Contact list Medical Groups 201504
Heritage Provider Network
Contact List
As of April 2015
Group
Department
Contact Type
Contact Name
Heritage Provider Network, Corporate Office
Claims Credentialing
Main Contact Escalated Contact Main Contact
Robin Morales Octavio Campos Mihir Sanghavi
Main Contact (Credentialing Audits) Marque Hernandez
Main Number:
Contracting
Main Contact
Jaya Kurian
(818) 654-3461
Plan Contact
Mihir Sanghavi
Plan Contact
Maciej Makowiecki
Plan Contact
Lindra Frandinata
Plan Contact
Jeff Rijadi
Plan Contact
Emre Sahinalp
Plan Contact
Rajat Malhotra
Plan Contact
Natjaya Chinda
Plan Contact
Irene Francisca
Plan Contact
Greshe Abraham
Plan Contact
Nilay Shah
Plan Contact
Neha Yadav
Compliance
Main Contact
Sandy Finley
Encounter/IT
Main Contact
Clinical, QM, UM, Care Mngt Main Contact
Scott Bae Teresa Kries
Title
Director of Claims Corporate Dir. of Special Projects Operations/Finance Manager II Director of Clinical Operations CFO, SVP Operations/Finance Manager II Project Manager II Director of Finance Director of Finance Sr Finance/Ops Analyst Project Manager Sr Project Manager Project Manager Sr Finance/Ops Analyst Director of Finance Data Analyst II Human Resources Manager Sr VP, Corporate Information Systems Vice President of Clinical Services
Phone
(661) 846-3927 (661) 951-3224 (818) 654-3463 (714) 908-5617 (818) 654-3455 (818) 654-3463 (818) 654-3464 (818) 654-3472 (818) 654-3479 (818) 654-3496 (818) 654-3434 (818) 654-3416 (818) 654-3483 (818) 654-3444 (818) 654-3462 (818) 654-3473 (661) 726-3826 (818) 654-3480 (714) 908-5608
High Desert Medical Claims Group
Main Number:
Credentialing
(661) 726-3800
Contracting
Compliance Clinical
UM/Authorization Cal MediConnect
Main Contact Escalated Contact Main Contact Escalated Contact Main Contact
Secondary Contact Main Contact Secondary Contact Main Contact Secondary Contact Escalated Contact Escalated Contact Main Contact
Secondary Contact Main Contact
Secondary Contact
Anthony Cockerill Octavio Campos Theresa Leon Mihir Sanghavi Lisa Nelson
Rafael Gonzalez Jeanine Olmscheid Sandy Finley Dr. Charles Lim Rafael Gonzalez Michele Christensen Saro Arakelians Denise Rock
Lynda Masco Michael Almazar
Denise Rock
Director, Claims Corporate Dir. of Special Projects Credentialing Supervisor Operations/Finance Manager II Sr. Director of Network Development / Provider Relations Administrator VP, Meas/Improv, QM/Compliance Corporate Human Resources Director Medical Director Administrator VP Opertaions PharmD DM and Pharmacy Director
UM Manager/Continuity of Care
VP, Care Management Associate VP, Care Management
UM Manager/Continuity of Care
(661) 726-3815 (661) 951-3224 (661) 726-3800 (818) 654-3463 (661) 951-3052 / cell (661) 810-0551 (661) 951-3083 (661) 726-3985 (661) 726-3826 (661) 726-3800 (661) 951-3083 (661) 951-3097 (661) 726-3956 Office: (661) 723-8761 Fax: (661) 952-3684 (661) 951-3361 (661) 726-3995 Office: (661) 723-8761 Fax: (661) 952-3684
Email
rmorales@ ocampos@ msanghavi@ mthernandez@ jkurian@ msanghavi@ mmakowiecki@ lfrandinata@ jrijadi@ esahinalp@ rmalhotra@ nchinda@ ifrancisca@ gabraham@ nshah@ nyadav@ sdfinley@ scbae@ tkries@
awcockerill@ ocampos@ tlleon@ msanghavi@ lknelson@
rgonzalez@ jolmscheid@ sdfinley@ cmlim@ rgonzalez@ mlchristensen@ sarakelianes@ drock@
ljmasco@ malmazar@
drock@
Group
Department
Heritage Victor Valley Claims Medical Group
Main Number:
Credentialing
