John M. Goldenring, MD, MPH, JD
FAAP, FSAM, FCLM
10496 Canyon Lake Drive
San Diego, California 92131
858-635-5500 Fax: 858-635-5600
Email: jgoldenr@san.rr.com

PERSONAL

  • Specialty
    • Pediatrics and Adolescent Medicine
    • Preventive Medicine

  • Certification
    • National Medical Boards Certification
    • American Board of Pediatrics
    • Adolescent Medicine Subspecialty Board
    • American Board of Preventive Medicine

  • Licensure
    • Medical: California (G37744)
    • Medical: Texas (J0955)
    • Medical: New York – Inactive
    • Legal Practice: California (CA Bar# 246144)

  • Organizations
    • American College of Physician Executives
    • American Academy of Pediatrics, Fellow
    • Society for Adolescent Medicine, Fellow
    • American College of Legal Medicine, Fellow
    • American Public Health Association
    • International Association for Adolescent Medicine

EXPERIENCE

  • August 2006 – Present
    (also November 2001 – September 2002 & May 2001 – September 2001) Consulting Medical Director
    • Care1St Health Plan
      Alhambra, CA
    • International Care Network
      Irvine, CA
    • Blue Cross California
      Wooldland Hills, CA
    • Medical-legal, UM & other consulting & Clinical practice
    • Sharp Rees-Stealy Medical Group
      San Diego, CA & other locums


  • October 2002 to July 2006
    Medical Director
    Riverside Physician Network
    1650 Iowa Ave, S220
    Riverside, CA
    • Responsible for all aspects of medical management - 54k lives - Commercial & Senior Plans
    • MLR reduced from 89% - 75%, profitability achieved


  • August 2001 - October 2001
    Vice-President & Chief Medical Officer
    Tower Health
    Long Beach, CA
    • Responsible for all health services including Health Education & Cultural & Linguistics programs.
    • Chair of UM, P&T, QM committees.
    • Contact with over 100 IPAs Commercial & Medicaid Plan - 100K lives
    • Worked with Conservators to close Plan per State order


  • November 2000 to August 2001
    October 2001 - December 2001
    Consulting Medical Director
    Tower Health
    Long Beach, CA
    • Responsible for UM, Claims Review, IPA denial oversight, Pharmacy
    • Developed disease management protocols and instituted an active case management program.
    • Chair, Utilization Management Committee
    • Returned to consulting position when company closed by State of CA


  • December 2000 to April 2001
    Medical Sciences Director
    Real-age.com
    Sorrento Valley
    San Diego, CA
    • Medical Director for science team for innovative Internet Health Information, Education and Disease Management website


  • September 1998 to December 2000
    May 2000 to December 2001
    Pediatric & Adult Urgent Care Medical Management
    & Medical-Legal Expert Consulting
    • Children's Hospital San Diego, Sharp Rees-Stealy Pediatrics, Valley Immediate Care, Clinica Consuela, Locum Tennans, CCN, Inc, TASA and others.


  • January 1998 to August 1998
    Medical Director & Director of Health Services
    Great American Health Plan
    San Diego, CA
    • Responsible for QA, QM, UM, Credentialing, Pharmacy and Health Education
    • Demonstrated quality in presentations to physicians, non clinical staff, managed care organizations, local/state political advocacy programs and consumers
    • Directed a cohesive health services team for start-up MediCal (Medicaid) Managed Care Company
    • Led the organization's first successful audit by the California Department of Health Services
    • Worked with start-up IPA and several others


  • July 1995 to October 1997
    Regional Medical Director
    FHP Health Care
    San Diego, CA
    • Responsible for all of Northern CA, plus half of Southern, CA
    • 500k lives and over 150 IPAs
    • Responsible for Physician and IPA liaison with assigned regions, as well as QM, Risk and Case Management reviews for Commercial and Senior Medicare risk HMO products
    • Improved Credentialing process
    • Revised and reinstated technology assessment program
    • Assisted in passing California tech assessment legislation
    • Transitioned various elements of the delivery system through financial and personnel changes and reorganizations
    • Member
      • California and National Pharmacy & Therapeutics Comm.
      • HEDIS Improvement Committee
      • Inter-regional Benefit Interpretation Committee
      • Southern California QM Committee
      • Statewide Credentialing Committee
      • Southern California Claims Appeals Board
      • California Government Affairs Committee
    • Chair
      • Subregional Health Care Advisory Committees
      • Technology Assessment Committee for California
      • Medical Director for California Organ Transplant Program
      • Medical Director for Government Affairs


  • May 1994 to July 1995
    Associate Medical Director - Southern California Market
    Aetna Health Plans of California
    San Bernardino, CA
    • Developed health education and community involvement programs for health plan members and employees
      Chair
      • Quality Management Committee
      • Pharmacy Committee
    • Developed epidemiological, evaluative and interventional clinical studies
    • Assisted national office in review of technology assessments and preventive health guidelines and programs
    • Prepared for NCQA review
    • Substitute Member, National Pharmacy & Therapeutics committee
    • Streamlined Credentialing process for over 9,000 physicians per year
    • Over 600K lives and over 100 IPAs


  • October 1991 to May 1994
    Associate Professor of Pediatrics - Internal Medicine, Surgery & Preventive Medicine
    Director of Adolescent Medicine - Pediatric & Adult Emergency Room Faculty
    University of Texas Medical Branch
    Galveston, TX
    • New Drug Approval Committee
    • Emergency Room Oversight Committee
    • Computer & Information Services Committee


  • 1987 to 1991
    Pediatrician, Private Practice
    Thousand Oaks & Redlands, CA
    • Attending Physician Pediatric Ward & Juvenile Clinics Ventura County Medical Center 1988
    • San Bernardino County Juvenile Hall, 1989 to 1991
    • Medical Director, University of Redlands College Health Center, 1990 to 1991


  • 1985 to 1987
    Assistant Professor of Pediatrics, Adolescent & Preventive Medicine
    New York Medical College
    Valhalla, NY
    • Successful Author of $600,000 Robert Wood Johnson Grant of Research, Adolescent Medicine Division


  • 1983 to 1985
    College Health Physician
    Student Health Center, Loyola Marymount University
    Los Angeles, CA

    • EDUCATION

    • 1973 - Georgetown University College of Arts & Sciences
      Washington, DC
      B.S.

    • 1977 - Georgetown University School of Medicine
      Washington, D.C.
      M.D.

    • 1978 - University of California Irvine Orange and Long Beach, California Pediatrics PL-1

    • 1980 - Children's Hospital of Northern California
      Oakland, California
      Pediatrics PL-2,3

    • 1981 - University of California, Berkeley
      Berkeley, California
      M.P.H.

    • 1983 - Los Angeles Children's Hospital
      Los Angeles, California
      Adolescent Medicine Fellowship

    • 2006 - Concord Law School
      Los Angeles, CA
      Juris Doctorate - July 2006
      Passed California Bar Exam on First Try July 20006


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