Lynne Padilla

WORK HISTORY

SKILLS

ABOUT LYNNE PADILLA

I’m a healthcare leader passionate about helping health plans, providers, and vendor partners succeed in risk adjustment—while keeping compliance, accuracy, and member outcomes at the center.Over the past 15+ years, I’ve led large-scale Medicare Advantage, Medicaid, and HHS Marketplace vendor coding operations, including a $200M+ business that grew by more than 50% year-over-year. My experience spans all areas in risk adjustment coding, RADV & OIG audit readiness, CMS/HHS regulatory alignment, AI/NLP platform development & automation, vendor management, and building high-performing teams that deliver quality at scale.I’ve had the privilege of supporting & partnering with more than 50 health plans—including the five largest in the U.S—designing & executing strategies that safeguard revenue, improve coding accuracy & completeness, and ensure audit preparedness. Whether building a new operational model, integrating technology, or guiding RADV mitigation, I focus on solutions that work in the real world.If you’re interested in advancing risk adjustment performance, scaling operations, or leveraging technology to drive better outcomes, let’s connect.