Amanda Lenahan
@amandalenahan
Experienced Senior Manager in Commercial Risk Adjustment Audit.
What I'm looking for
I am a well-qualified Senior Manager with 20 years of experience in Commercial Risk Adjustment Audit, specializing in risk adjustment coding and operational management. My background in medical practice management has equipped me with the skills to plan and implement improvement processes that align with organizational goals and regulatory requirements. I pride myself on being an authoritative communicator with a compelling style and insightful approach.
Currently, I lead a dynamic team at Florida Blue / GuideWell, where I execute risk adjustment operations and have successfully doubled output for commercial risk adjustment provider audits. My role involves overseeing high-priority projects, conducting quality audits, and collaborating with cross-functional teams to enhance workflow and accuracy. I am passionate about fostering team development and ensuring compliance with coding regulations.
Throughout my career, I have played a pivotal role in the growth of medical practices, contributing to the expansion from two locations to forty. I am dedicated to continuous improvement and have developed training initiatives that promote long-term excellence among my colleagues. As I pursue new professional opportunities, I seek a role that offers room for advancement and the chance to make a significant impact.
Experience
Work history, roles, and key accomplishments
Senior Manager Commercial Risk Adjustment Audit
Florida Blue / GuideWell
May 2022 - Present (3 years 1 month)
Oversee Commercial Risk Adjustment operations, implementing process improvements that doubled output for provider audits. Manage a dynamic team, support colleagues in achieving goals, and conduct quality audits to identify performance risks. Collaborate with analytics to enhance coding accuracy and compliance.
Associate Director of Risk Adjustment and Quality
Evolent Health Care
Aug 2021 - Apr 2022 (8 months)
Extract and analyze health data to provide insights for risk adjustment and quality measurement. Develop KPIs for providers and collaborate across departments to deliver scalable solutions, ensuring accurate Medicaid shared savings performance.
Risk Adjustment Supervisor
Island Doctors, MSO
Oct 2010 - Aug 2021 (10 years 10 months)
Supervised certified coders in medical risk adjustment, managing quality assurance programs and conducting audits. Developed training initiatives to enhance coding accuracy and compliance, focusing on specialty codes.
Risk Adjustment Operations Manager
Island Doctors, MSO
Feb 2003 - Aug 2021 (18 years 6 months)
Managed operations for a growing number of medical offices, ensuring compliance and patient safety. Conducted risk assessments, coordinated training, and collaborated with providers to enhance patient care and operational efficiency.
Education
Degrees, certifications, and relevant coursework
Southern New Hampshire University
Bachelor's, Health Care Administration
Bachelor's degree in Health Care Administration, focusing on the management and operational aspects of healthcare organizations.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Job categories
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