(760) 245-4747
Contracting
Compliance
Clinical
UM/Authorization
Sierra Medical Group Claims
Main Number:
Credentialing
(661) 945-9411
Contracting
Compliance
Clinical
UM/Authorization Cal MediConnect
Contact Type
Main Contact Escalated Contact Main Contact Escalated Contact Main Contact Secondary Contact Main Contact Secondary Contact Main Contact Secondary Contact Escalated Contact Main Contact Secondary Contact
Main Contact Escalated Contact Main Contact Escalated Contact Main Contact Escalated Contact Main Contact Secondary Contact Main Contact Escalated Contact Main Contact Secondary Contact Main Contact Escalated Contact
Heritage Provider Network
Contact List
As of April 2015
Contact Name
Title
Anthony Cockerill Octavio Campos Julia Shelton Mihir Sanghavi Rick Howells Debrah Bennett Stephen Orr Debrah Bennett Yvonne Lopez Susannah Meehan Dr. Mohinder Ahluwalia Yvonne Lopez Irma Still
Director, Claims Corporate Dir. of Special Projects Credentialing Coordinator II Operations/Finance Manager II Sr. Director of IPA Operations Director, Provider Relations Compliance Director, Provider Relations Audit and Compliance Specialist Director, Clinical Services Medical Director Audit and Compliance Specialist Referral Supervisor
Phone
(661) 726-3815 (661) 951-3224 (760) 245-4747 (818) 654-3463 (760) 261-5231 (760) 261-5227 (760) 261-6498 (760) 261-5227 (760) 261-5235 (760) 261-5297 (760) 514-7379 (760) 261-5235 (760) 261-5213
Anthony Cockerill Octavio Campos Belinda Hartson Mihir Sanghavi Belinda Hartson Dr. Tuan Phan Sherry Connelly Sandy Finley Dr. Tuan Phan Nilay Shah Sherry Connelly Dr. Tuan Phan Robert Caro Dr. Tuan Phan
Director, Claims Corporate Dir. of Special Projects Credentialing Coordinator Operations/Finance Manager II Administrative Assistant Medical Director Manager of QM/UM Corporate Human Resources Director Medical Director Director of Finance Manager of QM/UM Medical Director LVN Medical Director
(661) 726-3815 (661) 951-3224 (661) 579-2034 (818) 654-3463 (661) 579-2034 (661) 579-2012 (661) 579-2005 (661) 726-3826 (661) 579-2012 (818) 654-3462 (661) 579-2005 (661) 579-2012 (661) 480-2063 (661) 579-2012
Email
awcockerill@ ocampos@ jeshelton@ msanghavi@ rhowells@ dgbennett@ storr@ dgbennett@ ylopez@ slmeehan@ mpahl@ ylopez@ iestill@
awcockerill@ ocampos@ bkhartson@ msanghavi@ bkhartson@ tdphan@ slconnelly@ sdfinley@ tdphan@ nshah@ slconnelly@ tdphan@ rjcaro@ tdphan@
Group
Department
Bakersfield Family
Claims
Medical Center (BFMC)
Coastal Communities Physician Network (CCPN)
Credentialing
Contracting Compliance
Main Number:
(661) 327-4411 Clinical
UM/Authorization
Desert Oasis Healthcare Claims
Main Number:
Credentialing
(760) 320-8814
Contracting
Compliance
Clinical
UM/Authorization
Contact Type
Main Contact Secondary Contact Escalated Contact Main Contact Escalated Contact Main Contact Main Contact Secondary Contact Main Contact Secondary Contact Escalated Contact Main Contact (In-Patient) Secondary Contact (In-Patient) Main Contact (Out-Patient) Secondary Contact (Out-Patient)
Heritage Provider Network
Contact List
As of April 2015
Contact Name
Title
Phone
Mark Reyes Robin Dow-Morales Octavio Campos Tonya Walsh Mihir Sanghavi Stacy Reeves Debbie Zamora Renae Montez Manisha Mistry Dr. JuHwan Lee Dr. David Leece Manisha Mistry Theresa Peeples Casey Wilkerson Melissa Zavaleta
