Maxwell Thompson Email & Phone Number

Texas, United States

Oversees Centene Technologies entire Quality Product Ownership, Program Management and Data Acquisition strategy teams to improve quality health outcomes. • Developed and managed Centene Technologies entire quality product, program and project portfolios, ensuring achievement of financial objectives and adherence to timelines• Oversee the Quality Product Ownership team at Centene, utilizing agile methodology for product development, enhancements, and bug fixes.• Led Centene’s annual data acquisition strategy to reduce manual record review and unnecessary FTE costs by obtaining supplemental data through various Health Information Exchanges and Electronic Medical Records.• Spearheaded the establishment of a comprehensive Six Sigma process improvement organization, driving its creation from inception to a high-performing unit. • Successfully improved strategic initiatives related to HEDIS, STARS, CAHPS, HOS, and Pharmacy ops resulting in over $4M savings in 2022 through effective program management.

Wylie, Texas, United States

Oversees Population Health (HEDIS) program strategies that drive solutions impacting Technology Operations and the clients we support. • Led the transformation of 60+ recurring ad hoc reporting request into scheduled automated reports equivalent to savings of 4,320 FTE hours annually• Implemented a Language Line translation service to assist in outreach to non-English speaking providers during collection season. This mitigated language barriers that have historically created challenges in obtaining medical records from a small subset of providers. • Established an electronic mailroom facility to fulfill provider letters on the organization’s behalf. Saved ~ $0.60 per letter.• Successfully migrated UHC’s HEDIS engine to achieve more accurate expectations of retrospective results and stability across prospective programs. $2M savings through 2020.• Integrated 14 internal cross functional organizations from existing data warehouse to the Snowflake Data Cloud allowing for improved customization of data pulls and faster data retrieval.

Richardson, Texas

Manages a virtual team comprised of 9 healthcare economic consultants who build retrospective algorithms for the Medicare and Retirement line of business to identify claim overpayments made to providers.Recovered $20 million in 2017, $80M in 2018 and over $95M in 2019 new incremental savings from provider overpayments based on algorithms developed for the M&R line of business.Reduced algorithm deployment turnaround time by 40% in 2018 (42 to 25 days). Achieved an additional reduction of 20% in 2019 (25 to 20 days). Led an end to end quality redesign to improve client involvement and algorithm development. Reduce algorithm business iterations by 50% in 2018.Improved the User Acceptance Testing (UAT) process for algorithm development across all lines of business. Removed 11 non-value steps and reduced the overall UAT process from 7 days down to 3 without comprising quality. Established and promoted continuous improvement which resulted in 5 employees working towards their Six Sigma Green Belt and 2 employees toward college degrees.

Overland Park, Kansas

Oversaw process improvement projects for the entire OptumRx Overland Park Kansas mail order fulfillment center. Primarily responsible for increasing efficiency, throughput and safety for over ~89,000 prescription drugs dispensed across the nation per day. Reduced pharmacy packing station lockups by 20% in the Overland Park, KS fulfillment center, resulting in $300k hard savings per year.Implemented system enhancements to prompt packers to use packing material on common fragile drugs shipped. This resulted in a 30% reduction in order resends ($450,000 savings annually).Developed a drug reconciliation program to achieve 100% traceability of every drug lot number dispensed through OptumRx. Improved the visibility of drugs dispensed by the facility during FDA recalls.Enhanced the data entry processing screen to reduce common pharmacy drug formulation errors. Achieved 50% improvement in 2017 ($138,300 savings annually). Mentored two analysts through completion of Six Sigma Green Belt certification. Projects resulted in over $2M combined total hard savings.

Overland Park, Ks

Supervised 8 Claims Business Process Analyst who supported the entire OptumRx Commercial Client Audit process. Team was primarily responsible for auditing external pharmacy claims provided by audit firms and assisting with corresponding root cause analysis and corrective action plans. Reduced auditor questions to subject matter experts by 85% by creating a knowledge base repository of previous completed audits.Sustained 100% client retention in 2016 based on audit results and subsequent corrective action plans.Integrated two new audit programs through the migration of Catamaran in 2016. These audits measured contractual performance guarantees and potential payouts. Achieved 100% Manager effectiveness and Employee engagement as measured by Kenexa’s Vital Signs in 2016Developed and Promoted 4 employees to Senior Business Analyst.

Overland Park, Ks

Led process improvement projects directed towards improving quality for front-end pharmacy home delivery customer service and the Overland Park KS fulfillment Center. Developed a new quality control process for mailing sensitive pharmacy public health information (PHI) that resulted in $1.5 million savings in the form of fine avoidance.Led an automation pharmacy claims effort that reduced an 8-day auditing process down to approximately 20 mins utilizing automation efforts resulting in the ability for client specific claim auditing.Rebalanced and improved efficiency for over 300 dispensing drugs in the Overland Park, Kansas pharmacy center that led to $2.4 million in hard savings.Implemented process improvement efforts in packing and shipping resulting in an increased monthly throughput from 120 Rx/Hr. to 135 Rx/Hr. per packing station. Achieved $1.2 million in hard savings.

Overland Park, Ks

Validated information in AS-400 to ensure benefit information accuracy for all lines of business (E&I, C&S, and M&R)Achieved 100% quality results as measured by the Quality Management Audit the Auditor program.Completed on average over 15 audits per day with a goal of 5. Audited the most plans within my first year on the team.Created the audit process to audit the implementation of plans OptumRx acquired from United Healthcare (UHC) Employee and Individual (E&I) pharmacy benefit manager (PBM) from Medco. Mentored offshore staff on audit practices and procedures.

Kansas City, Missouri

Kansas City, Missouri

Master Of Business Administration (Mba), 3.9 Gpa

Bachelor Of Business Administration (Bba), Management