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Public Profile

Maria Lopes, MD
Maria Lopes, MD
  • Obstetrician and Gynecologist
  • Women’s Healthcare Group in Teaneck NJ
Dr. Lopes is an Obstetrician and Gynecologist. She was in private practice for several years with Women’s Healthcare Group in Teaneck NJ, affiliated with Holy Name Hospital which has an MS Center. She has a BA in Biochemistry from Wesleyan University, received her Medical Degree from the University of Connecticut and has a Masters Degree in Administrative Medicine from the University of Wisconsin. Dr. Lope also has a payer expertise, has been in the managed care industry for over 19 years. Her professional experience includes: Chief Medical Officer of MagellanRx, Chief Medical Officer of GHI/EmblemHealth, Chief Medical Director of Horizon BCBS NJ and CMO with AMCHealth. In her role, she has been responsible for clinical program development and implementation, patient outreach and clinical assessment, pathway development and strategic specialty solutions in areas such as: MS, Oncology, RA, IVIG, HAE, HIV, HepC, Neurotoxins, Gaucher’s, Hemophilia and PAH. She works closely with over 40 health plans to bring customized and innovative programs that add quantifiable clinical and economic value. Dr Lopes has extensive experience in Disease and Case Management, Employee Health and Wellness, and Quality initiatives to improve HEDIS/Medicare STAR performance. She has been responsible for Medical Policy Development and Implementation, Correct Coding initiatives, Fraud and Abuse, Physician Profiling and the development of a Medical Home Pilot project in NY. She has overseen Medical and Pharmacy Utilization in a network and a staff model. She has worked closely with Integrated Health Systems on innovative strategies in e-Health, data analytics and HIT to improve patient engagement, care coordination and Quality improvement to align incentives with providers, patients and payers.
Schedule28 Mar 2024