Daniel A. Liévano H.

Medical Director @Best Doctors Insurance

Miami, US

Establish and lead the company’s global medical strategy, ensuring consistent application across all medical operations and service lines.Direct and optimize high-impact medical decision-making for services such as air ambulance, organ transplants, chemotherapy, and radiation, balancing clinical excellence with cost-effectiveness.Oversee medical necessity reviews for coverage, case management, and claims resolution, applying benefit plan guidelines, clinical protocols, and best practices.Define and implement standardized work processes through internal training, continuous improvement initiatives, and KPI-driven performance monitoring.Collaborate with the Actuarial, Operations, Client Services, Legal, Marketing, Sales, and Provider Relations teams to ensure medical guidelines, cost control strategies, and service standards are met and continuously improved.Lead the Case Management and Medical Audit teams, setting negotiation strategies, cost-containment goals, and UCR guidelines while fostering cross-functional communication.Drive internal education programs (e.g, medical terminology, CPT coding) to elevate team expertise, productivity, and service quality.Design staffing and resource models to optimize workload distribution, ensure compliance with assignments, and maintain service excellence.Participate in policy review and development, proposing updates based on medical insight and operational needs.Represent the medical area in stakeholder engagement with agents, clients, and partners through calls, emails, seminars, and conventions.Supervise the on-call medical process, ensuring adequate resources, clear requirements, and uninterrupted high-quality service.Act as a coach and mentor to medical staff, fostering a culture of professionalism, continuous learning, and collaboration.

Universidad Internacional de La Rioja

Master in Business Administration (MBA)

Fundación Universitaria San Martín

Doctor of Medicine - MD, Medicine

Universidad Autónoma de Bucaramanga

Postgraduate Degree, Epidemiology

Fundación Universitaria de Ciencias de la Salud

Postgraduate Degree, Health/Health Care Administration/Management