Moira Muir Email & Phone Number

Boston, Massachusetts, United States

Greater Boston Area

Provide healthcare-related expertise and advice to help organizations improve their business performance in terms of operations, profitability, management, structure, and strategy. Resolve challenges in complex clinical and delivery systems. Provide assistance to states, health plans, and foundations related to health reform implementation, Medicaid managed care and strategies to improve access to behavioral health care with subject matter expertise related to emergency services.• Develop strategies for community-based organizations that work with ACOs and MCOs to provide targeted care management and coordination• Integrate behavioral healthcare into medical and surgical settings, and primary care into behavioral health locations• Design interventions to address the social determinants of health• Promote models that ensure culturally and linguistically competent care• Devise financial and programmatic strategies and identify opportunities for business development• Develop strategies for those with co-occurring substance use disorders and serious mental illness• Enhance compliance with federal and state regulations, including parity mandates for the provision of mental health and substance use disorder services

Danvers,Ma

Key contributor to promote change management within the organization relative to accountable care. Develop and manage a Behavioral Health Community Partner program providing integrated care management services to MassHealth members as part of healthcare reform initiative. Serve as Behavioral Health Director for Lahey’s MassHealth MCO Administered Accountable Care Organization (ACO). Collaborate with Lahey leadership on MassHealth ACO quality goals and pay-for-performance initiatives. Responsible for the oversight of fiscal and administrative operations of three Emergency Service Programs (ESP) and Community Crisis Stabilization (CCS) Programs with a 14M operating budget inclusive of 150 professionals and paraprofessionals. Ensure compliance with managed care and State contracts, direct quality improvement activities and access to care initiatives for the LHBS Population Health and ESP and Divisions. A contributor to the LHBS Senior leadership in support of the strategic planning and goals.

Greater Boston Area

Ensures that the strategic and operational components of MBHP’s primary care and behavioral health network management functions support and advance the operating needs of Mass Health, corporate leadership, and all departments within MBHP. Accountable for strategic planning and oversight of MBHP operations as active member of Executive Team. Developed, managed and integrated multiple functional departments including regional network management across five regional offices; statewide specialty departments managing addictions, youth and emergency services; primary care network management and quality improvement; and rehabilitation and recovery services. Directs the development and implementation of network quality, access, care, rate, and provider performance standards policies and procedures to ensure compliance with contractual obligations and to ensure members have access to and receive appropriate levels of care through network providers. Builds, develops, and maintains a positive relationship with the Commonwealth of Massachusetts Executive Office of Health and Human Services, and with consumers, advocacy organizations, trade associations, public officials, and other stakeholders

Boston, Ma

Key contributor to the planning, organization, development, management and direction of the provider network design. Support the VP in management of regional network management staff including the Emergency Service Dept.; provide strategic planning, development, direction to ensure quality, cost effective development, implementation of core behavioral health and integrated operations for MassHealth members and providers. Serve as a key liaison with state agencies’ central office staff promoting and advancing MBHP’s goals and objectives

Boston, Ma

Plan, manage and ensure quality in a large provider network and care delivery system in the Northeast Region, including both the behavioral health network and the primary care clinician network. Implemented all aspects of the managed care program locally, including network development and management, utilization management, quality initiatives and oversight of care management. Manage activities of the regional network management staff working with both PCC and behavioral health networks, as well as care management staff.

Beverly, Ma

Contributing member of the Senior Management team responsible for operations and oversight of behavioral health services for 92 bed multi-unit facilities. Program development, strategic planning and establish positive working relationships with managed care organizations including contract and rate negotiations. Interface with emergency department medical/nursing and administrative staff to ensure efficient delivery of services and quality of care

Burlington, Ma

Managed clinical and administrative functions of Massachusetts Regional Service Center including operation of a 24 - hour clinical call center for pre-certification of hospital admissions and utilization management for HMO members. Direct administrative and clinical management of 30 mental health nurses and social workers. Coordinate all aspects of daily operations including contractual compliance, customer and provider relations, network development and adherence to government regulatory guidelines.

Beverly, Ma

Assisted in the development and management of hospital based after-hours emergency psychiatric services.. Managed daytime and after hours emergency psychiatric service program for community mental health center. Coordinated intake services for community mental health center, development of policies and procedures including CQI.

Lynn, Ma

Clinical evaluation including psychosocial assessment, diagnosis and referral of diverse population. Crisis intervention and referral for children, adolescents and adults with substance abuse, eating disorders, acute stress reactions and trauma in emergency room setting.

Masters Of Science (M.S.), Psychology

Bachelor Of Arts (B.A.), Psychology