Rodney Collins Email and Phone Number

Senior Leader with over 18 years of experience working in a matrix environment and managing Health Plans, Commercial Plans, and Medicaid Plans covering millions of lives. Adept at managing over 60 team members across the country, driving revenue, and maintaining strategic partnerships with stakeholders, customers, employees and vendors. *50-60 team members in over 40 locations and all medical management functions for Clinical Care Services in more than 20 health plans.*Experience in RFP development; program development in conjunction with Medicaid and CMS regulatory guidelines; and process creation integrating compliance standards and auditing requirements.Core competencies include:Utilization Management ▪ Team Leadership ▪ Process & Efficiency Improvement ▪ Vendor ManagementData Analysis & Reporting ▪ Regulatory Compliance ▪ Audits ▪ Cross-Functional CollaborationMagellan Health ServicrsDirector of Clinical Care Services 2001 - 2019Led 50-60 team members in over 40 locations and all medical management functions for Clinical CareServices in more than 20 health plans.Oversaw utilization management and criteria-based care reviews and clinical appeals.Managed the health plan’s 24/7 Nurse Line program and clinical management of crisis calls.Oversaw staff audits, process audits, and pre-delegation and delegation activities.Identified learning opportunities and helped develop training materials for performance improvement.Established partnerships with local and national leaders in Quality Improvement, Analytics, Finance, and Network to effectively manage quality and cost of care.Responsible for departmental budgetary analysis for both medical-spend and administrative costs.Collaborated with network leaders to design and implement methods for working with hospitals, home health, and other service providers.Experience in RFP development; program development in conjunction with Medicaid and CMS regulatory guidelines; and process creation integrating compliance standards and auditing requirements.Select Accomplishments:Assisted with developing a medical/behavioral integrated product, “Magellan Complete Care”, including a nurse line; launched the Complete Care product in several states, increasing company revenue exponentially.Implemented live call transferring from customer service to care management, resulting in a reduction in call-backs and costs, an improvement in call statistics, and an increase in customer and provider satisfaction.Developed high performing groups that consistently exceeded the 98th percentile for call statistics.