DENA SMITH
Gulf Breeze,FL
Summary
Lead Medical Director for One Florida Humana. People leader for twelve medical directors and cross covers for 12 other medical directors in Florida Medicare market.
Overview
22
22
years of professional experience
Work History
Lead Medical Director for One Florida
Humana
Florida
03.2023 - Current
- Presented data-driven reports to senior leadership, influencing key decisions around resource allocation and business strategy.
- Managed high-performing teams, fostering a positive work environment that encouraged collaboration and innovation.
- Mentored newly hired employees and help train them in case types (FERs, LTACHs, inpatient preauths, outpatient preauths, PDs, SNFs, IRFs)
- Focus group to engage teaching/solutions for M.A. with new CMS 2 midnight rule.
- Chosen for first cohort for the Physician People Leadership Developmental Program
- Developed a pilot program approved by corporate DR. TEEP -(Decreasing Readmissions by utilizing an on-site Transition of care team to Enhance hEdis measure Plan all cause readmission PCR) 2025
- Helped iniate a program with National Kidney Foundation of Florida/Bayer/ Conviva to improve KED HEDIS measure
- Participation in NAN (Navigating Aging Needs) to support caregivers of Alzheimer members to decrease stress burden and ED visits.
- Decreasing provider abrasion by supporting Health Services Director with health system collaborative meetings.
- Successfully implemented an alternative schedule (Block Doc) in order to manage increasing case volume on weekends.
Reviewing Medical Director for CNFL
Humana
Florida
01.2020 - 03.2023
Internal Medicine Hospitalist
Glutality
08.2020 - 10.2020
- Telemedicine to monitor patients with diabetes/at home glucose monitoring
Internal Medicine Hospitalist
HNI Hospitalist Group
03.2020 - 07.2020
Internal Medicine Hospitalist
Ascension Medical Hospitalist Group
05.2016 - 03.2020
- Hospitalist over observation floor
- I was responsible for running daily multidisciplinary meetings with charge nurse, physician advisor, PT/OT, and CM
Internal Medicine Hospitalist
Holston Medical Group
02.2007 - 04.2016
Internal Medicine Hospitalist
Dr. Quinn's Hospitalist Group
05.2005 - 02.2007
Internal Medicine Physician
Premier Medical Group
10.2003 - 04.2005
Education
Doctor of Osteopathy -
West Virginia School of Osteopathic Medicine
Lewisburg, WV05.1999
B.S. Chemistry -
Marshall University
Huntington, WV05.1995
Skills
- MCG Certified
- Co-Chair Credentialing Committee 2023- 2024
- Trained in Grievance and Appeals reviews (MHK)
- One Florida trainer for new hire (outpatient preauthorizations)
- Board Certified by American Board of Internal Medicine
- Board Certified in Health Care Quality and Management
- Sub-specialty - Physician Advisor
- Certification in Patient Safety
- Accepted to take Capstone to obtain CPE in August 2025
- Trained (MHK) for Humana Grievance and Appeals
- Prior journalist for One Florida Newsletter
- Schedule development
- Project Planning
- Team Management
Accomplishments
- Humana Silver Star Award 2022, 2023
- Humana Century Star Award 2023, 2025
- Equality Award 2025
- Supervised team of 26 Medical Directors
Custom Section
upon request
Publications
- Chinese Red Rice-Induced Myopathy
- Southern Medical Journal
- December 2003
Timeline
Lead Medical Director for One Florida
Humana
03.2023 - Current
Internal Medicine Hospitalist
Glutality
08.2020 - 10.2020
Internal Medicine Hospitalist
HNI Hospitalist Group
03.2020 - 07.2020
Reviewing Medical Director for CNFL
Humana
01.2020 - 03.2023
Internal Medicine Hospitalist
Ascension Medical Hospitalist Group
05.2016 - 03.2020
Internal Medicine Hospitalist
Holston Medical Group
02.2007 - 04.2016
Internal Medicine Hospitalist
Dr. Quinn's Hospitalist Group
05.2005 - 02.2007
Internal Medicine Physician
Premier Medical Group
10.2003 - 04.2005
Doctor of Osteopathy -
West Virginia School of Osteopathic Medicine
B.S. Chemistry -
Marshall University