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DETROIT WAYNE MENTAL HEALTH AUTHORITY

Managed Care Operations (MCO)

Lorraine.jpgThe Managed Care Operations (MCO) Unit is led by Lorraine Taylor-Muhammad, MBA, LMSW.  She has over twenty-five years of experience in the mental health, and substance abuse field.  She worked for many years in direct service, and in managed care organizations.  Under her direction, Contract Management, Claims Processing and Business Operations are administered. Ms. Taylor-Muhammad has a strong belief that all contractors are held to a high standard to ensure that all individuals receive quality services in a cost effective manner.  The MCO team is comprised of a strong and effective contract management staff including a dynamic Claims Supervisor, Tracey Lee, Claims Adjudicator..

About MCO...
 

The Managed Care Operations Unit is responsible for developing, maintaining and continually evaluating a provider network to ensure adequacy to provide quality services to individuals within the Detroit Wayne system and to provide oversight for contracts as it relates to performance, outcomes and regulatory compliance.  

In addition to maintaining the network, MCO ensures capacity at all levels of care including inpatient, outpatient, crisis residential, ACT, and intensive crisis stabilization.

This unit has on-going communication and facilitates education of the provider network including changes in policies and procedures, and new provider orientation.

Additional responsibilities include impaneling of all providers in the Detroit Wayne service delivery system, oversight of the Managers of Comprehensive Provider Networks (MCPN), Access Center, COPE (Community Outreach for Psychiatric Emergencies), Department of Health and Human Services (DHhS) Outstation, and numerous specialty program contracts, and claims processing.

As Key Authority contact persons, Contract Managers ensure coordination and continuity in contractual interpretations, direction, technical support, monitoring and management of these contracts.

(To learn about Claims Processing and Impaneling, click on one of the buttons on the top right of this page)

2017 Upcoming Events

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(Click HERE or on the Flyer for full view and parking instructions)

   

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