Spotlight on: Amy Lyons, MBA, CPCS, CPMSM

Amy Lyons
Director, Physician Support Services
Legacy Health (Portland, Oregon)

Amy shared with me that her initial career goal was to become a nurse. During that period of time, it was quite difficult to get into nursing school (and it still is because of the shortage of nursing programs) and therefore Amy trained to be a medical assistant while waiting to get into a nursing program. She subsequently took a temporary position credentialing for a health plan. These were exciting times (if you thrive on change and uncertainty)! It was the very early years of NCQA and health plans were figuring out what credentialing was as well as how to do it and more importantly, how to document it in a way that would be in compliance with NCQA requirements. Amy enjoyed the challenge of what she was doing so much that she abandoned her plans to become a nurse and decided to work in the credentialing arena.

You might want to know what drew her to this profession (I was certainly curious). Here is what she enjoyed:

1. 1.    The skill set involved in what she was doing. She needed to be knowledgeable about requirements/regulations, work well with physicians, be a resource, etc.
2. 2.    Every day was different – she was never bored.
3. 3.    She enjoyed the “sleuthing” element of credentialing and gathering information.
4. 4.    She liked the credentials committee meetings and working with the physicians at those meetings.
5. 5.    She loved the fact that no one really knew what she was doing since the credentialing field for health plans was so new. She got to create her position.
6. 6.    And – the health plan environment was constantly interesting. Amy spoke about learning about the petitions patients would make to get coverage for specific treatments and the ensuing internal discussions. Fascinating to be part of those discussions.

After a couple of years with the health plan, Amy moved on to work with a large physician-owned multi-specialty medical group (800+ physicians). In this position, she had even more interactions with physicians and had the opportunity to learn more about the business end of the delivery of care – and to have an impact on the business of providing health care. During this time, Amy decided to go back to school and get a degree in healthcare administration which she believed would help her understand more about the business of health care. She was able to purchase and implement software designed specifically for payer credentialing and enrollment (she was one of the first customers of CredentialStream to implement Apogee software – now known as Network Management). Clearly, Amy was a pioneer in this field!

As time went on, there were myriad mergers and acquisitions on the payer side and Amy’s medical group went bankrupt. Amy returned to the health plan arena while earning her MBA. Amy noted that the environment then was very similar to what we are experiencing today, except today the focus of mergers and acquisitions are hospitals and health systems, rather than medical groups or health plans. Again – it was a time of tremendous change and challenges.

One of the themes of Amy’s career has been her love of change. Not everyone loves change – but for Amy, change brings opportunities to:

• Continue to learn
• Expand skill set
• Move into different, expanded roles
• Have a bigger impact in the healthcare organization
• Work with (and have influence) on a larger group of people

I loved hearing Amy talk about taking advantage of change, because that has been a constant during my career as well and I’ve always believed that change brings great opportunities for those who understand how to position themselves for new roles.

Amy’s current position has had a consistent upward trajectory since I first met her and started working with Legacy Health. Amy’s current position includes administrative responsibility for the organization’s CVS (centralized verification services), Medical Staff Services, Provider Enrollment (a fairly recent addition), Continuing Medical Education and Graduate Medical Education.

Some of Amy’s observations about her current position and career:

• She loved the opportunity to integrate provider enrollment into the CVS operations because she knew that there would be direct (and significant) financial benefits to Legacy.
• Amy appreciates the fact that she can be creative in her role – in many situations, she is creating new processes and therefore can be innovative in the way that new processes are established.
• She appreciates the trust she has with her organization leaders. They encourage her to be innovative.
• Amy advises others to not be afraid to try something new. Yes – there can be failures (not everything that you try will always be 100% successful). But it you don’t try something new, you are following – not leading.
• When asked about her greatest achievement, Amy said that she believes it is bringing disparate groups together into a system (and I’ve seen Amy’s success in doing that at Legacy Health).
• An upcoming challenge that Amy mentioned is that her organization is in the process of becoming “leaner” which can be terrifying to some, but for Amy is (you guessed it) OPPORTUNITY.

I hope that you have enjoyed learning about Amy Lyons. VerityStream is very proud to have Amy as one of our customers and we look forward to continuing to work with Amy and her team – they are a key Strategic Account.