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Amanda Lenahan

@amandalenahan

Experienced Senior Manager in Commercial Risk Adjustment Audit.

United States

What I'm looking for

I am looking for a role that offers advancement opportunities and allows me to leverage my expertise in risk adjustment and operational management.

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

FG
Current

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.

EC

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.

IM

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.

IM

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 logoSU

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

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Amanda Lenahan - Senior Manager Commercial Risk Adjustment Audit - Florida Blue / GuideWell | Himalayas