Summary
Overview
Work History
Education
Skills
Accomplishments
Work Availability
Timeline
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Lisa McLean, CPMA, CRC

Bend,OR

Summary

Experienced leader with a proven track record of delivering impactful solutions for complex projects. Strong analytical skills and ability to translate business needs into technical requirements. Collaborative team player focused on achieving results and adapting to changing project dynamics.

Overview

13
13
years of professional experience
2
2
Certificate

Work History

Senior Business Analyst

Premera Blue Cross
05.2024 - 06.2025
  • Developed comprehensive SharePoint site to increase adherence for 60 regulatory mandates.
  • Led cross-functional teams to identify and implement process improvements, enhancing operational efficiency.
  • Conducted gap analyses to identify discrepancies between current and desired states, leading to actionable recommendations.

Senior Compliance Administrator

Premera Blue Cross
12.2022 - 05.2024
  • Conducted thorough audits of internal processes to increase adherence to industry standards.
  • Served as the primary point of contact for Risk Adjustment and Marketing regulatory compliance.
  • Developed and implemented 10 compliance policies to align with regulatory requirements.

Managing Owner

Cascades Virtual Solutions, LLC
06.2021 - 09.2023
  • Managed client relationships, ensuring satisfaction through personalized solutions and effective communication.
  • Improved documentation and coding accuracy by an average of 25%.

Supervisor of Coding and Compliance

Summit Health Management
01.2019 - 09.2021
  • Supervised daily operations of 20 auditors, increasing compliance with health regulations and quality standards.
  • Improved provider coding and documentation accuracy rates by 25%.
  • Improved revalidation rate by 40%.



Auditor, Risk Adjustment

PacificSource Health Plan
03.2016 - 01.2019
  • Achieved accuracy and production rates of 95% or higher.
  • Timely completion of audit projects through effective planning and prioritization, meeting organizational deadlines consistently.

Manager of Regulatory Communications

PacificSource Health Plans
06.2016 - 01.2017
  • Mentored team members, fostering development and promoting a collaborative work environment.
  • Developed and implemented strategic initiatives to improve member engagement and satisfaction.
  • Managed 30+ vendors and insurance producers.

Senior Regulatory Communications Specialist

PacificSource Health Plans
05.2012 - 03.2016
  • Collaborated with external partners to enhance member outreach programs and promote health plan initiatives for 90,000+ members.
  • Created a SharePoint site to track 1,500 regulatory materials, enhancing regulatory communications adherence.


Education

No Degree - Business Administration And Management

Eastern Oregon University
La Grande, OR

Skills

  • Healthcare management
  • Data analysis
  • MA and ACA Risk Adjustment SME
  • Vendor oversight
  • Healthcare regulatory compliance
  • Strategic planning

Accomplishments

  • 95% of SLAs met by streamlining business processes
  • Redesigned Premera's Third-Party Code of Conduct Policy.
  • Increased provider coding accuracy by 25%
  • Improved gap closure rate by 40%.

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline

Senior Business Analyst

Premera Blue Cross
05.2024 - 06.2025

Senior Compliance Administrator

Premera Blue Cross
12.2022 - 05.2024

Managing Owner

Cascades Virtual Solutions, LLC
06.2021 - 09.2023

Supervisor of Coding and Compliance

Summit Health Management
01.2019 - 09.2021

Manager of Regulatory Communications

PacificSource Health Plans
06.2016 - 01.2017

Auditor, Risk Adjustment

PacificSource Health Plan
03.2016 - 01.2019

Senior Regulatory Communications Specialist

PacificSource Health Plans
05.2012 - 03.2016

No Degree - Business Administration And Management

Eastern Oregon University

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