James J. McCormick

Dr. James J. McCormick

Tradewinds Healthcare Consulting, LLC
P.O. Box 1613
Yanceyville, NC 27379
Office: 818-917-6189
Introduction

As a physician leader, I have designed and implemented systems to ensure medical recordkeeping meet legal, reimbursement, and quality benchmarks. I spearheaded the development of a multi-state governance framework for both primary and specialty care groups, ensuring peer review, credentialing, quality assurance, and utilization management processes are rigorously structured and defensible. I also led the creation of an enterprise-wide Utilization Management Committee to meet CMS mandates. The committee is empowered to critically evaluate national clinical policies before adoption—aligning frontline utilization decisions with evidence-based standards. With decades of expanding leadership across diverse healthcare sectors, I bring a fair, balanced, and meticulously documented expert perspective to every case I consider.


Areas of Expertise
  • Managed Care & HMOs
  • Medical Fraud
  • Medical Insurance

References

Available Upon Request