Review Consultant

Medical Utilization Review Consultant Glenda Flemister

Glenda E. Flemister, MD, FACP, FCCP, is Board Certified in Internal Medicine, Pulmonary Medicine, and Critical Care Medicine. Dr. Flemister has over 30 years of experience in her field. She received her MD from Loyola University Chicago Stritch School of Medicine and is licensed to practice in Illinois, Kentucky, New Mexico, and Oklahoma.

Currently, the Executive Medical Director for Medical Health Solutions, a company involved in predicting trends to optimize healthcare at an affordable and sustainable rate, Dr. Flemister provides education, consultation, and resources to the medical industry, medical providers, and managed care organizations regarding:

  • Technology & Devices
  • Pharmaceutical Issues / Pharmacy Genomics
  • Health Care Standards
  • New Legislation concerning Health Care and Best Healthcare Outcomes

Prior to Medical Health Solutions, Dr. Flemister served as the Mid-America Medical Director for Aetna where she provided clinical leadership for the utilization review management:

  • Pre-certification
  • Denials and Appeals
  • Specialty and Sub-specialty Reviews
  • All ages using nationally published and recognized clinical guidelines

Utilization reviews included evaluation of the health history, diagnosis, pharmaceutical utilization, and medical device review for appropriateness of medical services.

Dr. Flemister delivers educational lectures and seminars on topics within her expertise including HIV and Aids, Asthma Control, Ventilator Management, Chronic Obstructive Lung Diseases, (demographics, treatment strategy, outcomes, projected cost etc), Medical Genomics, and Medical Devices Strategies. Patient and patient advocacy support regarding insurance.

Additional Information

Board Certified in Pulmonary & Critical Care Medicine through 2023. Internal Medicine thru ABIM. Private Practice and sub-specialty medicine>28 years. >12 years experience in national insurance and payer companies. (Aetna, Blue Cross/Blue Shield as Medical Director. Interim CEO Next Level Health). Currently full time medical reviews(all levels) and expert medical reviews.