Daniel Mccrone Email & Phone Number

Portland, Maine Area

Martins Point Health Plan is an area insurance provider to the Department of Defense from Northern Maine to Erie Pennsylvania. We also offer a growing and successful 5.0 Star Medicare Advantage program. Martins Point Health Plan is backed by a popular 80+ PCP company-managed Delivery System that provides exemplary care for our Members and the communities we serve.

Fort Wayne, Indiana Area

Brea California, Miramar Florida, Boston, Massachusetts

Led medical quality improvement in a company with technology-driven specialty solutions in Oncology and Cardiology. Led a team that generated multi-million dollar savings for both NCH internal captitated business and insurer customers, mainly Humana.Published three small articles on improving safety, improving quality, adhering regimens to evidence based guidelines, and generating savings for Humana and its oncology population.

Boston And Quincy Massachusetts

Managed the BCBSMA oncology program from a medical perspective. Worked mainly in oncology case management but also general case management, oncology pharmacy, and radiation oncology.

Franklin Lakes New Jersey

Mclean Virginia And Sunrise Florida

Managed Oncology quality improvement for 25 million covered lives; managed a guidelines and pathways process for oncology surgery, medical oncology, and radiation therapy for 48 different tumor types; supervised utilization management efforts for inpatient and outpatient oncology care; managed a fully at risk program with tight analytics to assure positive financial performance.

Harrisburg And Pittsburg Pennsylvania

Managed all components of the medical loss ratio for the Harrisburg and Pittsburg operation(560,000 Members), which at that time was over half of Coventry United States business.

Manhatten, New York

Rewrote and led the implementation (Process Champion) of the entire medical policy set for Empire BCBS. Empire improved the claims "first pass" rate from 30% to 70% in the course of this process improvement. Developed a workable program for authorization of bone marrow transplants using outside expert reviewers. This program was adopted by other Blue plans and was instrumental in resolving the approval stalemate between insurers and transplant centers.

Washington Dc

CMO of an 120,000 member network model HMO. Acting CEO during a multi-month transition of senior management teams.

Towson Maryland And Owings Mills Maryland

Managed utilization management, quality improvement, hospital contracting, network contracting, regulatory affairs, provider services, pharmacy, and dental for the insurer's million plus 'indemnity' and 'self-insured' members.In 1990 created an "Exclusive Provider Organization" using Maryland Health Services Cost Review Commission Data to identify a less costly subset of the larger PPO Network. That Network is still being sold (2018) and is one of several innovative products developed at BCBSM during my tenure there including Greenspring Mental Health Services and Paradigm Pharmacy Management Services.Rewrote the entire BCBSM medical policy set and created uniform medical policy for the base business and the Company's four HMO's (FreeState, Carefirst, Delmarva Health, and the Columbia Medical Plan).