Doctors HealthCare Plans, Inc. brings you a team of highly experienced health care professionals with over 200 years of combined healthcare experience. Our purpose is to improve the way local health care is delivered. Our past results speak to our dedication, loyalty and commitment in providing beneficiaries and providers exceptional service. Our Senior Management Team includes:
• Rafael P. Perez, President and CEO – Mr. Perez has over 30 years of managed healthcare experience including over 20 years in senior executive management positions, including healthplan operations, contracting, medical management, company startup, and sales and marketing. Mr. Perez started his healthcare career as a pharmacy director for Humana. From 1990 through 1998 he was the Executive Director, Senior Vice President for CAC Ramsey and United Healthcare, Inc. responsible for all South Florida operations. Mr. Perez was co-founder, CEO and Chairman of Medica HealthCare Plans, Inc. until the sale of the company in 2012. Mr. Perez was a 2009 State finalist for the Ernst & Young Entrepreneur of the Year in healthcare. Mr. Perez has a pharmacy degree from the University of Florida and a Master’s degree in Business Administration from Nova Southeastern University.
• Martin J. Perez, Chief Financial Officer – Mr. Perez is an experienced executive with over 30 years of financial and operational management experience. As co-founder of Medica HealthCare Plans, Inc., Martin had a leadership role in the development and growth of the company from a startup to over 40,000 Medicare lives in Miami-Dade and Broward counties. As a Certified Public Accountant, he possesses strong financial knowledge and understanding of financial, compliance, statutory, and operational process and procedures that impact the management of a healthcare organization and its relationship with State and Federal regulatory agencies.
• Francisco Hernandez, M.D., Medical Director – A frequent lecturer and voluntary faculty member at several Florida universities, Dr. Hernandez has served as the Chairman and Chief of Staff of various hospital committees and sits on multiple national advisory boards. Following his internship and residency training in Internal Medicine at the University of Miami Jackson Memorial Hospital, Dr. Hernandez completed his Fellowship in Endocrinology, Diabetes and Metabolism at University of Puerto Rico Hospital. Since the 1990’s, Dr. Hernandez, has worked in numerous medical centers across the state of Florida in a wide range of roles and capacities. After serving as a Physician in Charge and Endocrinology Consultant for multiple institutions, Dr. Hernandez opened his own inpatient and ambulatory endocrinology practice, Endocare, Inc., in 1996. For the past five years, he has served as the Medical Director for Simply Healthcare Plans, Better Health and Clear Health Alliance.
• Susan Griffin, V.P. Administration – Ms. Griffin has nearly 30 years of health care experience, including 20 years of senior level executive management in areas such as health plan operations, compliance, accreditation, quality improvement, disease management, credentialing, member services, provider maintenance, network development, claims, and patient centered medical home. Ms. Griffin started her career working for the Department of Defense in the European Corridor. She moved back to the United States and coordinated the formation of a Medicaid HMO in Florida in 1994. Ms. Griffin served as Vice President of Great-West HealthCare from 1997 to 2003, leading operations for the Florida business. She went on to serve as a Compliance Officer for a Medicare Advantage organization in 2003. Ms. Griffin launched her own consulting firm in 2006, assisting clients with health plan licensing, operations, accreditation, and other efforts for various lines of business including Medicare, Medicaid, Commercial Insurance, ambulatory surgical centers, federally qualified health centers, health care for the homeless, as well as foreign held insurance companies serving US Territories. Ms. Griffin earned her Master of Science in Management in 1999 and in 2006 was awarded designation as a Surveyor for the Accreditation Association for Ambulatory Health Care (AAAHC), where she is also an active member of the Survey Standards Committee setting policy for the health care industry.
