Maria Lopes, MD, MS
Former Chief Medical Officer
Magellan Health
Dr. Lopes has been in the managed care industry for over 19 years. She is currently the Chief Medical Officer of CDMI/Magellan, former Chief Medical Officer of GHI/EmblemHealth, Chief Medical Director of Horizon BCBS NJ and CMO of AMCHealth.
In her role at CDMI, she oversees clinical program development and implementation, patient outreach and clinical assessment, pathway development and strategic solutions across medical and pharmacy benefits including: Oncology, RA, MS, 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 Geisinger Health Systems on innovative strategies in e-Health, data analytics and HIT to improve patient engagement, care coordination and align incentives as part of Geisinger’s Proven Health Navigator (Advanced Medical Home).
Dr. Lopes is an Obstetrician and Gynecologist. 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.
