, California
02.2024 - Current
  • Conducted concurrent reviews to ensure member services were consistently appropriate.
  • Engaged in collaborative efforts with physicians, nurses, case managers, discharge planners and social workers as well as other healthcare professionals to formulate a comprehensive plan of care adhering to specific guidelines.
  • Advised staff members on effective utilization management strategies.
  • Participated in interdisciplinary team meetings, analyzing intricate cases and suggesting unique treatment plans.
  • Monitored trends in utilization patterns and made recommendations for improvement as needed.
  • Reviewed appeals from providers regarding denied admissions or services according to organizational standards and procedures.
  • Identified opportunities for cost savings by recommending alternative treatments or modalities when appropriate.
  • Performed retrospective reviews for post-acute services such as home health, skilled nursing facilities, long-term acute care hospitals, rehabilitation centers.
  • Provided education and guidance on utilization management principles to internal staff members.
  • Adhered to all federal, state and local laws governing healthcare operations.
  • Utilized decision support tools such as diagnostic coding software programs to accurately assess data elements necessary for determining eligibility criteria.
  • Attended relevant meetings and conferences related to Utilization Review activities.

Medical Director

San Antonio Regional Hospital Palliative Care
Upland, CA
07.2021 - Current
  • Approving admissions of patients with complicated cases, ensuring appropriateness of care.
  • Establishment, review and updating patient care plan(s) during weekly IDT meetings.
  • Serve on the Professional Advisory Committee for Hospice and Palliative care patients.
  • Provide advice regarding best practice pharmaceutical management of patients.
  • Participate in education of staff and physicians.
  • Advised senior leadership on issues related to patient safety and regulatory compliance.
  • Identified opportunities for improving operational efficiency.
  • Provided medical oversight for clinical operations and staff.
  • Developed protocols and policies to ensure quality patient care.
  • Supervised clinical staff, providing continuous professional development opportunities and training to maintain and strengthen competencies.

Medical Director

High Risk/Post Discharge Clinic
Upland, CA
02.2013 - Current
  • Organize, direct, and oversee the operation of the High Risk/Post Discharge Clinic
  • Develop outpatient programs and services to high risk patients with acute care issues
  • Provide strategic leadership in management of Health plans, ensuring equitable distribution of resources.
  • Delivery of high quality, cost-effective healthcare and efficient management of patients.
  • Work in collaboration with emergency department medical staff to ensure safe outpatient transitional care of high risk patients.

Assistant Professor

University of California, Riverside
Riverside, CA
07.2016 - 12.2023
  • Provide clinical, programmatic and administrative leadership to the Hospice and Palliative Care service.
  • Provide physician services, clinical input and oversight for all patient treatment plans consistent with hospice and palliative care philosophy.
  • Amplify the awareness of the concepts, role and availability of Hospice and Palliative Care services among ambulatory, home-based, specialty and acute care clinicians.
  • Apprise the Hospice and Palliative Care team of medical care and practice standards
  • Plan and direct educational experience for medical students, residents, and fellows assigned to Hospice and Palliative Care.

Assistant Professor

Western University, Internal Medicine
Pomona, CA
05.2011 - 03.2020
  • Performed resident and medical student teaching for the Department of Medicine on traditional resident-led ward teams
  • Provided direct teaching of medical students in all four years of a brand-new clinical curriculum
  • Collaborated with researchers in our Center for Clinical Effectiveness, improving both patient care and clinical processes.

Assistant Professor

University of Arizona, Internal Medicine
Tucson, AZ
12.2007 - 05.2009
  • Attending physician for the teaching service at the VA Medical Center
  • Supervised and taught residents and medical students from the University of Arizona, providing direct patient care in hospital.
  • Participated in committees related to patient care, and trainee supervision, maintaining academic interests.

Education

Internal Medicine - Residency

Wright State University
Dayton, OH
06.2007

Medical Doctor - School of Medicine

Damascus University
Damascus, Syria
04.2000

Skills

  • Clinical Operations Management
  • Performance Improvement & Quality Management
  • Created inpatient/outpatient Palliative care Program in San Antonio Regional Hospital
  • Medical Staff Leadership & Development
  • Patient-Centered Care & Service Excellence
  • Risk Management & Patient Safety
  • Policy & Program Development
  • Risk Management
  • Utilization Management
  • Clinical Quality Program Standards
  • Curriculum Design and Development
  • Compliance Management
  • Organizational Leadership
  • Internal Medicine Residency Program implementation
  • Vice Chair Utilization Management Committee 2012-2023
  • Chair Utilization Management Committee 2023-present
  • Chair Peer Review Committee 2015-2022
  • Vice Chair Department of Medicine 2015-2023
  • Chair Department of Medicine 2024-2025

