We promote patient access to quality care at the right time and at the right place, adding value to our providers through innovative managed services solutions.
Industry Expertise
Clinical and operational leader
Specializes in provider network contracting, revenue cycle, and claims payment
Excels in meaningful analysis of medical data
Technical expertise in managed care and bilingual in Spanish and English
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Eddie Ortiz, MD, earned his Doctor of Medicine degree and his specialty in Family Medicine from the University of Puerto Rico, Medical Sciences Campus. Throughout his extensive professional journey spanning over two decades, he has been dedicated to delivering direct patient care combined with administrative functions. Prior to his present position at Provider Network Solutions of Puerto Rico, Dr. Ortiz served as the CEO, where he oversaw the operations and business development of a Management Services Organization in Puerto Rico. In this capacity, he was responsible for various critical functions, including provider network management, credentialing, re-credentialing, contracting, claims processing, and Risk Adjustment, within a large significant care delivery system.
Previously, Dr. Ortiz served as Vice President of Medical Affairs for an MCO, responsible for the corporate clinical vision and quality programs to ensure effective care to nearly 600,000 beneficiaries throughout the island. During his time as Vice President of Medical Affairs, Dr. Ortiz had responsibility for three lines of business: Commercial, Medicare Advantage, and Medicaid. Prior to joining this MCO, Dr. Ortiz served as a Medical Consultant and has held executive positions in several provider and health plan organizations in Puerto Rico, including being Medical Director in Humana PR, VP of Medical affairs in MCS, and Medical Director of Federally Qualified Community Health Centers.
Dr. Ortiz is particularly interested in reducing health disparities and improving access to digital solutions to provider networks and patients. As part of this interest, he completed an executive education program from Harvard School of Medicine on Leading Digital Transformation in Health Care. He is an active member of professional and community organizations in Puerto Rico. Dr. Ortiz is currently a Board Director in HFMA PR Chapter, a member of HIMSS PR, and a Board Member of Casa Juana Colón, a community-based organization dedicated to overcoming social and health disparities in rural areas of the island.
