MEL LAVIGNE
Houston,TX
Summary
Behavioral health leader with a background in utilization management, clinical program oversight, and multidisciplinary team supervision across inpatient, outpatient, correctional, and community settings. Leads regulatory compliance, documentation review, case management, and care coordination to support quality outcomes, patient flow, and operational consistency.
Overview
1
1
Certification
13
13
years of professional experience
Work History
Clinical Director
The Cheyenne Center
Houston, Texas
07.2026 - Current
- Ensures compliance with all state and federal regulations related to clinical services and HHSC/DSHS funding.
- Directs clinical services for Cheyenne Center addiction treatment programs.
- Reviewed client records to ensure adherence to center standards.
- Facilitated staff meetings to discuss care practices and implement policy updates.
- Supervised counselors in patient care and coordinated case management.
QMHP - Contract
Federal Bureau of Prisons (BOP)
Houston, TX
04.2025 - Current
- Conducts individual and group counseling to incarcerated clients stepping down to a lower custody level from the BOP in preparation to re-enter society.
- Provides Case Management and referral/resources
- Conducts clinical assessments
- Specializes in substance abuse, reform, recovery and personal accountability
- Creates and coordinates treatment plan
Adjunct Professor
Houston Community College
Houston, TX
01.2023 - Current
- Foster student engagement, accountability, and professional development among diverse adult learners
- Utilize structured instructional methods to support academic achievement and workforce readiness
- Developed and delivered curriculum for diverse student populations.
- Facilitated engaging discussions to enhance critical thinking skills among students.
- Collaborated with faculty to refine course materials and improve learning outcomes.
Clinical Program Manager
Virtue Recovery Center
Houston, TX
12.2025 - 07.2026
- Provides operational and clinical leadership for behavioral health treatment programs
- Monitors and checks treatment plans, clinical documentation for timely submission and thoroughness
- Supervises clinical staff and coordinates multidisciplinary care to support positive patient outcomes
- Develops and implement standard operating procedures to improve departmental functionality
- Oversees and manages departmental budgeting, reporting, resource allocation and operational planning initiatives
- Ensures adherence to evidence-based treatment models and regulatory standards
QMHP
Wilkinson County Correctional Facility
Woodville, MS
01.2025 - 12.2025
- Conducted individual and group therapy sessions
- Completed assessments including CSSR, PHQ-9, GAD, BDI, and biopsychosocial evaluations
- Supported inmate mental wellness through structured therapeutic interventions and treatment planning
- Collaborated with interdisciplinary teams to address behavioral health and crisis management needs
Director of Utilization Management
Acadia Healthcare
Valdosta, GA
07.2024 - 01.2025
- Directed utilization management operations supporting timely authorizations, and continued stay reviews.
- Managed denial recovery and appeals processes to support reimbursement optimization.
- Conducted provider peer reviews regarding therapeutic status and continued stay recommendations.
- Supervised multidisciplinary clinical teams while ensuring compliance with Joint Commission, CARF, and state regulations.
- Led quality improvement initiatives that strengthened documentation compliance and operational efficiency.
- Partnered with executive leadership to improve patient flow and optimize reimbursement.
Director of Intensive Outpatient Program (IOP)
Oceans Healthcare
Pasadena, TX
01.2023 - 07.2024
- Directed outpatient behavioral health operations including treatment planning, staffing, caseload coordination, program development, timely completion of psychosocial assessments and therapeutic services
- Managed referral processes, patient engagement initiatives, and community outreach strategies
- Conducted utilization reviews and monitored inpatient and outpatient service utilization trends
- Implemented operational improvements to reduce inefficiencies and support quality patient care delivery
Director of Utilization Management
Oceans Healthcare
Pasadena, TX
01.2021 - 07.2023
- Supervised utilization management team, ensuring adherence to regulatory standards, best practices while securing compliance with Joint Commission.
- Managed medical necessity reviews utilizing InterQual and MCG guidelines for inpatient behavioral health services
- Conducted peer reviews with providers to support continued stay authorizations and treatment necessity
- Led quality improvement and cost-reduction initiatives that enhanced operational efficiency and patient flow
- Collaborated with multidisciplinary leadership teams to improve care coordination and performance outcomes
Behavioral Health Case Management
Centene Corporation
Baton Rouge, LA
04.2018 - 11.2021
- Developed individualized care plans to address client needs and improve health outcomes.
- Coordinated multidisciplinary team meetings to enhance communication and streamline patient care.
- Monitored client progress, adjusting interventions to ensure adherence to treatment goals.
- Provided crisis intervention support, assisting clients in navigating acute behavioral health challenges.
Utilization Review Supervisor
AmeriHealth Caritas
Baton Rouge, LA
11.2015 - 03.2018
- Utilization Review - Process/submission of concurrent, pre-authorization
- Implemented process improvements to optimize care coordination workflows and reduce service delays.
- Led initiatives to educate patients on healthcare resources, improving access and engagement.
Care Worker of Utilization Review
Magellan Health
Baton Rouge, LA
09.2013 - 10.2015
- Streamlined the utilization review process for more efficient case management and improved resource allocation.
- Reduced instances of denied claims due to insufficient documentation by meticulously verifying the accuracy of all submitted materials during the utilization review process.
- Participated in external audits and surveys, providing documentation and insight to demonstrate the effectiveness of the utilization review program.
Education
Master of Clinical Mental Health Counseling -
Liberty University
Lynchburg, VA05-2027
Doctorate - Healthcare Administration
Virginia University of Lynchburg
Lynchburg, VA01-2024
Master of Addiction Counseling -
Grand Canyon University
Phoenix, AZ01-2022
Bachelor of Science - Sociology
Southern University And A&M College
Baton Rouge, LA12-2012
Skills
- Clinical Leadership
- Clinical Data Management
- Organizational and time-management
- Conflict Resolution
- Team Building
- Budget Management
- Proficient in Microsoft Office Suite and Google Docs
- Utilization Management
- Case Management
- Proficient in CMBHS, KIPU, WellSky, Notenetics, InSync, Epic, TruCare, TheraNest
- Training, orientation and mentoring
Certification
Licensed Chemical Dependency Counselor (LCDC), Certified Project Management, Certified Clinical Trauma Specialist
Timeline
Clinical Director
The Cheyenne Center
07.2026 - Current
Clinical Program Manager
Virtue Recovery Center
12.2025 - 07.2026
QMHP - Contract
Federal Bureau of Prisons (BOP)
04.2025 - Current
QMHP
Wilkinson County Correctional Facility
01.2025 - 12.2025
Director of Utilization Management
Acadia Healthcare
07.2024 - 01.2025
Adjunct Professor
Houston Community College
01.2023 - Current
Director of Intensive Outpatient Program (IOP)
Oceans Healthcare
01.2023 - 07.2024
Director of Utilization Management
Oceans Healthcare
01.2021 - 07.2023
Behavioral Health Case Management
Centene Corporation
04.2018 - 11.2021
Utilization Review Supervisor
AmeriHealth Caritas
11.2015 - 03.2018
Care Worker of Utilization Review
Magellan Health
09.2013 - 10.2015
Master of Clinical Mental Health Counseling -
Liberty University
Doctorate - Healthcare Administration
Virginia University of Lynchburg
Master of Addiction Counseling -
Grand Canyon University
Bachelor of Science - Sociology
Southern University And A&M College