Languages

English
Native/ Bilingual
Spanish
Limited
Arabic
Native/ Bilingual

Certification

  • Board Certified in Internal Medicine (2007-present)
  • Board Certified in Obesity Medicine (2021- present)
  • Board Certified in Hospice & Palliative Care (2012- present)
  • Certified in Health Care Quality & Management (CHCQM) (2023- present)

Timeline

PHYSICIAN ADVISOR

SAN ANTONIO REGIONAL HOSPITAL
02.2024 - Current

CHAIRMAN

Utilization Management Committee SARH
02.2024 - Current

Associate Program Director

OPTI-WEST WESTERN UNIVERSITY
01.2024 - Current

Medical Director

San Antonio Regional Hospital Palliative Care
07.2021 - Current

Assistant Professor

University of California, Riverside
07.2016 - 12.2023

Medical Director

High Risk/Post Discharge Clinic
02.2013 - Current

Assistant Professor

Western University, Internal Medicine
05.2011 - 03.2020

Founder, CMO

Premier Hospitalist Group of California
07.2009 - Current

Assistant Professor

University of Arizona, Internal Medicine
12.2007 - 05.2009

Internal Medicine - Residency

Wright State University

Medical Doctor - School of Medicine

Damascus University

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Research

  • Takeda
    A Double-Blind, Randomized, Placebo-Controlled, 5-Arm Forced Titration Study: Evaluate the Efficacy and Safety of xxxx when compared to xxxx and xxxx in subjects with Essential Hypertension.
  • Lutipold Pharmaceuticals
    A Multi-center, Randomized, Controlled Study: Investigate the Safety and Tolerability of xxxx vs. xxxx in Treating Iron Deficiency Anemia in Heavy Uterine Bleeding and Postpartum Patients
  • Gallo Smith Kline
    A Randomized, Double-Blind, Placebo-Controlled, Parallel Group, Multicenter Study: Determine the Efficacy and Safety of xxxx When Used in Combination with xxxx or xxxx in Subjects with Type 2 Diabetes Mellitus
  • Galxo Smith Kline
    A Randomized, Open label, Parallel group, Multicenter Study: Determine the Efficacy and Long term Safety of xxxx Compared with xxxx in Subjects with Type 2 Diabetes Mellitus
  • Galxo Smith Kline
    A Randomized, Double-Blind, Placebo-Controlled, Multicenter Study:
    Determine the Efficacy and Safety of xxxx When Used in Combination with a xxxx or xxxx in Subjects with Type 2 Diabetes Mellitus
  • Galxo Smith Kline
    A Randomized, Double-blind, Placebo-controlled, Multicenter Study: Determine the Efficacy and Safety of Two Dose Levels of xxxx Compared with xxxx in Subjects with Type 2 Diabetes Mellitus
  • Abbott
    A Multicenter, Randomized, Double-Period, Double-Blind Study: Determine the optimal protocol for treatment initiation with xxxx and xxxx combination therapy in patients with early rheumatoid arthritis

Research

  • Takeda
    A Double-Blind, Randomized, Placebo-Controlled, 5-Arm Forced Titration Study: Evaluate the Efficacy and Safety of xxxx when compared to xxxx and xxxx in subjects with Essential Hypertension.
  • Lutipold Pharmaceuticals
    A Multi-center, Randomized, Controlled Study: Investigate the Safety and Tolerability of xxxx vs. xxxx in Treating Iron Deficiency Anemia in Heavy Uterine Bleeding and Postpartum Patients
  • Gallo Smith Kline
    A Randomized, Double-Blind, Placebo-Controlled, Parallel Group, Multicenter Study: Determine the Efficacy and Safety of xxxx When Used in Combination with xxxx or xxxx in Subjects with Type 2 Diabetes Mellitus
  • Galxo Smith Kline
    A Randomized, Open label, Parallel group, Multicenter Study: Determine the Efficacy and Long term Safety of xxxx Compared with xxxx in Subjects with Type 2 Diabetes Mellitus
  • Galxo Smith Kline
    A Randomized, Double-Blind, Placebo-Controlled, Multicenter Study:
    Determine the Efficacy and Safety of xxxx When Used in Combination with a xxxx or xxxx in Subjects with Type 2 Diabetes Mellitus
  • Galxo Smith Kline
    A Randomized, Double-blind, Placebo-controlled, Multicenter Study: Determine the Efficacy and Safety of Two Dose Levels of xxxx Compared with xxxx in Subjects with Type 2 Diabetes Mellitus
  • Abbott
    A Multicenter, Randomized, Double-Period, Double-Blind Study: Determine the optimal protocol for treatment initiation with xxxx and xxxx combination therapy in patients with early rheumatoid arthritis

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Bilal R. Rayes