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Brenda Jordan, MBA, PHD, CHC, CPC, CRCBrenda Jordan, MBA, PHD, CHC, CPC, CRC

Senior Consultant

Brenda Jordan is a Health Plan Services Consultant with BluePeak Advisors, a division of Gallagher Benefit Services, Inc. She brings to BluePeak and its clients 30+ years’ experience in the healthcare industry with specialization in regulatory corporate compliance, managed care, auditing, and monitoring. She brings a broad scope of experience and knowledge in the healthcare regulatory compliance, fraud, waste, and abuse laws along with understanding in health insurance operations, compliance program implementation, and audits across government and commercial health plans. Her involvement includes working with clients to lead audits and appeals with regulators such as the Centers for Medicare and Medicaid Services (CMS), the Office of Inspector General (OIG), Attorney General’s offices Medicaid Fraud Control Units (MFCUs).

Prior to joining BluePeak, Brenda was a Senior Healthcare Compliance Consultant with proven and effective expertise in conducting gap analyses, risk assessments, and developing compliance programs for health care entities.  She has also served in leadership roles as Director of Compliance, Audits, and Education for management services for hospitals, health systems, and healthcare providers.

More recently, Brenda held the position as Regulatory Healthcare Audit Manager, for one of the largest auditing firms in the country. This role allowed Brenda to utilize and expand her internal auditing, risk management, and payer regulatory knowledge into most aspects of Part C, monitoring, reporting, and auditing.

Brenda has an undergraduate degree in economics and business, MBA, and PhD in Healthcare Management from the University of Phoenix. She is also a Certified Professional and Risk Adjustment Coder with the American Academy of Professional Coders. She has professional affiliation with the Healthcare Compliance Association, alumni Honor Society, and Marquis Who’s Who with most recent honorable induction in the Library of Congress, as an expert in healthcare compliance.

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Experienced Medicare staff: Ready when you are!

BluePeak knows how difficult it can be for Medicare Advantage plans and TPAs to find knowledgeable resources with experience in Medicare, especially when demands increase sharply given the Medicare annual cycle. BluePeak maintains a wide variety of experienced Medicare personnel to help you with seasonal projects, operational backlogs, compliance monitoring, remediation activities, and more.

Examples of projects that BluePeak has assisted plans in 2022 include:

  • Clinical chart review by licensed clinicians
  • Call center oversight, including listening to calls for accurate classification and calibration
  • Operational support to resolve grievance backlogs and provider directory compliance
  • Pharmacy support to resolve coverage determination backlogs
  • Program area specific operational and administrative responses to a corrective action (initiated internally or externally)
  • Compliance resources to support compliance program initiatives

Whether you need one resource or many, BluePeak can quickly staff any project, train resources, track results, and deliver success.

Contact us today!