Summary
Overview
Work History
Education
Skills
Websites
Accomplishments
Affiliations
Certification
Languages
Timeline
Generic

Henry Cook

Vestal,USA

Summary

Healthcare executive with managed care payer experience as medical director/educator and experience as physician advisor | Collaborator across highly matrixed business segments | Impactful individual contributor | leader of teams |mentor

Overview

34
34
years of professional experience
1
1
Certification

Work History

Medicare Medical Director

Humana Insurance Company
01.2016 - Current
  • Evaluated and rendered organizational determinations for Medicare Part A cases, Part B cases, and Appeals cases
  • Designed, developed, and delivered onboarding and skills training for new medical directors, including lectures with slide decks, self-study CBT modules, and individualized 1:1 live case training; 2018-present
  • Training team leader 2017-2022
  • Educator annually for new MCG updates
  • Developer annually of inter-relator reliability testing for NCQA accreditation and maintenance of accreditation
  • Auditor/peer reviewer of medical director cases

Physician Advisor

Executive Health Resources/Optum
01.2013 - 01.2016
  • Reviewed previously denied inpatient Medicare Advantage cases and commercial insurer cases; submitted unique rebuttal letters for each case to continue the appeals process; approximately 3500 cases reviewed
  • Only one of two selected for pilot new business offering reviewing previously denied inpatient cases and advised facilities of feasibility of successful appeal

Adult Hospitalist

Guthrie Clinic, Sayre PA
01.2012 - 01.2013
  • Evaluation and care of patients during hospital stay, including ICU care
  • ABIM Focused Practice in Hospital Medicine certified until left clinical care

Adult Hospitalist

United Health Services, Chenango Memorial Hospital
01.2007 - 01.2012
  • Evaluation and care of patients during hospital stay, including ICU care
  • ABIM Focused Practice in Hospital Medicine certified until left clinical care

Internal Medicine provider

Various entities Florida and South Carolina
01.1992 - 01.2007
  • Office based primary care with hospital rounds including ICU
  • Employed by health systems excepting private practice 2003-2007 in South Carolina with bariatric medicine practice

Education

Doctor of Medicine -

MUSC Charleston
Charleston, SC
01.1988

Bachelor of Science - undefined

Francis Marion University
01.1984

Skills

  • Utilization Management

  • Physician Education

  • Crucial Conversations

  • Clinical Documentation Integrity

  • Collaboration cross functional

  • Professional writing

  • Problem Solver

Websites

Accomplishments

  • Chenango County, NY Hospice Physician of the Year 2008
  • Humana Physician Executive Leadership Development Program 2019
  • Dale Carnegie onsite training “High Impact Presentations” 2019
  • Humana Physician Leadership Development Lead Mentor 2020
  • AcumenLearning—Seeing the Big Picture Part I and II 2022

Affiliations

  • State Medical Licensure in NY, PA, SC
  • Professional societies: AHIP, AAPL, ACPHE, AAPC
  • No malpractice history

Certification

  • ABIM Internal Medicine 1991; 2001; 2011; 2017
  • MCG UM certification

Languages

English
Native or Bilingual

Timeline

Medicare Medical Director

Humana Insurance Company
01.2016 - Current

Physician Advisor

Executive Health Resources/Optum
01.2013 - 01.2016

Adult Hospitalist

Guthrie Clinic, Sayre PA
01.2012 - 01.2013

Adult Hospitalist

United Health Services, Chenango Memorial Hospital
01.2007 - 01.2012

Internal Medicine provider

Various entities Florida and South Carolina
01.1992 - 01.2007

Bachelor of Science - undefined

Francis Marion University

Doctor of Medicine -

MUSC Charleston

Similar Profiles

CREATE PROFILE