Joseph Mcmahon Email & Phone Number

• Worked closely with client facing, Account Management (AM) teams to provide exemplary client service to achieve the goal of customer retention.• Monitored the performance of client contracts versus actual claims performance to demonstrate the value of meeting proposed savings targets and provided documentation to support those results.• Prepared and delivered all client related reporting associated with financial performance.• Developed value proposition of client accounts related to performance of guarantees.• Responsible for the preparation, management, accuracy, and delivery of financial reporting to targeted client bases.• Generated and reported performance of Proposed Savings Projections to various clients.• Supported AM teams with trend management – promoting overall trend performance for all clients.• Subject matter expert for all account related contract guarantee reporting• Determined cause of rebate and contract underperformance when this occurred.• Provided training to AM teams on all financial and contract guarantee reporting as needed.• Actively participated in strategic client meetings.• Various ad-hoc investigations into drug utilization and management and impact on client populations.

• Engaged all levels of management in Health Informatics, Sales & Customer Relations, Care Management, Provider Services, and Prescription Drug on group-specific and BOB reporting strategies to differentiate MMO in the marketplace.• Drove strategic thinking and direction to improve the company’s competitiveness in health information reporting. Evaluated and implemented new tools for reporting and publication.• Subject matter expert for internal and external customers on health care reporting, programs, and services in the company and the industry.• Researched, developed, and implemented methods for reporting new medical policies, Care Management and prescription drug programs, and benefit structures. Deployed presentations to Sales & Customer Relations and Health Informatics. Measured and evaluated successes, including industry trends, savings, and cost of care.• Provided in-depth and ongoing market and industry analysis as well as competitive reporting analysis and positioning.• Lead and directed project teams on strategic corporate and divisional initiatives. Provided coaching and mentoring to other Health Informatics analysts. • Ensured Health Informatics reporting outcomes are developed, measured, evaluated, and published• Developed and updated reporting content for Health Informatics to coincide with health care industry.

• Consulting analyst on the creation of a new opportunity assessment proposal focused on retaining the business of thee major retirement systems. Identified population trends and suggested possible cost saving strategies.• Lead corporate analyst investigating the ROI of utilizing a third party telemedicine services provider to reduce costs for both the member and Medical Mutual by potentially eliminating unnecessary emergency and urgent care visits. Managed junior analyst.• Spearheaded a cross departmental initiative examining the establishment of a regional MRI reference pricing structure for the company’s largest insured group.• Provided supporting statistical data for a proposal to incentivize one of Ohio’s largest hospital systems to significantly reduce all-cause readmissions by tying reimbursement to outcomes. Protocols learned for this project will eventually be utilized for all of MMO’s contracted hospitals.• Co-authoring an interdivisional study analyzing the financial and clinical effectiveness of case management programs for both internal stakeholders and external members.• Utilized medical literature review and data harvesting techniques regarding the ineffectiveness of certain chemotherapy drugs as a treatment for some cancers without the aid of genetic testing. Findings lead to the creation of a corporate medical policy. • Various other analytical projects ensuring appropriate utilization of resources, cost control and/or cost reduction, delivering matching levels of care, and identifying cost-saving healthcare services for MMO and its members.

• Lead project analyst in the development of a Patient Centered Medical Homes database and an online reporting tool for network provider use aimed at reducing company and member expenses while increasing patient quality of care.• Managed several junior analysts regarding pharmacy benefits reporting. Assigned project requests and reviewed finished reports while maintaining report completion in a timely and accurate manner for senior level executives and sales staff.• Supported sales staff, group account representatives, and external brokers as well as the legal and pharmacy benefits departments by developing reports summarizing group drug and pharmacy utilization and member specific reporting.• Reported cost and volume comparison for both internal and external physician advisors and provided data to Chief Medical Officer, Care Management EVP, and Director of Clinical Accreditation.• Created and maintained data reference warehouse containing contracts and contractual information contributing to Medical Mutual’s ability to better interact and negotiate with external vendors and clients. • Led a multi-departmental/divisional initiative that developed a tracking mechanism and protocols investigating the contractual compliance of a large, external pharmacy benefits management company.

• Helped reduce expenses associated with patient stays by developing and maintaining critical trending reports regarding key Length of Stay indicators for all clinical institutes across the organization.• Assisted in increasing staffing efficiency and decreasing payroll costs through the creation of online reports to track nursing productivity statistics used by all high-ranking executives and nurse managers.• Utilized nationwide Medicare data to generate mortality studies comparing the Cleveland Clinic to all other hospitals throughout the country.• Created Web-based dashboard application to identify, track, and reduce patient readmissions for the entire hospital health system.• Developed and maintained online business review tool for all areas of the hospital to record and report pertinent organizational metrics.• Consulted with several layers of management on issues affecting performance and decision making for individual clinical areas and the organization as a whole.

• Identify strategies to increase the amount and rapidity of revenue collection by the Weston, Florida operation.• Maintain homegrown denials database system and advise others regarding its most efficient use.• Develop and maintain trending reports used by all levels of management.• Serve as direct liaison between outside claims vendor and all levels of internal users.

• Prepared daily, weekly, and monthly production summaries and financial statements for management. • Developed and maintained accounting systems using spreadsheet applications to generate critical reports.• Acquired expert skills in financial accounting, budgeting, PC-based accounting systems, and Windows-based applications.• Trained all clinical areas on new front-end cash receipt and reconciliation procedure.

• Handled statement reconciliation and premium disbursements.• Used accounting principles to analyze financial information for financial reports. • Created various tables, queries, forms, and reports. • Documented new procedures, and trained staff on procedures.• Assumed added responsibilities of resolving insurance balance issues initiated via external correspondence.

• Applied accounting principles to financial analysis for information processing, and preparation of financial reports.• Gained experience in both customer service and supervisory positions. • Significantly increased revenue collection on delinquent accounts through direct customer contact.

Mba, Business Administration

Activities and Societies: Beta Gamma Sigma Honor Society

Bs, Consumer Affairs

High School, College Preparatory