Amanda Walling Email & Phone Number

Franklin, Tn

Franklin, Tn

Reporting to the CIO, supporting clinical business intelligence for Acadia's Clinical Services Department.• Work with clinical and Information Technology teams, preparing data to support key clinical process development: report hospital performance, and work with other external entities on data issues.• Understand and analyze hospitals’ population health, clinical productivity, key performance indicators, and operational improvement.• Develop graphs, reports, and presentations to summarize key results, including but not limited to HBIPS measures.• Oversee routine and ad hoc reports as needed. • Identify opportunities for hospitals to make decisions by analyzing data gathered and to promote performance improvement.• Assist in requirements gathering, analysis, and data flow diagramming for clinical intelligence reports and projects of moderate complexity.• Conduct data mapping and validation processes to support development activities.• Work with the technical team to develop plans to achieve goals and assist in meeting target dates for projects. Identify and report on project status and risks to schedule.• Coordinate prototype review, integration, system, and user acceptance testing (UAT).• Prepare supporting documentation, reports, training, and presentation materials. • Train clinical users in clinical analysis tools. Assist customers in the interpretation and use of the results; ensure that the data is understood by users.• Assist with implementation of relevant data into Database and assist in resolution of identified data quality issues• Participate in writing data specs, identify root causes for dirty data, and facilitate negotiations between various team members to develop and implement solutions to remediate any data concerns.• Serve as data point person for the team, liaising with the IT team and the Clinical Service Team.• Develop health care subject matter expertise related to specific products, data elements, and business processes.

Cool Springs, Tn

• Managing components of the Coding Quality Assurance Operation including auditors that are contracted and full-time employees remotely and onsite.• Creating the reports and performing the analytics necessary to provide recommendations and action plans to exceed client and program requirements.• Responsible for capacity planning, production planning and project execution to meet capacity and production requirements.• Diagnose process improvement opportunities and develop solutions using principles of process excellence and related tools. • Ensure auditors are meeting production standards set by the department.• Overall program and production management for specific programs and initiatives.• Creation and oversight of the Standard Operation Procedures, Program SLAs and contractual requirements.• Provide support for both short and long term operational/ business strategies. • Work collaboratively with business and function owners on solutions and progress tracking.• Designed and Built Databases for the Training and Quality department scoring.• Implemented and streamlined processes for testing and scoring for the department.

Franklin, Tn

• Provides analyses and data-driven solutions to Fresenius Rx management pertaining to, but not limited to Fresenius Rx operational productivity, finance forecasting, clinical and quality outcomes, customer satisfaction and attrition, enrollment, and patient demographics• Understands and translates requests, identifying constraints and suggesting solutions related to data and reporting• Works closely with IT Business Analyst and Finance/Operations Analyst to help structure and interpret business requests. Reviews requests and develops queries, reports, extracts, and interfaces to provide solutions and analyze data making suggestions and recommendations to end users.• Designs, develops, and tests complex SQL queries for Fresenius Rx reports, extracts, and interfaces.• Collaborates with IT Business Analyst to document reporting/query requirements and create detailed specifications.• Interprets data, performs quantitative analyses, and makes recommendations to Fresenius Rx management regarding findings, data collection and quality issues, and follow-up enquiries/work.• Defines and populates scorecards for Fresenius Rx management and performs statistical analyses such as linear regression models for both explanatory and predictive purposes.• Analyzes and evaluates content and performance of queries, reports, and other data-based processes suggesting improvements which may include changes in the structure or indexing of data, as well as programming changes in generation, and distribution of reports/queries.• Work closely with pharmacy software vendors and other functional areas within FMCNA to gather and document data-related information.

Franklin, Tn

- Perform detailed data analysis to trouble shoot and identify issues by creating SQL queries and reports- Identified customer data discrepancies, new business rules, and defects in the monthly package- Troubleshoot data intake processes for multiple clients across multiple platforms- Create and update documentation for data intake processes and testing for multiple clients- Coordinate multiple teams to perform testing of new processes - Analyze problems and work to find solutions across multiple data intake systems