Director of Claims Management Corporate Claims Director Corporate Dir. of Special Projects Credentialing Coordinator Operations/Finance Manager II ACO/Quality/Provider Relations VP, Risk Management Compliance Coordinator VP of Medical Management Medical Director Chief Medical Officer Vice President of Medical Management Util Review Administrative Supervisor Sr Director of Utilization Management Utilization Management Lead
(661) 616-9415 (661) 846-3927 (661) 951-3224 (661) 846-4708 (818) 654-3463 (661) 616-9432 (661) 846-4639 (661) 616-9412 (661) 301-5705 (661) 345-7147 (805) 550-2993 (661) 301-5705 (661) 846-3972 (661) 616-9416 (661) 846-4849
Email
mreyes@ rmorales@ ocampos@ twalsh@ msanghavi@ sreeves@ dzamora@ rmontez@ mmistry@ jhlee@ dleece@ mmistry@ tlpeeple@ cwilkerson@ mzavaleta@
Main Contact Escalated Contact Main Contact Escalated Contact Escalated Contact Main Contact Secondary Contact Main Contact Secondary Contact Main Contact Main Contact - HMO Main Contact - ACO Escalated Contact Escalated Contact Main Contact Secondary Contact
Clare Abadie Lauren Beyeler Cathy Brandon Carlos Schroeder Mihir Sanghavi Helene Leclair Ken Rains Carlos Schroeder Randy Vaughn Dr. Marc Hoffing Tom Rancilio, RN Brian Hodgkins Teresa Hodgkins Dr. Osmundo Saguil Carlos Schroeder Tom Rancilio, RN
Director, Claims
(760) 323-2614, ext 1907
VP of Finance and CFO
(760) 969-6515
Regional Credentialing Manager/CME Man(760) 320-4122, ext 1310
VP, Quality & Compliance
(760) 320-4122, ext 1440
Operations/Finance Manager II
(818) 654-3463
VP of Network Administration
(760) 320-8814, ext 1575
Director of Contracting
(760) 320-8814, ext 1577
VP, Quality & Compliance
(760) 320-4122, ext 1440
Compliance
(760) 360-3193
Medical Director
(760) 320-4122, ext 1400
VP, Clinical Services
(760) 969-5262, ext 1400
Pharm D, EVP Clinical Ops & ACO
(760) 969-5262, ext 1400
PharmD, AVP, Clinical Perf. & Outcomes )760) 320-4122, ext 1313
Medical Director Clinical Services
(760) 969-5262, ext 1400
VP, Quality & Compliance
(760) 320-4122, ext 1440
VP, Clinical Services
(760) 969-5262, ext 1400
cabadie@ lbeyeler@ cbrandon@ cschroeder@ msanghavi@ hleclair@ krains@ cschroeder@ rvaughn@ mhoffing@ trancilio@ bhodgkins@ thodgkins@ osaguil@ cschroeder@ trancilio@
Group
Department
Contact Type
Regal Medical Group (RMG)
Lakeside Medical Group (LMG)
Claims Credentialing
Main Contact Escalated Contact Main Contact Escalated Contact
Affiliate Doctors of
Contracting
Orange County (ADOC)
Main Contact Secondary Contact Main Contact - RMG/ADOC
Main Number:
Compliance
Main Contact
(818) 654-3400 Clinical (818) 637-2000 Burbank / Los Angeles / Glendale / Contact
San Fernando Valley Escalated Contact
Escalated Contact (afterhours)
Simi Valley Contact Escalated Contact Escalated Contact (afterhours)
Inland Empire (Riverside/San Contact - Pomona/Chino/Covina Bernardino) / Pomona / Chino
Valley and Covina Contact - Inland Empire Escalated Contact Escalated Contact Escalated Contact Escalated Contact (afterhours)
ADOC (Orange County) Contact Escalated Contact Escalated Contact Escalated Contact Escalated Contact
Heritage Provider Network
Contact List
As of April 2015
Contact Name
Title
Soon Huh Becky Nething Irania Jauregui Mihir Sanghavi Will Jukes Julie Feind Jasmine Torgerson Jeff Baron
Director, Claims Processing Senior Director, Claims Credentialing Manager Operations/Finance Manager II Vice President of Regional Operations Director of Network Management SVP Network Management Compliance Officer / Privacy Officer
