Michelle Duchamp Vanhooser Email & Phone Number

Conroe, TX, US

Indianapolis, Indiana, US

Account leadership and oversight of external entities within the 'West' Region for Carelon Behavioral Health.

Indianapolis, Indiana, US

• Apply behavioral health (BH) subject matter expertise to analyze Medicaid state contracts and create response strategies for requests for proposals, qualifications, and information at managed care organization. Define.
• Reviewed and aligned all contracts to fulfill any new clinical requirements in each state, collaboratively building new processes that incorporate best practices into service offerings to develop more competitive.
• Built relationships with BH entities and connected these partners with health plans in different states to deliver innovative support and technologies that fill health plan service gaps, increase patient access to.

Indianapolis, Indiana, US

• Serves as a thought leader regarding improvements of end to end processes enterprise wide, with integration points in key business areas, Operations, Finance, Actuary and IT. Leads initiatives from assessment through.
• Partnered with CMO and CEO to establish BH governance structure in health plans across multiple states for government business division of Elevance Health (formerly Anthem). Traveled to interface with health plan.
• Created governance model documents and framework to review trends and BH spending for each market, implement best practices, and build standard operating procedures. Led national teams remotely and consulted with local.
• Aligned with company transition from centralized team management to localized oversight of health plan operations as Anthem pursued Managed Behavioral Healthcare Organizations (MBHO) accreditation from National.
• Established Medicaid trend work groups and meeting cadence to support MBHO accreditation efforts.

Indianapolis, Indiana, US

• Oversaw national Medicaid and Medicare utilization management teams reviewing prior authorizations and current requests, mitigating facility complaints and claims issues as hands-on leader of company’s entire market of.
• Implemented and managed health care management, utilization, cost, and quality objectives. Ensures program compliance and identifies opportunities to improve the customer service and quality outcomes
• Strategized with CEO to develop new staffing model from scratch, assessing case volume and time spent on each case to ensure appropriate resource allocation.
• Developed standardized process and comprehensive team coverage schedule for responding to crisis calls, defining steps of action, documentation, and follow-up procedures to ensure consistent and equitable responses.

US

• Management of After Hours Intake, call center providing clinical assessment and triage for behavioral health admissions for nationwide membership. Participated in Clinical Model Implementation and development of the.
• Ensured seamless communication and customer experience on both day and night shift to maintain trusting relationships with providers and members by creating training for after-hours team members.
• Initiated and developed IEX system, a workforce management system, for After Hours Care Advocates
• Created site grid reference tool to drive company-wide compliance by compiling multi-state health plan requirements into 1 location for reference during national calls from different lines of business.

Houston, Texas, US

Neurobehavioral programming - behavioral stabilization and assessments - treatment planning - mid management. Conduct behavioral assessments of resident’s, develop and implement individual behavior protocols based on their needs and patterns. Monitor and supervise therapeutic staff for effectiveness, accuracy of completion of behavior protocols. Liaison.

Med, Counseling And Development

Bs, Psychology