Neil Mcclain Email & Phone Number

Florida, United States

Millersville, MD, US

• Focused on delivery and pivotal improvements for NDMS and healthcare programs with the Department of Health & Human Services (HHS) and other agencies.
• Oversee seamless program operations, ensuring compliance with established protocols and regulations
• Exercise financial stewardship over all programs. overseeing budgets, expenditures, and reporting
• Ensure the timely and accurate completion of all tasks associated with the NDMS and other contracts
• Uphold high standards of efficiency, accountability and quality across all programs and contracts
• Prepare and submit comprehensive reports related to the NDMS program and other contracts

Eden Prairie, MN, US

• Plan and facilitate client engagements, serving as the primary liaison to ensure exceptional delivery of all commitments.
• Completed research, devised business development strategies, pitch decks, and client pricing for engagements
• Executed client engagements, including pricing, SOW, kickoff, weekly tasks, meetings, and deliverables
• Crafted and delivered comprehensive final engagement decks with clear deliverables, and actionable roadmaps
• Developed a tool to proactively manage engagement margins and create forecast models for planning
• Effectively maintained suitable margins for all engagements by adjusting resources as appropriate

Boston, MA, US

• Implemented a comprehensive Payment Integrity program and managed end-to-end aspects of Claim Operations
• Chaired the cross functional Payment Integrity Steering committee and reported results to the executive team
• Deployed a comprehensive claims configuration, issue tracking and reporting system via JIRA
• Identified and helped correct encounter process data issues leading to CCAs highest-ever accuracy rates
• Developed savings tracking tool, driving a 30% increase in savings in 2020 and doubling them in 2022
• Organized large scale overpayment recovery project to recoup over $10 million across 1500 providers

Franklin, TN, US

• Established the Northeast region, accountable for client operations, financial expansion, and strategic direction
• Served as a member of the Executive Strategy team, actively contributing insights during planning sessions
• Managed budgets, relationships, implementations, data transfers, inventory, performance, and compliance
• Successfully onboarded and managed the largest healthcare provider in Massachusetts as the inaugural state client
• Performed quarterly reviews with client executives, presenting in-depth metrics and savings analysis
• Developed dashboard reports, scorecards, and actionable KPIs resulting in numerous operational efficiencies

South Jordan, UT, US

• Provide strategic direction for client engagements with a combined yearly auditable spend exceeding $6 billion.
• Enhanced tools, training, documentation, reporting, and QA programs, boosting 2016 performance by 22%
• Elevated recoveries to $40 million in 2017 driving revenue up by over 25% from 2016
• Precisely reconciled finance ledger, generating monthly client invoices ranging from $2 to $4 million
• Conducted independent analysis of aging inventory and discovered $500,000 in overlooked accounts receivables
• Compiled metrics and crafted PowerPoint decks for Quarterly Business Reviews with client executives

Plano, Texas, US

• Responsible for defect resolution during configuration and implementation of Oracle Health claim system (OHI).
• Coordinated service delivery and reporting between configuration, IT, Operations and the client
• Performed analysis on existing defects and reduced the open defects by 500% in the first 6 months
• Streamlined processes, cutting average defect resolution time by 40% and optimizing defect tracking
• Fostered account relationships, providing leadership updates and addressing any potential member impacts
• Led daily SCRUMs with onshore and offshore resources to coordinate configuration and defect resolution

Boston, MA, US

• Directed a Project Management Team to develop applications, processes, programs, training, and tools for Operations.
• Spearheaded over 70 projects across 14 business areas to maximize resources, savings, productivity and quality
• Generated Quality Scorecard and Call Center Recognition programs, improving customer satisfaction to 92%
• Developed Mentor/Mentee program and designed an application to suggest matches based on skills and goals
• Implemented an automated scripting library, enhancing quality and saving 4,500+ administrative hours annually
• Deployed multiple time-saving, quality data comparison tools using a weighted matching algorithm for accuracy