Danielle E. Laurange
Rochester
Summary
Dynamic Senior Clinical Director with extensive experience in clinical oversight and stakeholder collaboration at Excellus Blue Cross Blue Shield. Proven expertise in driving quality improvement initiatives and ensuring regulatory compliance, utilizing data analysis and program development to enhance healthcare delivery. Committed to fostering integrated care solutions that promote community engagement and improved patient outcomes.
Overview
26
26
years of professional experience
Work History
Senior Clinical Director, Healthcare Engagement
Excellus Blue Cross Blue Shield/Centene Corporation
02.2016 - Current
- Clinical oversight of an integrated team of ~ 270 RNs, Licensed Behavioral Health Clinicians, Compliance and non-clinical support staff
- Primary lead on the implementation of NYS requirements including the Children’s Transition to Managed Care for physical health, foster care and behavioral health clinical teams for CM, UM and Compliance
- Ensure compliance with all key performance indicators and service level agreements regulated by both State and Federal guidelines
- Collaborate with corporate-wide leadership on Health Care Improvement multi-year strategy development, implementation, and evaluation
- Oversee all activities which relate to specific medical and behavioral health service utilization and case management clinical and quality programs
- Evaluate and recommend opportunities to advance integrated processes and programs across clinical and operational teams
- Lead ongoing cost-benefit/quality evaluation of present and future clinical management program needs, staffing models, industry trends, and program advancement
- Create and implement quality improvement activities to maintain compliance with HEDIS, QARR, CAHPS and NCQA measures
- Work with community organizations and regulatory agencies (OMH, OASAS, DOH, DFS, NCQA) to coordinate multi-prong interventions across members, providers, and the community at large to best service the health of populations across all lines of business
- Present to and collaborate with stakeholders, Board of Directors, participating providers and community-based organizations
- Development and oversight of all compliance related activities including internal and external audits of programming and outcomes
- Lead business owner for technological enhancement opportunities for internal and external stakeholders working with potential vendors and reviewing requests for proposals and contracting elements
Clinical Supervisor
Rochester Regional Health
12.2013 - 01.2016
- Supervised licensed behavioral health therapists working with complex and co-occurring disorders
- Trained staff in new policies, procedures and regulatory requirements
- Compiled data and generated reports requested by funders
- Participated in a multi-interdisciplinary treatment team to develop appropriate interventions and recommendations
- Coordinated care with community resources and case management agencies
- Corporate liaison working with both Chemical Dependency and Mental Health management and staff to create an integrative care model
Quality Program Manager, Learning and Performance
Excellus Blue Cross Blue Shield
10.1999 - 03.2013
- Identify and trend specific areas for improvement in order to increase quality performance
- Work closely with internal stakeholders in Customer Service, Claims and Membership and Billing to review and implement new processes and procedures
- Act as liaison between Customer Service and Corporate Audit in relation to all MTM and PGG errors
- Gather data, reports, and present findings for complaints to the NCQA committee
- Strategically create an operating plan that meets the training and development needs of the operating departments
- Analyze the training process to identify training needs or process improvements to provide operations with effective training programs
- Oversight of the Training Improvement and Analytic team responsible for all Training and Compliance reporting by implementing new databases, innovative ideas and analytical procedures
Education
Master’s Degree - Mental Health Counseling
St. John Fisher College
Bachelor’s degree - Criminal Justice Administration and Psychology
Columbia College
Executive Leadership Certificate -
Cornell University
Skills
- Licensed Mental Health Counselor
- National Board-Certified Counselor
- Clinical oversight
- Stakeholder collaboration
- Quality improvement
- Regulatory compliance
- Data analysis
- Cost-benefit analysis
- Technology implementation
- Program development
- Community engagement
Skills Special Training
- Licensed Mental Health Counselor, License # 9043851
- National Certified Counselor, License # 669982
- Diversity curriculum development and trainer
- Certified from AHIP (America’s Health Insurance Plans) in Customer Service Strategies of the Insurance Education Program
- Lean Six Sigma Yellow Belt
Timeline
Senior Clinical Director, Healthcare Engagement
Excellus Blue Cross Blue Shield/Centene Corporation
02.2016 - Current
Clinical Supervisor
Rochester Regional Health
12.2013 - 01.2016
Quality Program Manager, Learning and Performance
Excellus Blue Cross Blue Shield
10.1999 - 03.2013
Master’s Degree - Mental Health Counseling
St. John Fisher College
Bachelor’s degree - Criminal Justice Administration and Psychology
Columbia College
Executive Leadership Certificate -
Cornell University
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