Melissa Moody
South Lyon,MI
Summary
Dynamic leader with extensive experience in clinical operations management at Detroit Wayne Integrated Health Network. Proven track record in utilizing population health analytics to enhance quality improvement and achieve significant cost savings. Highly proficient in business development and strategic planning, fostering operational efficiency while cultivating strong partnerships across diverse stakeholders.
Overview
13
13
years of professional experience
1
1
Certification
Work History
VP of Clinical Operations
Detroit Wayne Integrated Health Network
Detroit, MI
08.2020 - Current
- Provided leadership and oversight for clinical operations and programs as a Pre-Paid Inpatient Health Plan in Detroit/Wayne County, serving over 120,000 members.
- Utilized population health data to identify high-risk individuals and populations, achieving cost savings and improved quality of care through targeted interventions.
- Employed HEDIS measures to evaluate program effectiveness, resulting in reduced hospitalizations and increased medication adherence.
- Facilitated provider network collaborations to enhance engagement and reduce administrative burdens.
- Implemented policies and procedures for quality treatment aligned with NCQA standards.
- Collaborated with executive team members on major decisions regarding company-wide initiatives.
- Reviewed reports from functional areas to assess progress towards organizational goals.
- Coordinated major project initiatives from planning through to execution, ensuring timely completion.
- reviewed and approved budgets for program initiatives.
- Ensured compliance with applicable laws and regulations regarding operations activities.
- Oversaw operations across multiple departments, ensuring alignment with strategic objectives.
- Established policies that promote company culture and vision through proper communication channels.
- Served as an escalation point for customers who had unresolved issues or complaints about products or services provided by the organization.
- Managed all contracts for the substance-use disorder network.
Vice President of Programs
Neighborhood Service Organization
Detroit, MI
01.2019 - 08.2020
- Managed administrative, clinical, and programmatic functions across multiple locations for I/DD and SMI populations.
- Negotiated contracts with subcontracted providers and funding sources to secure optimal funding models.
- Implemented local, state, and federal grants to enhance program delivery and compliance.
- Executed strategic planning initiatives utilizing scorecards to track performance metrics.
- Assessed quality trends and trained staff to drive continuous improvement.
- Ensured that all staff members had the necessary training and tools to perform their job duties effectively.
- Cultivated relationships with external partners, including government agencies, private sector companies, and non-profits.
- Managed budgets for multiple programs, ensuring cost-effectiveness while meeting project requirements.
- Developed strategies for expanding services.
- Created processes to ensure compliance with applicable laws, regulations, policies and procedures.
- Analyzed data from past initiatives to identify areas for improvement in future projects.
Director of Specialty Behavioral Health
Easter Seals Michigan
Southfield, MI
04.2012 - 12.2018
- Oversaw 150+ staff across four programs, including family and adult services, senior reach services, and outpatient insurance programs.
- Managed a $23 million budget, creating efficiencies that reduced costs while enhancing outcomes.
- Developed an integrated care model with Oakland Integrated Health Network, Great Lakes Laboratory, and Genoa Healthcare.
- Coordinated high-risk cases with Molina Healthcare and United Healthcare to improve quality outcomes and HEDIS measures.
- Collaborated closely with Medical Director to enhance processes for individual care and compliance with MIPs and Meaningful Use.
- Ensured service delivery met medical necessity, fund source rules, Medicaid guidelines, and Mental Health Code standards.
- Evaluated program benchmarks and established key performance indicators to drive performance improvements.
- Coordinated multidisciplinary teams to enhance integrated healthcare coordination.
Education
Masters of Business Administration - Master of Business Administration
Ottawa University
05.2008
Master’s Certificate - Gerontology
Eastern Michigan University
Ypsilanti, Mi.01.1995
Master of Science - Clinical-Behavioral Psychology
Eastern Michigan University
Ypsilanti, Mi.01.1994
Skills
- Clinical operations management
- Population health analytics
- Quality improvement
- Budget management
- Strategic planning
- Contract negotiation
- Data analysis
- Operational efficiency
Certification
Limited Licensed Psychologist, Michigan
Training and Certifications
- Effective Management Practices
- Co-Occurring & Stage wise substance use treatment
- Motivational Interviewing
- DiSC Trainer
- NiaTx Process Improvement
- Six Sigma Certified
References
References available upon request.
Timeline
VP of Clinical Operations
Detroit Wayne Integrated Health Network
08.2020 - Current
Vice President of Programs
Neighborhood Service Organization
01.2019 - 08.2020
Director of Specialty Behavioral Health
Easter Seals Michigan
04.2012 - 12.2018
Masters of Business Administration - Master of Business Administration
Ottawa University
Master’s Certificate - Gerontology
Eastern Michigan University
Master of Science - Clinical-Behavioral Psychology
Eastern Michigan University
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