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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