Hello, I'm Dr. Arthur Flores
I am seeking an opportunity that will best utilize almost 30 years of clinical experience in the practice of medicine and healthcare administration. My career experience provides a diverse array of physician leadership roles I have assumed for Managed Care Organizations, Healthcare Delivery Networks, Clinical Academic Programs, and Health and Wellness Companies. I hope to contribute to the success of a healthcare organization by lending my experience, skill-set, and knowledge of healthcare administration toward advancing the delivery of quality and cost-effective health care that improves health outcomes and ultimately the quality of life of the patients and families we serve.


Arthur Flores, M.D.
Physician Executive
Phone:
219-688-8641
Email:
Address:
11345 Abercairn Court
Zionsville, IN 46077
Medical Education
The Ohio State University College Of Medicine
Specialty - Certification
Family Medicine

SUMMARY OF CAREER EXPERIENCE
Dr. Flores' career demonstrates an unusually broad combination of executive medical leadership, managed care, population health, disease management, quality, and clinical operations. His current position as Deputy Chief Medical Officer at Trillium Health Resources, combined with his previous Chief Medical Officer role at Aetna and National Medical Director position with Anthem, demonstrates experience operating at the highest levels of healthcare strategy and medical leadership. His background with organizations such as WebMD Health Services, American Family Health, Anthem Blue Cross - Blue Shield, and Aetna, further demonstrates extensive exposure to health-plan operations, medical management, Medicaid and Medicare, regulatory guidelines, NCQA, URAC, HEDIS, and population-health strategy. This combination makes Dr. Flores particularly well suited for an executive position requiring someone who can connect medical strategy, clinical operations, quality performance, regulatory requirements, and patient-centered healthcare delivery. He is seeking to leverage his extensive executive experience while contributing to broader organizational strategy. His managed-care and population-health background is particularly valuable in developing scalable clinical programs, strengthening quality outcomes, improving healthcare value, and aligning medical operations with organizational objectives.
Additionally, Dr. Flores has had multiple clinical leadership roles for Health Clinics and Healthcare Delivery Networks including Chief Medical Officer roles with NorthShore Health Centers, Adult & Child, and Third Street Family Health Services, all Federally Qualified Health Centers (FQHC). In these clinical leadership roles he has demonstrated knowledge of Medicare and Medicaid regulations, Value Based Care, Clinical Care Guidelines, HEDIS and clinical quality, health outcomes reporting, development of clinical programs, coding and clinical documentation, population and public health, and day to day operational oversight of physicians and clinical staff providing direct patient care. His healthcare knowledge and experience has allowed him to advance health clinics by achieving FQHC and JCAHO accreditations, expand provider staff, grow clinical facilities through the opening of new clinics, and ensuring the medical needs of the population served were met. These roles required extensive collaboration and coordination with community partners such as hospitals, health systems, pharmacies, academic medical centers, and civic resources including State and Federal Government. His clinical practice has included Family Medicine, Urgent Care Medicine, Occupational Medicine, Aesthetic Medicine, and Health and Wellness. He has provided patient care in hospital and ambulatory care settings, as well as free standing Emergency and Urgent Care facilities.
EDUCATION
1998-2001
Family Medicine Residency
Chief Resident
1994-1998
Doctor of Medicine, M.D.

Columbus, Ohio

Columbus, Ohio
1988-1992
Bachelor of Science Biology, B.S.

Bloomington, Indiana
EXPERTISE
Medical Management
Care Management, Disease Management, Utilization Management
Value Based Care
Payor and Provider Perspectives, Risk Adjusted Contracts based on Population Data, Risk Sharing Models
Population Health
Whole Populations and targeted Sub-Populations
Digital Health Tools
EMR / PHR, Medical Management Platforms, Provider and Patient Portals, Digital Health Apps
Government Programs
Managed Medicaid & Medicare,
Predictive Modeling
Risk Stratification, Algorithm Creation, Predictive Analytics, Risk Distribution
Provider Relations & Engagement
Network Management and Network Adequacy, Clinical / Physician Advisory Committees
Clinical Care Guidleines
Evidence Based Medicine and Application of Clinical Guidelines, Medical Necessity
Clinical Quality
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Change Management
Navigating shifting State and Federal regulations / laws
Regulation, Accreditation, and Complaince
HEDIS, KPI's, NCQA, URAC, JCAHO, STAR
Pharmacy, Pharmacy Benefits Manager,
340-B Drug Program
Collaboration and Monitoring of Health Plan Pharmacy Benefit Manager, knowledge of 340-B Program
SKILLS

Public Speaking & Presentations - Advanced
Microsoft Office - Proficient
Project Management - Advanced
Leadership, Coaching, and Team Building - Advanced
Predictive Modeling and Analytics - Advanced
Data Analysis - Advanced
Oral and Written Communication Skills - Advanced
Program Development, Practice Start-up, Health Integrations - Advanced