Lisa Pincher, Msn, Bsn, Rn, Phn
About Lisa Pincher, Msn, Bsn, Rn, Phn
Lisa Pincher is a healthcare professional with over 20 years of experience in healthcare management, currently serving as the Director of Program Management for Complex Clinical Audit at Carelon. She focuses on improving healthcare outcomes through payment integrity and transparency, utilizing intelligent analytics and evidence-based clinical criteria.
Work at Carelon
Lisa Pincher has been serving as the Director of Program Management for Complex Clinical Audit at Carelon since 2021. In this role, she focuses on improving healthcare outcomes by ensuring payment integrity and transparency. Her responsibilities include overseeing audit programs that enhance operational efficiency and address payment integrity challenges. She leverages her extensive experience in healthcare management to implement effective strategies that align with Carelon's mission.
Previous Experience at Change Healthcare
Prior to her current position, Lisa Pincher worked at Change Healthcare as the Clinical Specialty Audit Manager from 2015 to 2021. During her six years in this role, she was based in the Orange County, California area. She successfully implemented various audit programs, specifically in areas such as DRG coding, clinical validation, and fraud/waste/abuse. Her work contributed to significant improvements in clinical documentation and regulatory compliance.
Experience at Anthem, Inc.
In 2021, Lisa Pincher held the position of Director of Enterprise Data Science at Anthem, Inc. for a period of six months. Although her tenure was brief, she contributed to initiatives aimed at enhancing data-driven decision-making within the organization. Her expertise in healthcare analytics played a role in addressing complex challenges in the healthcare sector.
Education and Expertise
Lisa Pincher earned her Bachelor of Science in Nursing from the University of San Francisco, where she studied Registered Nursing from 1997 to 2001. With over 20 years of experience in healthcare management, she specializes in clinical documentation, quality improvement, and regulatory compliance. Her passion for using intelligent analytics and evidence-based clinical criteria supports her commitment to addressing payment integrity challenges in the healthcare industry.
Achievements in Healthcare Management
Throughout her career, Lisa Pincher has demonstrated a proven track record in enhancing operational efficiency and achieving cost savings through the development of audit programs. She has successfully implemented initiatives that focus on clinical validation and payment integrity, contributing to improved healthcare outcomes. Her extensive experience positions her as a knowledgeable leader in the field of healthcare management.