Amanda Adams MBA, RN

Lead provider engagement strategy and oversee value-based financials, incentives, reconciliations, and performance reporting to optimize ACA Exchange (IFP) provider performance and alternative payment models.

Supported provider groups in value-based reimbursement arrangements through performance monitoring, operational guidance, and contract reporting to drive quality, utilization, and cost improvements.

Managed provider engagement operations for physician organizations in value-based programs, analyzing utilization, quality, and risk-adjustment data to improve population health and contract performance.

Facilitated physician participation in value-based care through strategic analysis and reporting to support performance and population health objectives.

Provided embedded nurse case management and care coordination for Medicare populations, partnering with providers to manage complex cases, improve quality outcomes, and reduce utilization.

Managed team performance and led quality improvement initiatives in inpatient case management to optimize clinical workflows and patient outcomes.

Executed utilization review processes to ensure regulatory compliance and optimize resource use across clinical services.

Delivered direct patient care in a cardiac short-stay unit, managing procedural and acute cardiac patients while ensuring clinical quality and safety standards.

Provided post-operative nursing care for cardiovascular surgery patients, supporting recovery and evidence-based clinical outcomes.

Provided post-operative nursing care in a cardiovascular recovery unit, monitoring hemodynamics and managing complex cardiac patients to facilitate safe discharge.

Completed a Master of Business Administration with an analytics concentration to support healthcare operations and data-driven decision making.

Earned a Bachelor of Science in Nursing with clinical experience in cardiovascular and acute care settings.