Leondra McClendon

• Manages a diverse portfolio of accounts, ensuring timely communication and effective problem resolution.
• Successfully resolves escalated issues, preventing potential loss of valuable clients while maintaining positive relationships with all parties involved.
• Serves as a knowledge and resource expert regarding complex provider issues impacting provider satisfaction; research, analyzes, and coordinates prompt resolution to complex provider issues and appeals through direct contact with providers and internal matrixed partners.
• Collaborates within a cohort of internal matrix partners to triage issues and submit work requests.
• Research complex issues that may impact future provider contract negotiations or jeopardize network retention.

Accountable for managing two Independent Physician Associations (IPA) to achieve positive financial performance through value-based care and risk agreements. Each IPA successfully generates a surplus YOY. I conduct monthly data analysis to monitor performance and strategize with the Engagement Rep, IPA Participating PCPs, and IPA Board Leaders on resolving.
issues impacting their KPI trends.

• Partnered in development of strategic plans aligned with organizational goals by providing valuable input during planning sessions.
• Responsible for educating IPA leadership on any updates in policies and procedures by CMS impacting their Part C & D measures & gaps of care aligned to their membership.
• Manage monthly meetings for two IPA Boards & UMQM Committees
• Review IPA performance in conjunction with IPAs budget MOM to ensure IPA is meeting metrics
• Drive IPA Actions plans successfully through monthly Board Leader Meetings
• Responsible for setting monthly priorities for LLC Board and UMQM Committees in
  conjunction with IPA Chair and Medical Directors
• Responsible for bi-weekly growth strategy meetings with CareAllies & Sales Team to identify opportunities to grow and implement successful strategies to grow and keep IPA
  membership
• Participate in monthly IPA Provider Performance metrics to level set goals/targets and identify negative trends
• Develop individualized performance improvement plans for PCPs not meeting IPA goals/targeted metrics
• Responsible for managing 3,000 Cigna Medicare Advantage lives between two IPAs.
• Manage field reps, offering guidance, feedback, and mentorship that contributed to their professional growth and development.

• Discover root causes of problems to identify appropriate solutions.
• Act as a primary resource for assigned, high profile providers or groups to establish, oversee, and maintain positive relationships by assisting with or responding to complex issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs.
• Manage specialty, pediatric, family, and internal medicine group contracting for Southern New Jersey.
• Supervise site investigations, reported issues and escalated those that required further assistance.
• Meet with key providers periodically to ensure service levels are meeting expectations.
• Manages the development of agenda, validates materials, and facilitates external provider meetings.
• Collaborated with cross-functional teams to identify areas of improvement, leading to increased operational effectiveness.

• Identified opportunities and analyzed marketplace key performance indicators to diversify campaigns, expand visibility, and improve performance.
• Calculated correct costs for project-specific services by gathering information from team members, sub-contractors, and vendors.
• Utilized cost estimation systems to document project information, create estimates, and revise project costs to reflect current data.
• Provided recommendations and executed strategies for revenue growth opportunities, leading to annual cost savings.
• Facilitated data analysis, search query mining, and development of ad hoc reporting by performing data pulls via SAS.
• Created monthly quality scorecards via SAS to ensure providers were staying within state and federal guidelines specific to quality measurements
• Conducted routine root cause analysis's on claim reporting as well as government program policies.

• Built strong relationships with customers through positive attitude and attentive response.
• Developed strategies to promote team member adherence to company regulations and performance goals.
• Managed/Monitored incoming/outgoing member enrollment and education calls daily.
• Collaborated with other department leads to streamline workflows, improve interdepartmental coordination, and achieve business goals collectively.
• Demonstrated knowledge of company mission and goals and mentored employees in reaching objectives aligned with company core values.
• Provided constructive criticism regarding quality assurance on collections team phone calls.
• Lead departmental new hire processing and existing training programs.
• Participated in cross-functional team-building activities.
• Minimized resource and time losses by addressing employee or production issue directly and implementing timely solutions
• Created detailed project plans outlining goals, timelines, resources, and budgets to ensure alignment with company objectives.
• Developed and maintained effective relationships with key stakeholders to better understand their needs and expectations.