Finding Purpose and Delivering Value Through Medical Review, Interview With AMR’s Operations Manager, Stephanie Nguyen

I work in health care. Am I a nurse or doctor? No. Do I deliver direct patient care? No. Am I making a difference in people’s lives and the industry as a whole? Definitely.

I started my career in health care as a dental assistant with plans of going through dental school to get into a more direct patient care environment. However, after some time, that career path was no longer appealing. Like many young adults, I wanted to make my mark and change the health care industry for the better. What I didn’t know at the time was that I could accomplish my goals in ways I had not previously considered.

Understanding the industry

I came to Advanced Medical Reviews (AMR) not knowing for certain how this job would help me accomplish my goals of making a difference in patients’ lives. I knew the company performed peer reviews, but I didn’t know precisely what that meant. It took some time, but the more responsibility I was given, the better I understood the peer review industry. I began to recognize that even though my work did not seem as “glamorous” as working in an emergency department or seeing patients in a clinic, I was still contributing to ensuring high-quality patient care.

As with many new employees at AMR, I first joined the company as a Medical Review Coordinator. My job consisted primarily of verifying clinical information and finding physician reviewers in our nationwide network to perform peer reviews. Though some might find this sort of work mundane, I found it exciting. There were so many variations in the cases I worked and that gave me a deeper understanding about the nuances of patient care.

Through my interactions with physician reviewers, I learned about trending medications for particular diagnoses and all sorts of interesting details about the newest medical procedures. Sometimes a client would share something in passing that they thought was unimportant, but to me, it was actually very important information that could significantly impact how a case should be handled. I found so much value in working on these cases and being able to “care for the patients” by helping coordinate the best peer review possible with all the knowledge I had gained. Yes, working for an Independent Review Organization (IRO) like AMR did not feel like a typical job in healthcare, but the work I did still felt rewarding and important.

Making a direct difference

In my current role as Operations Manager for AMR, my goal is to help improve quality in patient and managed care. I recently had the opportunity to work on a complex case with a tight deadline. The patient at the center of the case was scheduled to have an amputation in only a few days.

The crucial question was whether or not hyperbaric oxygen therapy, a less invasive alternative to amputation, was medically necessary. Once the case passed through our quality assurance process, the physician reviewer informed the health plan that the patient did not need to have the amputation, at least not until first trying other less invasive and appropriate treatment options.

It is while working on cases like this that I see firsthand how my work impacts patients’ lives. It’s what the utilization management (UM) process is all about – ensuring patients receive appropriate care. Even though the UM process has been around for many years, IROs like AMR help ensure the process is being continually improved through new technologies and policies driving patient-centered care.

Leading by doing

It is important to me that our employees find value in the work they do at AMR. At times this can be difficult, especially considering that many of our employees have never heard of an IRO when they first come through the door. Nonetheless, I strive to provide our team with enough information and experiences to help them discover why this type of work is so important to the larger healthcare industry.

I’ve found being an effective leader is achieved not only by what you say but also by what you do. For this reason, it is important to make sure our team members are very comfortable calling me when they need assistance, and that they know I am always happy to offer guidance, or talk through an issue no matter how complicated it might seem. In my role, I am always learning something, whether it’s new information or a different perspective on a familiar situation, and it is all to the benefit of my team as a whole.

Finding meaning in my work and learning something new every day is a strong motivation for me, and I want to instill that in others. I want the next generation of AMR employees to feel as passionate about our work as I do. I believe that everyone who comes through the door can offer a unique experience or skill set to provide value to AMR and the UM process as a whole.