Post Acute Authorization Expert Witnesses
Post acute authorization expert witnesses and consultants listed here may be able to form expert opinions, draft expert witness reports, provide expert witness testimony at deposition and/or trial as or serve as consulting (non-testifying) experts on post acute authorization. The post acute authorization expert witness listings on this page are typically from fields/areas of expertise such as: HMO and Insurance.
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James J. McCormick, M.D., M.B.A
Medicare Advantage Prior Auth Physician Expert
Yanceyville, North Carolina
HMO, Insurance
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prior authorization, PA, Medicare Advantage, MA, Outpatient authorization, Inpatient authorization, Post Acute authorization, Appeals, documentation standards, managed care, helicopter transportation
As a physician leader, I have designed and implemented systems to ensure medical recordkeeping meet legal, reimbursement, and quality benchmarks. I spearheaded the development of a multi-state governance framework for both primary and specialty care groups, ensuring peer review, credentialing, quality assurance, and utilization management processes are rigorously structured and defensible. I also led the creation of an enterprise-wide Utilization Management Committee to meet CMS mandates. The committee is empowered to critically evaluate national clinical policies before adoption—aligning frontline utilization decisions with evidence-based standards. With decades of expanding leadership across diverse healthcare sectors, I bring a fair, balanced, and meticulously documented expert perspective to every case I consider.
Tradewinds Healthcare Consulting, LLC 04/2025 - Present
- Consulting Expert
- Testifying Expert
- Clinical case review
Humana, Inc. 08/2023 - 04/2024...