• Maria Eugenia Duran, V.P. Network Development – Maria Eugenia is an experienced managed care executive with over twenty-five years in managed health care. Ms. Duran has held various managerial and executive positions throughout her professional career and has been employed by various Health Plans including CAC Medical Centers, United HealthCare, and Medica HealthCare Plans. Ms. Duran attended Barry College where she obtained a Bachelor of Science with a Major in Accounting and a Minor in Marketing and graduated with Magna Cum Laude. Ms. Duran has assisted and participated in the submission and completion of applications for Health Care Provider Certificate and for Certificate of Authority. She has also been a part of the development of policies and procedures, programs and contracts approval by the Agency of Health Care Administration (AHCA). Throughout her years of experience, Ms. Duran has assisted in network development and provider relation managerial responsibilities to ensure compliant provider contracts in accordance with state and federal guidelines and regulations in order to meet State, Federal, and accrediting standards.
• Julie Ferro, V.P. Provider Relations – Julie began her professional career in managed health care over 30 years ago. As a Provider Relations Representative with one of only 2 HMOs awarded a TEFRA demonstration contract in South Florida by the Health Care Federal Administration at the time, she has experienced the progression of this industry personally throughout the years. Ms. Ferro has been employed by various Health Plans including Humana, PCA and Physician HealthCare Plans with a primary focus in the development of Medicare Managed Care Products in the state of Florida. Most recently from 2002 through 2012 she was a Managing Director and shareholder of Medica HealthCare Plans, Inc., a highly successful Health Plan which was purchased in 2012 by United HealthCare Group of South Florida. In 2013, she established herself as an independent Health Care Consultant working with various MSOs and other health care professional entities in developing markets. She has also been in the forefront of emerging MCOs for the Medicaid population with Jackson Memorial Health Plans, Inc. among others. Julie Ferro has been dedicated to working in Provider Relations in South Florida and dedicated to the ongoing development of health plan options for Medicare beneficiaries pursuant to the Medicare Advantage (MA) Program.
• Belkys Jimenez, Finance Director – Belkys began her career in finance and accounting more 20 years ago. In 2007, after working in various fields, she transitioned to the managed care industry and joined the Medica HealthCare Plans team. During the sale of Medica Healthcare Plans in 2012, Ms. Jimenez played a key role in the preparation of financial reports and analysis; her extensive accounting background enabled her to take a leadership role in the process, communicating with and supporting non-accounting departments and supervising independent annual audits and OIR audits. Since 2012, she has served as a Finance Director and Financial Planning Analysis Manager for several healthcare companies, where she further expanded her leadership capabilities. Ms. Jimenez obtained a bachelor’s degree in accounting from the Universidad Tecnologica de Santiago (UTESA) in the Dominican Republic and a master’s degree from St. Thomas University in Miami.
• Arlen Delgado, Sr. Sales and Marketing Director – Arlen began her professional career in managed health care over 17 years ago. From 2002 to 2013 Arlen led the Sales and Marketing Department in 17 counties for Preferred Care Partners from the inception of the health plan. Mrs. Delgado, experienced the rapid growth and development of the organization and was instrumental in creating channel wide sales processes and sales distribution channels which included a staff of 30 Career Agents, 17 exclusively contracted Independent Agents and 15 Telephonic Enrollment Associates. She held primary accountability for ensuring that the sales organization teams where properly trained and in compliance with CMS guidelines. In 2013, Mrs. Delgado, explored her ability to work with providers and was the VP of Provider Relations at Global Health Advisors, where she led a team of associates in the development of the provider network and marketing efforts. Most recently from 2016- 2018 she was the Sales Director for Humana- Miami-Dade MarketPoint where she led a team of 35 Career Agents, 4 Territory Managers and the Sales and Marketing Support Associates. Mrs. Delgado was the recipient of the President’s Club award in 2017 and 2018.
