HOSPITAL QUALITY, RISK MANAGEMENT MEDICAL DIRECTOR

Specialties & Experience of this Expert Witness

Additional Information

General specialities: Internal Medicine, Hospital Medicine, Health Plan Administration, Health System Administration, Office Based Solo Practice and Group Practice Keywords: Operations Medical Director, Risk Mitigation, Medical Malpractice Hospital and Office-Based Medicine, Quality Performance, Hospital Acquired Conditions, Standard of Care, Skilled Nursing Facilities, Good Clinical Practice, Patient Management, High Reliability Organizations, Billing and Claims Review, Strategic Planning, Business Intelligence. Dr. Rydelski is a Board Certified Internal Medicine physician with 20 years experience in Medical Malpractice Peer Review for Hospitals, Malpractice Evaluation and Risk Mitigation for a Malpractice Company, Hospital Peer Review Committee and Statewide Health Plan Peer Review. Her career includes extensive experience as a Health Plan Operations Medical Director, Subject Matter Expert for Fraud, Waste , Abuse, Utilization Management Medical Director, and Hospital Physician Advisor. She is an invited presenter to Hospitals, Physicians, Employer Groups; she is a published co-author "A Difficult Case of Hypercalcemia." Additional areas of expertise - Risk Management - Change Management - Quality Improvement, Quality Management - High complexity medical care - Data Analytics to identify Fraud, Waste, Abuse - Standard of care for outpatient, hospital and skilled nursing facilities - Value based care ( ACO, HMO, Medicare; HEDIS, Medicare STARS) - Contract modeling and execution - Transition of care and readmissions - Risk adjustment factor (RAF), Hierarchical Condition Category (HCC) - Regulatory compliance ( Commercial and Medicare Plans) - Manager Quality Index (MQI) 100%