For more than a decade, Carlos Luna has been a trusted adviser to stakeholders in healthcare, claims, utilization review, managed care, insurance, and government agencies in workers’ compensation. A recognized thought-leader on national workers’ compensation issues, Carlos has been published by industry-leading publications such as WorkCompCentral, WorkCompWire, Insurance Business Magazine, Louisiana CompBlog, and more. He was named a “New Leader in Workers’ Compensation” by WorkCompWire in 2017 and was featured as LegalNetInc.com’s “ThursdayThought Leader” in 2018. He is a Subject Matter Expert in:

Workers’ Compensation Claims

• Develop and implement workflows to minimize inappropriate medical treatment and reduce costs due to over-utilization of treatment and inappropriate drug prescriptions
• Develop and implement return-to-work / stay-at-work programs (full duty and modified duty) to expedite physiological recovery
• Analyze existing claim programs for efficacy in reducing days of disability and achieve an optimal return to work outcome
• Incorporate predictive modeling programs to identify claims with a high risk of long-term disability and high cost
• Develop and implement effective communication programs ensuring accurate and timely information sharing
• Develop benchmark reporting capabilities

Government Affairs

• Develop and implement government affairs strategy
• Proficient in tracking and interpreting pending regulation and legislation
• Proficient in writing and delivering expert witness testimony for committee and sub-committee public hearings
• Proven track record in creating thought-leadership among regulators and legislators
• Proven track record in seeing regulation and legislation through to enactment

Evidence-Based Medicine (EBM)

• Proficiently analyze EBM sources for development quality and trustworthiness
• Develop and implement processes to incorporate EBM into claims and clinical workflows
• Develop and implement programs to enhance claims and clinical adherence to EBM tools protocols
• Support data integration of EBM content into software systems (claims, RMIS, EMR)
• Expert trainer in optimizing the use of EBM in claims and clinical settings

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