Billie McCaulley

Successfully led a team of 15 licensed Case Managers (BH and RN) in assisting members in meeting their health care goals and improving health outcomes. Responsible for ensuring condition specific assessments, care plans, care plan reviews and coordination of care are completed accurately, timely and per contractual requirements. Responsible for training and managing a team of BH clinicians to respond to member crisis calls and outreaching mobile crisis unit or local law enforcement if safety is at risk. Responsible for ensuring the case management team is compliant with policies, code of conduct, applicable federal and state laws and regulations

Efficiently managed teams of clinical and admin staff in the After Hours and Higher Level of Care Precert departments as well as Member Crisis Queue. Responsible for ensuring Precert team is compliant with CVS policies, code of conduct, applicable federal and state laws and regulations. Guided a team that consistently met member needs, phone metrics, compliance audits, and training requirements.

Completed inpatient behavioral health pre-certifications and member crisis calls, collaborated with Medical Directors to ensure member’s clinical needs and MNC were met. Effectively trained and supervised new Care Managers. Performed monthly chart audits of peers to ensure quality and accuracy. Participated in Staff Cheer Committee to support peers, celebrate milestones and build team cohesiveness.