Hloy GREEN
Lawrenceville,GA
Summary
Patient-oriented Family Physician eager to apply comprehension of clinical outpatient management to continue to develop proficiency in utilization management. Efficient and productive with 9 + years of hands-on experience in family medicine. Talented and proficient. Able to complete multiple claims reviews and decision them within an 8 to 10 hour period.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Medical Director
Medical Review Institute of America
08.2024 - Current
- Review medication authorization requests for Medicare, Medicaid, CVS, Molina, and Aetna.
- Determined if skilled rehabilitation met the requirements for approval per Medicare or Humana guidelines.
- Trained in peer-to-peer requests for medication, trained in speaking with prescribing provider about individual medication requests for peer-to-peers.
- Mentored and trained medical staff on clinical protocols, enhancing team performance and efficiency.
Primary Care Physician
Veterans Affairs Medical Center
11.2020 - 07.2024
- Educated patients on diagnoses, treatments and medications and self-management to drive recovery and outcome goals.
- Achieved consistent referrals and high patient satisfaction scores by providing exceptional care and support.
- Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
- Delivered information regarding care and medications to patients and caregivers in comprehendible terminology.
- Interpreted and evaluated diagnostic tests to identify and assess patient's condition.
- Determined and prescribed medication, dosages and schedule given patient's condition and allergies.
- Demonstrated leadership by making improvements to work processes and helping to train others.
- Diabetes management project in 2023 with clinical pharmacists to improve access to diabetic information available in different locations of primary care clinics.
Primary Care Physician
Weatherby Healthcare
07.2019 - 10.2020
- Travel medicine physician assignment in North Carolina and South Carolina for primary care and urgent care.
- Determined and prescribed medication, dosages and schedule given patient's condition and allergies.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
Primary Care Physician
Delta Locums
08.2016 - 10.2020
- Travel medicine physician assignment for various primary care and urgent care offices in North Carolina and South Carolina.
- Helped serve rural and underserved clinics needing physician coverage for a pre-determined time period.
Primary Care Physician
CaroMont Regional Medical Center, Gaston Memorial Hospital
11.2014 - 08.2016
- First primary care outpatient physician employment following completion of residency.
- Organized office wide pain management medication policies for controlled substance refills.
Education
Internship And Residency - Family Medicine
Prisma Health
Greenville, SC06.2014
M.D. - Doctor of Medicine
University of South Carolina School of Medicine
Columbia, SC05.2011
Bachelor of Science - Biology
Tuskegee University
Tuskegee, AL05.2004
Skills
- Electronic Medical Records Systems
- Trained in multiple Utilization Management Queues
- Interpretation of Medical Policies
Certification
- American Board of Family Medicine, 2015-01-01 to 2025-01-01
- Active /unrestricted licenses to practice primary care, South Carolina, 2023-01-01 to 2025-01-01, North Carolina, 2023-01-01 to 2024-01-01
- Active DEA certification for North Carolina
Timeline
Medical Director
Medical Review Institute of America
08.2024 - Current
Primary Care Physician
Veterans Affairs Medical Center
11.2020 - 07.2024
Primary Care Physician
Weatherby Healthcare
07.2019 - 10.2020
Primary Care Physician
Delta Locums
08.2016 - 10.2020
Primary Care Physician
CaroMont Regional Medical Center, Gaston Memorial Hospital
11.2014 - 08.2016
M.D. - Doctor of Medicine
University of South Carolina School of Medicine
Bachelor of Science - Biology
Tuskegee University
Internship And Residency - Family Medicine
Prisma Health
Activities
Member, American Academy of Family Physicians