Connie Lightner Email & Phone Number

Connie has 10+ years Medicare Advantage risk adjustment (RA) work experience for both provider systems and health plans. Her RA work focuses on prospective and retrospective analytics such as member and provider targeting, in home assessments and provider engagement; chart review chase list development and ROI analysis; risk score and revenue reconciliation and forecasting; technical solutions, processes, and dashboards development to monitor YTD risk score performance to support strategic operations; risk score trends analytics; CMS-HCC model software implementation and simulation; RAPS/EDPS data submissions to CMS and reconciliation; analytics and data extracts to support vendor technical solutions and outreach programs. Connie has strong technical skills and expertise in risk adjustment, clinical data analysis, data mining and manipulation using SQL/SAS, database development and administration, clinical quality, Epic Clarity and EMR. Connie is a certified SAS programmer. Connie's skills and work ethic have enabled her to contribute significantly to initiatives and programs that improve the quality of patient care, ensure accurate and complete member health status documentation and retrospective payment adjustment. Working in the healthcare industry has been a most rewarding career choice for Connie.