Loren A McLean Resume

1. Loren A. McLean, PCMH CCE
33 Winthrop Street Extension  Danvers, MA 01923  (978) 549-4858  lorenamclean@hotmail.com
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Healthcare Executive
Successfully design, implement and manage multi-organizational clinical quality improvement programs. Proven
ability to collaborate across functional lines of responsibility, build consensus with staff and senior leadership of
multiple organizations, think critically, communicate clearly and resolve conflict.
Key Strengths
Strategy and Vision
 Business, financial, market positioning and operational workflow redesign for physician practices
 Physician practice best-practice consulting including operations, quality improvement and budget
 Electronic medical record (EMR) implementation
Leadership and Continuous Quality Improvement
 Account and physician practice management and transformation
 Physician, practice staff and direct report coaching and training
 Process and outcome quality improvement and performance activities
 Direct report mentoring
Fiscal Excellence and Regulatory Compliance
 Allied health services pay-for-performance and contract negotiation
 Federal Center for Medicare and Medicaid Services (CMS) regulatory compliance
Professional Experience
Mount Auburn Cambridge IPA (MACIPA), Brighton, MA 2014 to 2016
Pioneer ACO Project Manager
 Lead, manage and monitor all aspects of participation in the Center for Medicare and Medicaid Services
(CMS) Pioneer Accountable Care Organization (ACO) program
 Developed strategies and oversaw initiatives and project implementations that supported primary care
and specialist physician ACO program success
 Achieved entire-IPA Medicare ACO quality performance score of 91.4% for 2014 by developing,
monitoring, analyzing and tracking quality improvement and performance activities to meet and exceed
CMS standards
Joslin Diabetes Center, Boston, MA 2009 to 2014
Operations Manager, National Client Physician Practices
 Responsible for success and growth of nationwide Joslin endocrinology ambulatory practices by providing
consultation for effective care delivery systems and development of practice transformation policies and
procedures
 Collaborated with client C-suite stakeholders for buy-in of recommendations for client practice
development, maintenance and growth
 Mentored client practice management to ensure practices upheld Joslin clinical and administrative
standards
 Initiated Dayton, Ohio client practice and Joslin Boston practice transformation via NCQA’s Patient-
Centered Specialty Practice Recognition as Early Adopters of the program
 Designed individual marketing analyses and custom five-year financial models that demonstrated
potential and existing ambulatory practice client service area growth potential
 Empowered nationwide client staff in physician practice marketing techniques with training and coaching
 Ensured client practices maintained robust quality improvement and performance

2. Mount Auburn Cambridge IPA (MACIPA), Brighton, MA 2004 to 2009
Director of Quality Improvement and Systems Implementation
 Overall responsibility for all quality improvement and performance activities, initiatives, and programs to
support primary care and specialist physician quality of care initiatives
 Designed, implemented, managed and monitored custom preventive health and disease management
programs for 400+ physicians IPA-wide.
 Developed, implemented and analyzed trend data for quality programs that earned reimbursement for
primary care and specialist physicians in pay-for-performance health plan patients contracts
 Led the implementation of clinical quality, decision support and registry reporting aspects of
eClinicalWorks (eCW) EMR implementation
o Trained primary care and specialist physicians on quality and registry reporting in eCW
o Designed and implemented custom preventive health and disease management processes and
alerts within eCW to maximize contract reimbursement
 Awarded NCQA Excellence for practice management workflow redesigns due to eCW participation:
o NCQA Excellence in Diabetes Physician Recognition Program – 2004, 2007
o NCQA Excellence in Heart Stroke Physician Recognition Program – 2005, 2008 (first in MA)
 Directed, managed, and mentored staff of three
Network Health, Cambridge, MA 2003 to 2004
Manager of Quality (Medicaid)
 Designed, implemented, managed and monitored all aspects of Medicaid clinical quality program
standards as set forth by the Massachusetts Division of Medical Assistance (DMA).
 Led Medicaid clinical and operational quality disease management and preventive health programs
 Successfully passed the quality portion of the Medicaid DMA audit by overseeing HEDIS data collection
and reporting
 Improved company skills, knowledge, and documentation by developing and implementing a Project
Management Office
Tufts Health Plan, Watertown, MA 1996 to 2003
Senior Project Manager
 Design, manage, implement, and analyze multiple concurrent preventive health, hospital services and
disease management programs, projects and initiatives.
 Successfully facilitated and led multi-disciplinary project teams consisting of physicians, nurses and IT
 Modeled, analyzed, measured, and benchmarked data
 Developed, communicated, and presented recommendations for actionable process improvement strategies
to senior management
 Managed communications / customer expectations
Manager, Training and Regulatory Compliance
 Design, develop, implement, and monitor department training program to meet NCQA regulatory compliance
Senior Contract Administrator
 Negotiate, implement, manage, and maintain contracts and capitation arrangements for network Laboratory,
Organ Transplant, and Assisted Reproductive Technology service providers
 Execute financial modeling to ensure favorable financial terms for Tufts Health Plan
 Audit service providers by performing site visits and ensuring compliance with Tufts Health Plan standards
 Recommend and credential new network providers in these service lines
Education
University of Vermont, Burlington, VT B.S. Medical Technology
National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home
Certified Content Expert