Medicaid Who’s Who Interview: Amanda Ratliff

Amanda Ratliff is the CEO of ACR Consulting Services & COO of Paragon Technology Partners.

Check out her LinkedIn profile HERE.

1. Which segment of the industry are you currently involved?

Network Development for Payers, Managed Care Consulting, Credentialing, FQHC/Radiology and Vision Billing, Directory maintenance and IT Solutions (BigData, encryption, PDM).

2. How many years have you been in the Medicaid industry?

I have the worst baby face (I literally look 12), but over eighteen years.

I started at Aetna in the member services call center and worked my way up to CEO. I never turned work down – I always did the dirty stuff no one wanted to and kept learning. When it was hard and there was no structure or policy, I kept at it until we had clear sight. Medicaid is a tough industry and doesn’t have a lot of funding. It takes dedicated teams with a true passion and vision. I have been lucky enough to work with some of the greatest teams.

I always wanted to do the best I could with minimal spend. We helped to orchestrate a consolidation of 3 different systems while at an MCO. They were paying 3 different teams and 3 separate software programs. It didn’t make sense. All data should be in one source.

3. What is your focus/passion? (Industry related or not)

My main passion is Contracting and Provider Data Maintenance. I love to contract Providers/Groups/Hospitals and make sure the data collected in the process is correct, clean, valid and complete. Incorrect directories and fat finger typos drive me absolutely INSANE. Also, automation – if there is a way to do something faster – I am visioning how to make it happen.

4. What is the top item on your “bucket list?”

Professionally – I would like to see Provider Data Management (PDM) solution solved so Payers could manage their data, and not be fined for incorrect information.

Personally –  I would love to be able to go to Italy with my husband – his grandfather came over off the boat from Naples and he wants to visit his history (and eat a bunch of pizza and pasta!)

5. What do you enjoy doing most with your personal time?

Watching non stop episodes of Heart of Dixie on Netflix, women’s bible study, helping others, Horseback riding, and quality time with my 16 yr old son and 10 yr old daughter (if they like me that day).

6. Who is your favorite historical figure and why?

Martin Luther King Jr. – he rose above all odds, stuck to his faith and did what was RIGHT in every scenario. You don’t see people STAND UP like that with deep concern to risk everything. He didn’t give up and he had every right to. His battle is unlike anything I’ve ever experienced and I admire his unwavering passion. That man changed the complete path of our nation, amazing.

7. What is your favorite junk food?

Fritos and Nacho cheeeeeeese

8. Of what accomplishment are you most proud?

Stepping out in faith and opening a business with employees (I never thought of myself as a boss – it’s still weird for me to think about).

My employees are simply the best and often outwit me. Steve Jobs said – “you should hire people who are smarter than you”, and I am thankful that my team is well equipped and have such a deep knowledge of the space.

I just continue to let God lead – he pushed me off the cliff and I haven’t fallen yet! When in doubt, take the risk and TRUST HIM.

9. For what one thing do you wish you could get a mulligan?

Not finding Christ sooner……… and picking on my older brother and him always winning!

He stuck me on top of a 6 foot bookshelf, turned the lights off and left Opera music playing so loudly he couldn’t hear my screaming and crying.

Then, one time I asked him what to do about my skinned knee – and he told me to put lemon juice on it…and I DID! I wish I was the oldest and not youngest.

(Yes, I am whining about it after 30 years).

10. What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?

A. BigData, lots of data and data analytics. Smaller MCO’s and new MA plans coming in don’t have access to well adopted systems/policies/etc. They lose a lot of revenue in start up or initial bids/risk to secure agreements.

B. Technology – who is coming out with what and why? Is there a list of all this awesomeness?

C. Patient Care and Access – we need more doctors and nurses to care for (and accept) patients. Lots of them are lost in the shuffle, especially the homeless.

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