Kenisha E. Hodges
Portrait of Kenisha E. Hodges
Healthcare Transformation & Implementation · Business & Technology Alignment · End-to-End Delivery · Operations Improvement

Kenisha E. Hodges

I connect people, process, technology, and data to turn complex operational problems into practical, scalable solutions.

Norfolk / Hampton Roads, Virginia linkedin.com/in/kenishahodges Kenisha.Hodges@outlook.com
Senior Business Information Consultant, Process Engineering · Elevance Health
$45M+Medical recovery and cost savings contributed (Cost Containment, 2011)
$3.2M+Invalid interest & penalty payments recovered
40%+Faster Medicare Enrollment turnaround through automation
99%+Ohio Medicaid encounter acceptance at go-live, vs. a 98% target
$300K+Annual cost avoided by securing video outreach approval
$241.5KAnnual cost avoidance from Medicare Enrollment queue automation
$160K+Annual savings from electronic Perinatal Case Management
~18 yrsIn healthcare payer operations across Medicaid, Medicare, and Commercial
About

Curious about the whole system, focused on what gets done

I have spent nearly 18 years inside healthcare operations: encounter data and EDI, state Medicaid implementations, payment integrity, Medicare enrollment, and grievances and appeals. That range lets me sit down with claims, clinical, IT, vendor, and state partners, understand what each one needs, and connect it into a solution that works for all of them.

My work has moved from implementation lead to Chief of Staff, to digital transformation, and now to process engineering. The thread through all of it is the same. I look past the immediate issue to find root causes, dependencies, and broader impact, then bring structure to the ambiguity so ideas move from discovery into action.

I value curiosity, collaboration, transparency, strong relationships, and continuous learning. I am especially interested in how AI and automation can thoughtfully improve how organizations operate, and I bring hands-on experience with Power Apps, UiPath, and IBM Blueworks Live to that work.

How I work

From discovery to go-live, and after

01 · DISCOVER

Map the current state

Stakeholder discovery, case journeys, and operational data to see how work really flows.

02 · DIAGNOSE

Find the upstream cause

Root cause, variation, and dependencies across business lines, not just the symptom downstream.

03 · DESIGN

Shape the future state

Workflows, controls, and automation that teams can put into practice.

04 · DELIVER

Make it stick

Readiness, UAT, governance, KPIs, and post-go-live performance.

Career path · Amerigroup / Elevance Health

Steadily wider scope, one employer

2026–now

Process Engineering

Health Benefits Execution & Governance (National Operations Command Center prior to Sep 2026)

Appeals Volume Mitigation / Shift-Left for the Grievances & Appeals future state; Power Apps administration.

2023–2026

Digital Transformation / Enterprise Performance Excellence Lead

Enterprise Performance Office, then NOCC (same team, rebranded Sep 2025)

Medicare Enrollment automation (40%+ faster), $3.2M+ interest & penalty recovery, Commercial Clinical G&A redesign and execution, Payment Integrity CI&W adoption analysis, enterprise Digital & AI idea intake in Aha!

2022–2023

Chief of Staff, Business Improvement

Government Business Division

Leadership decision support across Claims, Benefits, Encounters, UAT, and Quality; led Ohio Medicaid encounter go-live and UAT Transformation.

2018–2022

Encounters Implementation & Vendor Management Lead

Government Business

Medicaid and Medicare encounter implementations, EDI, delegated vendors, and state readiness.

2014–2018

IT Customer Account Manager

Government Business

Enabled Anthem's first connection to the Georgia Health Information Network (GaHIN).

2008–2014

Health Care Economics Analyst · Cost Containment SME

Amerigroup

Encounter production across HIPAA transactions; contributed to $45M+ in 2011 recovery and savings.

Toolkit

Strengths, tools, and credentials

Areas of strength

Implementation & readinessEnd-to-end deliveryIntake & prioritizationGovernance & controlsBusiness & technology alignmentRoot cause analysisCross-functional facilitationFuture-state designProcess engineeringState & regulatory engagementExecutive reporting

Tools & methods

Power AppsUiPathIBM Blueworks LiveProcess MiningAha! RoadmapsJIRA / eazyBIqTestSQL ServerLean Six SigmaAgile / SAFe

Education & credentials

B.S., Information Systems, Security Administration concentration, Strayer University, Cum Laude

Health IT Engineering Certificate, Tidewater Community College, Cum Laude

Lean Six Sigma Yellow Belt Certificate, Elevance Health (2022)

Certified Healthcare Technology Specialist (CHTS-TS), AHIMA

SAFe 4 Certified Scrum Master & Agilist, Scaled Agile (held 2017–2023)

Training: PMP Exam Prep (36 contact hours, 2020); AI Principles (2025); Prompt Engineering Fundamentals (2024); Responsible AI with Microsoft Copilot (2026)