• Mayra Campuzano, Compliance Officer – Mayra has over thirty years of experience in the managed care field, both on the payer and provider side. She has held positions with market leaders like Humana and UnitedHealthcare. Over the years she has led Contracting/Network Development, Grievance & Appeals, Customer Service, Provider Services, System Development, Implementation and Training teams. This includes managing large multi-specialty medical centers with busy front offices. For the last eleven years, Mayra has worked in the Compliance field and is certified with the Health Care Compliance Association. Mayra is the former Associate Director of Regulatory Compliance for Humana/CarePlus. Her responsibilities included the oversight and compliance of Humana Puerto Rico and CarePlus Health Plans in Florida. She excelled working in compliance by creating an environment where people understand the rules while also promoting a culture that allows them to make use of the department to answer questions and address any issues. She enjoys actively participating in the daily operations, and recognizes the value that compliance can bring to achieve business goals. She strives to engage people throughout the organization on a daily basis through training, auditing, monitoring, and documenting compliance activities. Mayra has a Graduate Certificate in Special Studies in Health Care Administration and Management from Harvard University – Extension School, a Bachelor of Business Administration from Florida International University and an Associate Degree in Business Administration from Miami Dade College.
• Jenny Curbelo-Castillo, Member Services Director – Jenny has over 25 years of experience in the Health Care industry. She has always shown a strong interest in the field, with an underlying passion for providing exceptional customer service. Ms. Curbelo-Castillo has been part of a number of different positions within multiple branches in health care. Starting in 1993 with M.U.R.A. in the Coordination of Care unit. She later was promoted to a position in Provider Relations, which set her on her Managed Care path. In 2000 Ms. Curbelo-Castillo worked for South Florida Physicians Network as a Supervisor of Coordination of Care. In 2003 Jenny was presented with a great opportunity to play an integral role in the development and implementation of Medica HealthCare Plans, Inc., where she served as Director of Member Services and the Appeals & Grievances Department. While at Medica, she created Operational Policies and Procedures to ensure regulatory compliance and satisfying HIPAA requirements. She developed and monitored corrective actions required by regulatory agencies, managed assigned members with the purpose of decreasing voluntary disenrollment, proactively contacted established members for continued education and member satisfaction. In 2013, Jenny took a position as V.P. of Operations at Primum Healthcare, LLC, a local M.S.O., continuing to develop professionally and strive in facilitating its physicians and members with simplified healthcare solutions, while providing exceptional customer service. Ms. Curbelo-Castillo accepted the position of Director, Member Services for Doctors HealthCare Plans, Inc. on February, 2018.
• Lazaro Miranda, IT Director – Lazaro began his career as IT professional over 22 years ago after obtaining his Degree of Bachelor of Science in Nuclear Physics. A results-driven IT professional with extensive management and hands-on experience in a wide range of areas such as security, network design, administration, virtualization, storage, migration, integration, hardware and software solutions. Having previous IT managements experiences on different industries, in 2008 he joined efforts as IT Director and shareholder of Medica HealthCare Plans, Inc. Multiple upgrades and technological solutions were implemented, and in 2012 the Health Plan was purchased by United HealthCare Group. Moving into Optum Technology, Lazaro was leading the IT integration efforts from Medica’s legacy systems into the United Health Care platforms, while providing support to UnitedHealthcare of South Florida. Lazaro joined Doctors HealthCare Plans, Inc. on April 1st, 2018.
• Gloria Hernandez, Enrollment Director – Gloria began her career in the managed care industry with Medica Healthcare Plans 13 years ago. During this time, she was promoted to different roles in the company including Enrollment Supervisor, responsible for maintaining the day to day functions of the Enrollment Department including monitoring the team effectiveness, training team members, and coaching and developing of staff. Gloria has spent the last 4 years as an Enrollment Manager for Simply Health Care Plans overseeing a department of 27 employees. Some of her main responsibilities included ensuring that all the enrollment processes for Medicare and Medicaid were completed within established time frames and deadlines based on Department policies, CMS and AHCA requirements. This included daily oversight of file processing, discrepancies, letters, and RPC cases. Gloria also conducted monthly audits of the Enrollment process, provided employee feedback, and performed focused training and development. Gloria accepted the position of the Enrollment Director on April 30, 2018.
Last Updated: 8/30/2018