Violetta Smolyar Shelly Mason Beth Gibbons
Margie Manwell Shelly Mason Beth Gibbons
Alexis Mutuc Diana Bravo Faith Nation Lisa Ali Barbara Caudill Beth Gibbons
Diana Bravo Alexis Mutuc Barbara Caudill Beth Gibbons Sarada Mylavarapu, MD
Director of Inpatient Case Mgmt VP of Clinical Services SVP Clinical Services
Supervisor of Med Management VP of Clinical Services SVP Clinical Services
Manager of Case Mgmt Manager of Inpatient Case Mgmt Director of Inpatient Case Mgmt Director of Vital Care VP Medical Management SVP Clinical Services
Manager of Inpatient Case Mgmt Manager of Vital Care VP Medical Management SVP Clinical Services Medical Director
Phone
(818) 654-3430 (818) 357-5069 (818) 357-5031 (818) 654-3463 (818) 654-3424 (818) 637-2000, ext 4149 (714) 908-5633 (818) 637-2000, ext 1248
Email
shuh@ bnething@ igjauregui@ msanghavi@ wajukes@ julie.feind@ jtorgerson@ jbaron@
(818) 637-2000, ext 1223 (818) 637-2000, ext 3371 (626) 646-2710
(805) 210-7404 (818) 637-2000, ext 3371 (626) 646-2710
(626) 646-2740 ext. 3261 (626) 646-2740, ext 3259 (909) 380-7144 (626) 646-2709 (909) 380-7137 (626) 646-2710
(626) 646-2740, ext 3259 (626) 646-2740, ext 3261 (909) 380-7137 (626) 646-2710 (714) 539-3100, ext 1215
vsmolyar@ smason@ bgibbons@
mmanwell@ smason@ bgibbons@
Amutuc@ dbravo@ Fnation@ Lali@ bcaudill@ bgibbons@
dbravo@ amutuc@ bcaudill@ bgibbons@ smylavarapu@adoc.us
Group
RMG / LMG / ADOC (continued)
Department
Contact Type
UM/Authorizations Simi Valley Contact
San Fernando Valley Contact Burbank / Los Angeles Contact
Glendale Contact Escalated Contact
RMG Orange County / ADOC / Covina / GCMG
Contact
Riverside / San Bernardino / Pomona / Chino Valley
Contact
Cal MediConnect
Simi Valley / San Fernando Contact Valley / Burbank / Glendale / Escalated Contact
Los Angeles Escalated Contact Escalated Contact Escalated Contact
Riverside / San Bernardino / Contact Pomona / Chino Valley / Covina Contact
and Orange County Contact Contact Contact Escalated Contact
Heritage Provider Network
Contact List
As of April 2015
Contact Name
Title
Phone
Email
Alma Maldonado Lisetta Huerta Veronica Robles Jennifer Acevedo Dania Sanchez-Pinnick
Prior Auth Coordinator Prior Auth Team Lead Prior Auth Coordinator Prior Auth Coordinator Senior Manager-Prior Authorization
(818) 707-9603, ext 5160 (818) 707-9603, ext 5226 (818) 707-9603, ext 5093 (818) 707-9603, ext 5193 (818) 654-3408
amaldonado@ lishuerta@ vrobles@ jacevedao@ dlsanchezpinnick@
Cindy Sarmiento Jeremy McDonald
Prior Auth Manager, LVN Prior Auth Manager, RN
(626) 974-0440, ext. 268 (909) 383-2384
csarmiento@ jmcdonald@
UM Department Christine Frega Luana Oneil Tara Jett Keith Campeau, MD
UM Department Enrique Cabrera Trinette Magee Candace Smith Dr. Tenzing Wangyal Jeremy McDonald
Prior Auth Case Manager Prior Auth Coordinator UM Coordinator Medical Director
Prior Auth Nurse UM Coordinator UM Coordinator Medical Director Prior Auth Manager, RN
(213) 835-2820 (818) 637-2000, ext 1336 (818) 637-2000, ext 3024 (818) 637-2000, ext 5080 (818) 637-2000, ext 3276
(909) 890-2674 (909) 890-2674, ext 7175 (909) 890-2674, ext 7227 (909) 380-7145 (714) 539-3100, ext 5905 (909) 383-2384
Fax: (818) 933-5439 cfrega@ loneil@ tjett@ keith.campeau@
Fax: (909) 890-0629 ecabrera@ tmagee@ casmith@ twangyal@ jmcdonald@
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