DR. CARL G BYNUM, D.O.
Marriage and Family Therapists at Jeanine Dr, Tempe, AZ

Associate Regional Medical Director at Corizon: Arizona Regional Office

Hospital & Health Care

Corizon: Arizona Regional Office - Tempe, AZ since Mar 2013 - Associate Regional Medical Director Corizon: Missouri Regional Office Jun 2010 - Mar 2013 - Regional Medical Director HealthCare USA Jul 2006 - Jun 2010 - Medical Director Primaris Mar 1997 - Nov 2005 - Medical Director

Saint Louis University 1990 - 1992
MPH A.T. Still University of Health Sciences 1971 - 1975
D.O.

Corizon HealthCare - Tempe, AZ
Medical Director Corizon HealthCare - Jefferson City, MO
o Medical Director Utilization Management Corizon HealthCare
o Regional Medical Director Corizon HealthCare
o Associate Regional Medical Director A.T. Still University of Health Sciences
Chair Coventry HealthCare
o Medical Director Coventry HealthCare - St. Louis, MO
Medical Director Coventry HealthCare
o Consultant Medical Director Primaris - Columbia, MO
Medical Director Primaris
o Medical Director Occupational Health Clinic - Jefferson City, MO
Medical Director Family Practice
Owner/Operator Family Practice
Director, Family Practice Residency Program Family Practice
Chief of Staff

The scope of my clinical practice has allowed me to experience healthcare from both a provider and a payer perspective. My provider experience encompassed care provided at all levels (pediatric, obstetric, adult, and senior care) and in all settings (outpatient clinic, hospital, nursing home, emergency room, and correctional facilities). My administrative and utilization management experience required an understanding of Federal, State, and local regulations and laws (Medicare, Medicaid, and the prison setting). During this time I have also been extensively involved in Federal, State, and local affairs, including serving on various committees within organized medicine and in the local community. Specific details of experience: Reviewed DRG validation, admission/discharge, and length of stay determinations. Determined the level of inpatient care, the necessity for continued care including discharge planning and appropriateness of alternative level of care settings while ensuring proper utilization and quality of care through the extensive use of InterQual criteria. Provided direct communication with providers to discuss adverse decisions and presided over the patient grievance process. Analyzed health plan data to identify utilization discrepancies and developed strategies to improve the efficiency and effectiveness of providing appropriate quality health care. Supervised over fifty health care providers throughout the State including direct interaction regarding provision of acute care, peer review of medical records, and continuous recommendations for outpatient and inpatient treatment and referrals. Maintained open communication with Federal and State regulatory agencies regarding the provision and monitoring of health care services. Assisted physicians in understanding the benefits of electronic health records and provided guidance in the selection process. Supplied feedback to the Department of Corrections in the development and implementation of an electronic health record system. Conducted regular healthcare provider training regarding appropriate utilization of resources, updates of clinical guidelines, and review of outlier (long length-of-stay) cases. Created consistent messages from the utilization management department to the healthcare providers regarding alternative treatment plans for inpatient and outpatient services. Managed a panel of consultant specialist and coordinated communication between the specialist and our healthcare providers. Exhibited excellent presentation skills that engaged and motivated the providers to adhere to the goals and values of the organization.

Osteopathic Manipulative Therapy

950 W Elliot Rd STE 220, Tempe 85284
(480) 897-9515 (Phone), (480) 897-9605 (Fax)
3702 W Truman Blvd STE 104, Jefferson City 65109
(573) 635-5315 (Phone), (573) 635-5512 (Fax)
1701 E Jeanine Dr, Tempe 85284
(573) 230-1313 (Phone)

Osteopathic Manipulative Medicine

Healthgrades Honor Roll

English

Family Physician

3702 W Truman Blvd, Jefferson City, MO 65109
950 W Elliot Rd, Tempe, AZ 85284