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Lori Lynn Lewis - Executive Vice President, Chief Operations Officer

Allied Management Group since 1972

Developed and managed over 20 provider networks in the west, central and southeast United States including medical, prescription drug, optical, dental and subacute.
Organized, licensed, and developed two Health Maintenance Organizations (medical)
Participated in the development of one Health Care Organization (worker compensation)
Organized and developed six Managed Care Organizations
Organized, licensed, and developed four Third Party Administrators (TPAs)
Developed a California medical network to over 30,000 providers
Consulted in the development and management of California statewide medical benefit programs for George Washington Life, National American Life Insurance Company, First Continental Life and Accident Insurance Company
Designed a true "24 hour health care" program combining workers compensation with health care benefits
Assisted in the Developed of a Medical Savings Account (MSA) program for fully insured large deductible and underlying self-funded products, and a discount (cash for service) program.

Special Investigation Unit (AMG-SIU)

Designed specification and participated in the development of the web-based fraud detection and investigation system, business intelligence techniques, claims pre-editing system, and reporting system (medical, prescription, DME, behavioral health, and ancillary provider claims).
Responsible for saving an average of 14% of health claims prior to payment.
Responsible for the identification of 23% of paid claims for health plan recovery.
Developed compliance programs and trained health plan staff on waste, fraud, and abuse.
Represent and report for health plans to regulatory agencies.
Developed the Special Investigation Unit and corporate operational and financial infrastructure, including: data matching/analysis, trending, statistical analysis, correct coding, investigation guidelines and procedures, medical record review, extensive investigations, investigational tracking, monitoring and educational programs, regulatory reporting, case documentation, and fund recovery.
Faculty member of several anti-fraud associations providing training and education to government agencies and health plans.

Executive Vice President, Chief Operations Officer - MedNet Information Services specializing in data information processing and transmission for the medical, health care, and managed care industries. Participated in the design and development of a complete integrated medical web and network system linking medical providers and third party payors.

Chief Operations Officer - Columbia Provider Services, a subsidiary of Columbia/HCA Healthcare Corp. a $2.2 Billion dollar division in the Columbia /HCA Healthcare Corp. As a hands on Consultant, developed the Managed Care Organization (TPA and UR agency licensure) and physician network (501a) for the North Texas Division. Involved in all aspects of the company including the administration of the 12 geographic networks located in the Dallas/Fort Worth metroplex, the 501a provider network, the Third Party Administration company and Utilization Review Agency. Involved in the development, re-organization re-write of all corporate and inter-company legal documents, claims processing, support services, credentialing, UM/UR/QAI and information systems. Served as a liaison to the Board of Directors.

Vice President, Chief Operations Officer - for California Advantage, a for profit managed care organization owned 51% by the California Medical Association with the remaining stock owned by individual and group physicians. From a nationwide search, was selected as the 2nd executive hired. Took company from "boxes of applications and stock purchases" to an automated system reconciled to the accounting records to meet SEC audit. Organized and increased the physician network from 6,500 to 28,000 physicians. Within 2.5 months, participated in the approval of the Health Insurance Plan of California (HIPC) to participate in 55 of the 58 California counties and became the only plan to offer EPO, PPO, and POS products in all 55 counties.

Operations Officer - acting for Premier Health Management, a subsidiary of Memorial Medical Center in Savannah, Georgia. As a Consultant, developed the operational and financial infrastructure for the management company and operationalized the four developing physician networks in Florida and Texas. Participated in the presentations to potential investment group physicians throughout Florida and Texas.

Executive Vice President - for Meditech Insurance Administrators, a third party administration company. Instrumental in bringing the company from a concept to fruition. Developed a Payor and network management system including claim processing software for use by HMOs, TPAs, insurance carriers, and self funded groups servicing multiple plan types while incorporating EPO, PPO, and POS products.

Executive Vice President, Chief Operations Officer - of Allied Medical Groups, believed to be the first full medical service IPAs in California. Participated in the development and operations of the company including the 8,000 physician network to service self-funded groups, HMOs, and insurance carriers under capitated and fee-for-service contracts.

Chief Executive Officer - of RX-Card, a national pharmacy network providing a "card" system to Payor's patients. Developed all aspects of company including the software systems.

Chief Executive Officer - Opticare, a California statewide optical network. Developed the company from start-up and in two years negotiated the sale for a substantial profit.

Vice President - of a California financial institution, responsible for over 1.2 Billion dollars in annual deposits. Was noted in the Wall Street Journal for involvement in this innovative and fastest growing bank in the U.S.

Executive Vice President of Product Development, Chief Financial Officer - BLS Development Company, developed a data processing center for one of northern California's largest financial institutions. Increased demand deposit portfolio by over 10 million dollars in daily average balances in the first year of operations.

Managing Partner - of Medical Systems, Inc., a software development company that developed a state of the art medical system for complete automation of physician offices and is widely used in today's physician automation industry.

For more information on how our health care business management and consulting services can improve your bottom line, contact Allied Management Group today.