Open to opportunities

Valeria Lopez Girons

@valerialopezgirons

Senior medical auditor and physician specializing in pediatric clinical medicine, cost control, and healthcare management.

Argentina

Message

What I'm looking for

I’m looking for roles where I can lead medical auditing and healthcare management to improve authorization quality, medical appropriateness, and cost containment—using performance metrics, evidence-based protocols, and cross-functional teams to deliver efficient patient care.

I’m a senior physician with over 15 years of experience in medical auditing, healthcare management, and cost-control strategies across public and private healthcare systems. I focus on ensuring medical appropriateness, efficiency, and cost containment through rigorous evaluation.

In my current role as a Medical Auditor, I audit outpatient and inpatient services and assess high-impact areas including patient transportation, home hospitalization, and medical supplies. I also develop medical protocols and care pathways while implementing workflow optimization to improve authorization and validation processes.

Previously, I led national auditing processes as Head of Medical Auditing & Disability Services, evaluating high-cost medical services and applying strategies to optimize healthcare expenditure. I supervised multidisciplinary teams and coordinated Mental Health, Disability, and Home Care services to strengthen performance metrics and service efficiency.

My clinical foundation includes pediatric practice as a Pediatrician and on-call work in a pediatric clinical department, plus teaching experience as an Assistant Professor at the University of Buenos Aires. I bring both day-to-day clinical insight and structured auditing methods to improve resource allocation and guideline compliance.

Experience

Work history, roles, and key accomplishments

Current

Medical Auditor

Current

OSSB (Bancarios Health Insurance)

Jun 2025 - Present (1 year)

Conducted medical auditing for outpatient and inpatient services, including patient transportation, home hospitalization, and medical supplies. Developed medical protocols and care pathways and coordinated Mental Health, Disability, and Home Care services.

Medical Auditing Concurrent Review Retrospective Review Care Pathways Home Hospitalization Auditing Case Management

Head of Medical Auditing

OSPEDYC

Jan 2021 - Jan 2025 (4 years)

Led national medical auditing processes focused on cost control and service efficiency, evaluating high-cost medical services for medical appropriateness. Implemented strategies to optimize healthcare expenditure and supervised multidisciplinary auditing workflows.

Medical Auditing Cost Control

Assistant Director - Medical Benefits

Incluir Salud Program

Jan 2018 - Jan 2024 (6 years)

Performed technical and pharmacological audits of high-cost medications and supported authorization processes and case validation. Ensured compliance with medical guidelines to maintain cost-effectiveness.

Medical Authorization Medical Auditing Appropriateness Checks

Pediatrician

OSECAC

Jan 2009 - Jan 2021 (12 years)

Provided comprehensive clinical care for pediatric patients and coordinated with interdisciplinary teams. Supported ongoing patient follow-up within a pediatric clinical setting.

Pediatrics And Interdisciplinary Teams Clinical Assessment Medical Documentation Care Coordination

On-Call Physician - Pediatrics

HIGA P. Fiorito

Jan 2013 - Jan 2018 (5 years)

Worked 36-hour active ER shifts in the Pediatric Clinical Department and performed clinical assessment and follow-up of hospitalized patients. Managed continuity of care during on-call coverage.

Pediatric Assessment Pediatric Inpatient Care Clinical Monitoring

Assistant Professor of Pediatrics

University of Buenos Aires

Jan 2013 - Jan 2017 (4 years)

Served as Assistant Professor of Pediatric Clinical Medicine, delivering undergraduate teaching for medical students. Participated in academic activities and practical evaluations within a teaching hospital unit.

Medical Education Clinical Teaching Academic Coordination Teaching Hospital Participation

Administrative Coordinator

District II Medical Council

Jan 2014 - Jan 2015 (1 year)

Coordinated academic and organizational administration for the Pediatric Clinical Medicine specialization course. Supported course execution during the 2014–2015 period.

Academic Administration Course Coordination organizational management Program Planning