Summary
Overview
Work History
Education
Skills
Timeline
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LeAnne McDonald

Dallas/Fort Worth,Texas

Summary

Accomplished leader with a strong background in revenue cycle management and staff training, achieving an 87% retention rate and a 30% reduction in errors. Expertise in financial forecasting and business strategy development, with a focus on optimizing revenue streams. Demonstrated ability to implement innovative strategies that drive growth and enhance profitability. Effective communicator skilled in building cross-functional teams to achieve shared objectives.

Overview

16
16
years of professional experience

Work History

Director of Revenue Integrity and Training

Professional Medical Services/Elevate PFS
11.2014 - Current
  • Successfully managed the companies' recruiting, hiring, training, and auditing teams for over 10 years.
  • Hired approximately 250 employees a year.
  • Able to maintain an average retention rate of 87% through effective onboarding, training, mentoring, and quality reviews.
  • Able to decrease staff's error ratio by 30% with deep dives into the step-by-step process of resolving accounts.
  • Able to build an exceptional, passionate group of leaders to oversee each line of business.
  • Worked closely with managers and upper leadership to understand the hiring needs of the company.
  • Continually reviewed new and improved hiring and training techniques, and implemented new concepts when needed.

Client Benefits Manager

CVS Caremark Corporate Office
10.2013 - 11.2014
  • Manages the day to day operations of a team whose primary responsibility is to analyze government claims and build quality pharmacy/benefit plans for clients.
  • Ensure strict turnaround times are met for client deliverables and client intent is met on all plans.
  • Researching client benefit requests/issues and recommends alternative solutions to internal partners in meeting client needs.
  • Identify root cause analysis and create defect elimination plans.
  • Successfully lead a team in adhering to strict timelines around client deliverables with 98% accuracy.
  • Overall responsibility for functions supporting the accurate capture and validation of client intent on benefits setup, providing clients and internal partners with consultative insight into plan options, system capabilities and final quality review of test results to ensure Benefit plans deployed to production are accurate and meet client intent.
  • Emphasize data analysis for various programs such as Formulary, Specialty Pharmacy, and Utilization Management, specifically related to CVS Caremark standard product lists used for benefits claim adjudication and design.
  • Oversight of benefit reviews and updating RxCLAIM/AS400 changes for accuracy related to standardized programs, document review, current system validation, trending analysis.
  • Monitor the creation and implementation of prescription plan set up.
  • Collaborate with internal departments to ensure client deliverables meet CVS/Caremark standards.

Regional Operations Director

HCFS, Inc.
02.2010 - 02.2013
  • Operations Manager who managed multiple facility territory in various Texas, Colorado, Montana and California.
  • Creatively worked with CEO’s, Revenue Cycle Director’s, and Business Office Directors to decrease hospital AR and increase hospital revenue.
  • Increased customer satisfaction rate from 54% to 92% during Operations Managers tenure.
  • Decreased hospital AR by 28% through implementation of new programs.
  • Reviewed and audited claims to ensure accuracy. Acted as liaison between HCFS, Inc. and Billing Department Management within hospitals. Notified management when errors were identified for correction and re-billing of claims.
  • Decreased bad debt by 17% through converting self-pay patients to government funded insurance programs.
  • Positively hired, trained and developed employees in a Call Center environment and in a hospital setting.
  • 40 direct reports in call center environment and 25 employees at contracted locations.
  • Developed and empowered 10% of employees into leadership roles and provided expertise to move towards Operations Manager position.
  • Created and implemented Individual development plans, incentive and motivational plan for team increasing productivity by 35%.
  • Operations Manager who maintained the highest retention rate for employee’s in the company.
  • Performed client renewal, contract revision, and Client Service Instruction preparation for complex programs.
  • Developed action plans when issues arose with customers to resolve issue.
  • Reviewed staffing plans to ensure appropriate staff was assigned to customers’ needs.
  • Created and implemented strategic plans after detecting gaps in services.
  • Operations Manager who achieved 97% of regional operational objectives and goals set by Operations Manager, VP of Operations and President of company.
  • Maintained and expanded customer base by counseling with sales team on climate of region.

Education

Bachelor of Science - Health Education

Texas A&M University
College Station, Texas

Master’s Education -

Texas Woman’s University
Denton, Texas

Skills

  • Grow and develop exceptional Leaders
  • Connect/engage with people
  • Meet strict timelines
  • Collaborative
  • Highly driven
  • Thrive in challenging situations
  • Revenue cycle management
  • Staff training
  • Data analysis
  • Process optimization
  • Regulatory compliance
  • Client relationship management

Timeline

Director of Revenue Integrity and Training

Professional Medical Services/Elevate PFS
11.2014 - Current

Client Benefits Manager

CVS Caremark Corporate Office
10.2013 - 11.2014

Regional Operations Director

HCFS, Inc.
02.2010 - 02.2013

Bachelor of Science - Health Education

Texas A&M University

Master’s Education -

Texas Woman’s University

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