Greater Nashville Area, Tn

• Advanced skills in analytical/problem solving, communication, presentations, organization, initiative, working independently as well as in teams, and managing and completing multiple tasks with tight deadlines• Proficiency using advanced Excel features and techniques. Advanced proficiency with dataset application development. Experience working with a variety of information systems and data files, including large and complex files: analyzing file structure, using and creating file layouts, transforming raw data into finished products• Proficient knowledge of Medicare Advantage terminology, CMS data files and concepts associated with risk adjustment (MMR, MOR, HCCs, and medical record diagnosis coding), medical terminology, cost components, contracting methodologies• Familiarity with various types and sources of health care information, including financial and patient-level data files• Planned and facilitated meetings and presentations to staff and Executives• Develops and analyzes functional and operational data, performance reports, and provides notations of performance deviations and anomalies• Interprets results using a variety of techniques, ranging from simple data aggregation via statistical analysis to complex data mining• Creates and publishes periodic reports, as well as any necessary ad hoc reports, using simple to complex analysis techniques• Takes operational issues and devises the best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools• Makes recommendations based upon data analysis. Designs, develops, implements, and maintains business solutions• Validates data to ensure accuracy, quality, and integrity• Contributes to group knowledge and best practices• Provides leadership to less experienced staff

Franklin, Tn

• Assign all health plan work received from internal Business Unit and Programming teams to the necessary resources while carefully balancing the workload and priorities• Facilitate bi-weekly team meeting to keep eleven team members apprised of new corporate initiatives and goals, new incoming work, and policy or procedure updates• Generate and audit daily sign off rotation calendar for the team • Coordinate closely with the Implementations team to transition new health plan work to the Production Operations Team• Conduct meetings to evaluate colleague engagement scores and derive an impact plan for improving the level engagement for the team• Document, communicate, and distribute new processes and procedures for team• Minimize revenue-impacting defects • Ensure that there is no missed revenue during implementation of products for both new and existing customers• Provide improvement opportunities focused on process efficiency to internal Business Unit customers• Make new audit recommendations to internal Business Unit customers • Mentor and trains new Data Transfer Coordinators

• Ad Hoc file moving requests received to the distribution group • Monitor workflows and scheduled jobs and perform Daily Sign Off process for Legacy, Radical and Embrace • Daily and Weekly Ad Hoc/Special Processing - loading, monitoring or processing if applicable • Run scheduled reports on assigned accounts• Ad Hoc documented scheduled reporting and or exports• Manage workflows and assist team with production control assignments• Run and process Daily utilizations• Import Raw data from Health plans into the Healthways Algorithms• Stage data into the correct schemas• Perform audits on data • Download data to the call center• Work with Data Analyst when issues arise• Manage the PGP keys and FTP credentials • Upkeep of small modifications to the processing documentation in starteam

Import Raw data from Health plans into the Healthways AlgorithmsStage data into the correct schemasPerform audits on data Download data to the call centersAnswer and questions from the call centers about the dataInvestigate anomalies in data using PL/SQLGenerate reports for monthly processesWork with Programmer/Developer when issues arise

Perform technical and Business analysis using MS Access, MS Excel & SQL Server Create and develop queries using SQLReport/query generation and data extracts for all Health Plan Services reporting functions including Regulatory reports to the State of Tennessee using member and provider dataDevelop and enhance automated tools for quality audits, credentialing, statistical analysis and department workflow/ metricsPerform reporting and data analysis in support of strategic initiatives to acquire new businessCreate and maintain reports for automated reporting tools designed to ensure integrity of provider financial and demographic data supporting accurate payment of claims, enrollment, and timely credentialingWork with internal programmers as required to produce reporting tools or reports using MS Access and SQL ServerEnhance management reporting by development and maintenance of database tools designed to track workflow and streamline processesProvide advanced assistance to internal and external customers of provider and member dataPrioritize and execute multiple complex tasks in a fast-paced environmentEnhance Reports with Graphs to make them easy to readFormat and Design Reports for readability

Answered providers inquiries via lettersEducated suppliers on coding using CPT and ICD-9 codesEducated and assisted suppliers on how to bill MedicareAdjusted claims using MCSTested the Part B Voice Response System and notified IT when problems arose

Answered incoming callsAssisted Medicare recipients with claims informationAssisted Medicare suppliers with claims information using VMSProvided technical support to suppliers on how to bill Medicare Educated Medicare suppliers about new rules and regulationsResearched and solved suppliers inquiriesTraining new hires

Answered incoming callsAssisted customers by looking up accounts on an IBM MainframeAssisted customers by accessing AS/400 to search accountsAssisted customers with their electronic ordersProvided technical support for Ingram's databases and softwareWrote and maintained reports in Microsoft ExcelTrained other associates

Master'S Degree, Healthcare Informatics

Bachelor Of Science, Computer Information Systems Minor In Art