Lee Buttz

About Lee Buttz

Health plans and health systems have to balance patient and provider satisfaction along with payor reimbursement to achieve cost and quality goals. You need a Physician Executive who understands clinical care management and population health strategy to deliver high quality healthcare. I am able to drive market leading performance in the delivery of value-based care across commercial and government populations. As a Chief Medical Officer with 20+ years of managed care experience in the provider, payer, and military environments, I optimize operational efficiency, access to care, and outcomes. My foundational experience in direct primary care delivery enables me to develop and implement strategies for clinical, utilization, and practice management that reflect day-to-day patient care realities.• As a leader, I have a strong track record of effectively collaborating and communicating with providers, operations, and executive leaders.• I am committed to optimizing healthcare access, quality and cost outcomes, and positive provider / patient experience. • I use data-driven analyses to identify and implement innovative medical cost management and coding initiatives that deliver quantifiable results.• I’m certified in medical coding and have used my expertise with the Epic EMR system and HMS Essette to ensure appropriate RAF and MCR. I am retired from the military at the rank of Colonel. I did my medical internship and residency training at Fort Belvoir, VA and served four years in Germany as a Clinic Commander and Chief of Primary Care in Aschaffenburg and Nuremberg, respectively. During my early career I was a private practice Partner with Harrisonburg Family Practice.In my leisure time I am a multi-sport athlete participating in sprint triathlons and enjoy wood turning. I’m engaged in and support veterans’ causes.

Experience

1. Corporate Medical Director, Grievances and Appeals

   Humana

   Oct 2024 — Present

   Provide first level appeal reviews for Medicare services that were not approved on initial physician review. These appeals are for all types of denials including inpatient services, post-acute care, behavioral health, DME, surgical procedures, et al.

Education

• James Madison University

  Master of Business Administration (MBA), Concentration in Health Care

• Drexel University

  Doctor of Medicine (MD), Graduated from Hahnemann

• Williams College

  Bachelor of Arts (BA), Chemistry, Economics

Skills

• Physicians
• Healthcare
• Clinical Research
• Medicare
• Quality Improvement
• Medicine
• Emr
• Hospitals
• Healthcare Information Technology
• Hipaa
• Healthcare Industry
• Informatics
• Healthcare Management
• Health Policy
• Disease Management
• Healthcare Consulting
• Working with Physicians
• Managed Care
• Internal Medicine