Neil Mcclain Email and Phone Number
Are you seeking a visionary executive and dynamic problem solver with a creative, entrepreneurial flair to navigate the intersection of healthcare and technology operations? Look no further! I specialize in crafting innovative solutions amidst calm or chaos, regardless of your current technology. I will deliver process optimizations, superior quality, appropriate technologies, and improved associate engagement regardless of your current environment. Throughout my career, I've been dedicated to driving operational excellence for my clients. I've spearheaded process improvements that resulted in substantial man-hour savings, optimizing workflows and enhancing efficiency. My commitment to quality has consistently elevated standards, and I'm proud to have delivered tangible savings amounting to millions of dollars. I have quickly and consistently delivered value in all of my roles.My track record speaks for itself, with success stories at both large and small employers, including some well-known organizations such as Optum, Cotiviti, Revecore, NTT Data, multiple Blue Cross Blue Shield plans, and John Hancock, among others. This extensive experience has equipped me with a deep understanding of healthcare operations and a proven ability to deliver outstanding results.My Mission:• Transform processes for efficiency gains.• Harness technology for enhanced performance.• Develop problem-solving mindsets in teams.• Identify opportunities for cost savings.• Cultivate a versatile skill set across healthcare domains.• Bridge the gap between operations and IT. Experience Highlights:• Consistently delivering significant value to teams, clients, and stakeholders.• Leading successful client engagements.• Supporting new business development initiatives.• Serving as the primary client liaison for exceeding deliverables.Core Competencies:• Leadership• Operational Enhancements• Customer Relationship Management• Analytics• Innovation• Strategic PlanningTools of the Trade:• Agile Principles• Streamlined Project Management Methodologies• Extensive Dataset Management• Technical Savvy• VisionGuiding Positive Change:• Thought leader in dynamic environments.• Navigating organizational transformations.• Overcoming complex business challenges.• Guiding through intricate implementations.Let's connect to explore how I can be a catalyst for positive change and savings in your healthcare and technology operations journey. Together, we can chart a course toward innovation, efficiency, and excellence.
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J29 Inc.Florida, United States
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Program Director For Hhs ServicesJ29 Inc. Oct 2023 - PresentMillersville, Md, UsFocused 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• Provide transparency and program insights for NDMS and other contracts• Primary Point of Contact for all matters concerning the NDMS program and other contracts
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Director Advisory ServicesOptum Jun 2022 - Aug 2023Eden Prairie , Mn, UsPlan 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• Collaborated with other business areas to enhance audit efficiency with technology and resource optimization• Discovered over 50 operational improvements and $65M+ in savings during 2 recent engagements -
Director Of Payment Integrity And Claims OperationsCommonwealth Care Alliance Mar 2020 - Jun 2022Boston, Ma, UsImplemented 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• Devised savings forecast models and team budgets, obtaining executive leadership approval• Increased operational efficiency by revising quality controls, procedures, and more strategic KPIs -
Executive Director, Client OperationsRevecore Aug 2018 - Dec 2019Franklin, Tn, UsEstablished 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 -
Account Manager, Payment Accuracy And Audit OperationsCotiviti Jul 2015 - Oct 2017South Jordan, Ut, UsProvide 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 -
Senior It Business Consultant, Ohi Benefit Configuration And Defect ManagementNtt Data Services Jan 2014 - Jun 2015Plano, Texas, UsResponsible 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 -
Senior Manager, Operations Support For Member And Provider ServicesBcbsma Sep 2001 - Aug 2013Boston, Ma, UsDirected 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• Led data normalization and inventory tracks for the development of an Integrated Provider Management system
Neil Mcclain Education Details
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Lesley UniversityBusiness Administration And Management
Frequently Asked Questions about Neil Mcclain
What company does Neil Mcclain work for?
Neil Mcclain works for J29 Inc.
What is Neil Mcclain's role at the current company?
Neil Mcclain's current role is Program Director at J29 Inc.
What schools did Neil Mcclain attend?
Neil Mcclain attended Lesley University.
Who are Neil Mcclain's colleagues?
Neil Mcclain's colleagues are Monica Watson, Brooke Battles, Aimee Davis, Shevon Kotlowski, Logan Lally, Rae Anne Thompson, Amber Dietrich.
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