Patrick Mcmahon Email & Phone Number

• Lead all contracting and expansion activities into multiple states resulting in 300% + network growth for the organization in two years. Expansion into CT, Iowa, Idaho, MI, NY and OH over the past three years.
• Lead all aspects of provider network strategy to include CMS adequacy analysis, network operations and determine the feasibility of entering new markets.
• Collaborate with sales and marketing team to improve member experience and overall salability of product.
• Develop and negotiate value based (upside/risk) arrangements with care partners leading to increased profit margins and improved member outcomes.
• Renegotiated ancillary lines of business resulting in improved financial outcomes.
• Revamped the credentialing department using Six Sigma lean principles results include improved processing times and reduced resources.

• Direct the provider network and contracting activities nationally and led all aspects of provider network strategy including access analysis, network operations and support leadership decision making process to enter.
• Oversee network development staff and external consultants in the development of provider networks across expansion markets.
• Perform periodic analyses of the provider network from a cost, coverage, and growth perspective. Provide leadership in evaluating opportunities to expand or change the network to meet Company goals.
• Manage budgeting and forecasting initiatives for product lines to networks costs and provider contracts
• Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations
• Managed credentialing and provider data activities for the organization nationally

Richmond, VA, US

Managed Network Development division of HMO in Virginia and South Carolina. Spearheaded strategic planning, implementation, automation, provider data management and expansion efforts resulting in increased revenues from $28M to $1B. Led start -up of Medicaid HMO in South Carolina resulting in expansion into all 46 counties. Developed reimbursement.

Richmond, VA, US

Masters Business Administration

Bs, Journalism, Advertising

Post Baccalaureate- Information Systems, Information Technology