Justin Musilli
McMechen,WV
Summary
Accomplished Senior Manager at UPMC Health Plan, adept in strategic planning and cross-functional collaboration. Excelled in enhancing team productivity and developing innovative case management models, saving costs while ensuring high-quality services. Skilled in operations management and partnership development, with a proven track record of fostering strong relationships and achieving significant quality measure compliance.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Senior Manager
UPMC Health Plan
06.2021 - Current
- Provided strong clinical leadership to enhance team productivity and morale across a cross-discipline team of 30 Nurses and Social Workers and 2 Supervisors.
- Developed strong relationships with Behavioral Health Managed Care Organizations and served as leader for PH/BH integration, tripling the annual goal of 1200.
- Leveraged predictive analytics and developed case management models to save cost and provide high quality services. Projected annual savings of 1.4 million
- Worked to ensure compliance with Pennsylvania Department of Human Services, CMS, and quality measures such as HEDIS, PA DHS QQRM and QICP, and NCQA.
- Designed an HIV Care Management program by partnering with ASO's across Pennsylvania.
Supervisor
UPMC Health Plan
09.2018 - 06.2021
- Oversaw daily operations of the department, supervising 13 employees, ensuring smooth workflow and timely completion of tasks.
- Applied strong leadership talents and problem-solving skills to maintain team efficiency and organize workflows.
- Increased team productivity by 40% by implementing efficient workflows and setting clear expectations for staff members.
- Demonstrated commitment to the organization's core values, leading by example and fostering a culture of excellence.
- Conducted performance evaluations for staff members, identifying areas of improvement and guiding professional development plans.
Social Worker/Health Manager
UPMC Health Plan
01.2017 - 09.2018
- Educated an average caseload of 120 members on available community resources, connecting them with essential services such as housing assistance, financial aid, or healthcare providers.
- Collaborated with multidisciplinary teams to ensure appropriate care coordination and resource allocation for clients.
- De-escalated stressful situations through individual and family crisis interventions.
- Maintained accurate case documentation, ensuring compliance with regulatory standards and facilitating informed decision-making by team members.
- Developed strong knowledge of Medical Assistance, Medicare, and Commercial health insurance products.
Therapist
Washington Communities Human Services
04.2013 - 01.2017
- Built strong rapport with clients, fostering trust and open communication for effective therapy sessions. Routinely billed for 7 patients per day.
- Maintained detailed case notes and documentation, ensuring effective tracking of progress and continuity of care across providers.
- Established clear boundaries with clients, maintaining ethical practice standards while preserving therapeutic relationship.
- Provided individual and group therapy sessions to patients suffering from mental health issues.
- Documented patient information, treatment plans, and patient responses.
Blended Case Manager
Washington Communities Human Services
11.2007 - 04.2013
- Promoted client self-sufficiency by teaching life skills and goal-setting strategies, empowering individuals to make positive changes in their lives.
- Worked with different disciplines including physicians and therapists to provide cohesive care to patients.
- Demonstrated commitment to cultural competence by adapting communication style and approach based on individual client backgrounds and preferences.
- Reduced barriers to care by advocating for clients' rights and needs within the mental health system.
- Strengthened partnerships with community organizations through regular communication and collaboration on shared goals.
Education
Master of Social Work -
West Virginia University
Morgantown, WV05.2010
Bachelor of Arts - History
West Virginia University
Morgantown, WV05.2000
Certificate - Military And Veteran's Behavioral Health
Widener University
Chester, PA05.2014
Skills
- Strategic Planning
- Cross-Functional Collaboration
- Operations Management
- Team Development
- Partnership Development
Certification
- Licensed Social Worker - PA #129220
- Licensed Graduate Social Worker - WV #BP00943795
- Certified Case Manager -#4254992
Timeline
Senior Manager
UPMC Health Plan
06.2021 - Current
Supervisor
UPMC Health Plan
09.2018 - 06.2021
Social Worker/Health Manager
UPMC Health Plan
01.2017 - 09.2018
Therapist
Washington Communities Human Services
04.2013 - 01.2017
Blended Case Manager
Washington Communities Human Services
11.2007 - 04.2013
Master of Social Work -
West Virginia University
Bachelor of Arts - History
West Virginia University
Certificate - Military And Veteran's Behavioral Health
Widener University
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