Mike Halsey
Oakland Township,MI
Summary
Dynamic healthcare leader with a proven track record at SAGILITY, excelling in strategic leadership and clinical operations. Spearheaded program development, enhancing member engagement by over 400%. Expert in utilization management and cross-functional collaboration, driving quality improvement initiatives and fostering high-performing teams to achieve operational excellence.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Associate Director of Clinical Operations
SAGILITY
06.2024 - Current
- Lead multidisciplinary clinical and non-clinical teams-including Enrollment Specialists, Customer Service Agents, Care Managers, RNs, LPNs, Licensed Therapists, and Therapy Assistants-across multiple lines of business, including Utilization Management (Inpatient, PAC, Home Health), Aging in Place, Social Determinants of Health, Medication Adherence, Care Management, and Clinical Coaching.
- Built and led high-performing teams, improving Clinical Operations NPS from -80 to 0 within six months through targeted coaching, workflow redesign, quality redesign and oversight, and performance management.
- Conducted comprehensive workflow analyses to eliminate operational barriers and implemented data-driven strategies, increasing member engagement from 1.6% to 7.25%.
- Automated manual tracking and reporting systems, increasing team productivity by 18 cases per day and reducing reporting time by 8 hours daily.
- Spearheaded program development from statement of work (SOW) through launch and steady-state operations, ensuring SLA adherence and operational readiness.
- Served as a client-facing leader for program implementations, quarterly business reviews (QBRs), and strategic planning sessions.
- Partnered with SVPs, directors, and cross-functional stakeholders to deliver insights that led to informed planning, quality improvement, compliance oversight, budgeting, and operational enhancements, resulting in new line-of-business launches.
- Collaborated with Clinical Practice and Technology teams to assess operational feasibility, drive innovation, and identify cost-saving opportunities.
- Proactively forecasted and mitigated SLA risks, consistently meeting or exceeding performance targets while protecting P&L outcomes and avoiding financial penalties.
Associate Director, Medical & Clinical Operations
OPTUM - Home & Community Care
04.2019 - 05.2024
- Oversaw utilization management and value-based care operations for IRF, LTAC, and SNF programs, leading teams of 40+ clinical and non-clinical staff across multiple states.
- Ensured compliance with regulatory standards while driving operational excellence, quality outcomes, and client satisfaction.
- Successfully launched multiple health plans, including the organization's largest (700K+ lives), contributing to significant revenue growth and market expansion.
- Maintained 93% employee satisfaction and 91% client satisfaction through strong leadership, engagement strategies, and relationship management.
- Reduced client escalations by 80% and increased member satisfaction by 12% through targeted operational improvements and proactive issue resolution.
- Streamlined workflows and procedures to improve efficiency, quality, and turnaround times.
- Automated client reporting tools, reducing delivery timelines from three business days to under 30 minutes.
- Led and presented executive-level client meetings, including QBRs and Joint Operating Committee (JOC) sessions.
Director of Rehabilitation
SELECT REHABILITATION
, Michigan
08.2013 - 04.2019
- Directed clinical operations and rehabilitation program implementation across multiple skilled nursing facilities.
- Managed and developed 50+ interdisciplinary staff, ensuring regulatory compliance, quality outcomes, and operational consistency.
- Designed and launched clinical programs that improved patient outcomes and enhanced financial performance.
- Implemented data-driven scheduling and staffing strategies, increasing productivity by 15%.
- Partnered with ACOs, physicians, and interdisciplinary care teams to improve discharge timeliness and care coordination.
- Established strong relationships with community-based organizations and referral partners.
Education
Master of Science - Health Services Administration
Central Michigan University
Mt. Pleasant, MIBachelor of Science - Occupational Therapy
Western Michigan University
Kalamazoo, MISkills
- Strategic leadership
- Clinical and operational oversight
- Utilization management
- Program development and implementation
- Change management
- Care management and coordination
- Coaching and talent development
- Regulatory compliance
- Quality improvement initiatives
- Performance metrics and KPIs
- Client relations and retention
- Cross-functional collaboration
- Project management
- P&L management
- Data analysis and reporting
- Workflow optimization strategies
- Value-based care practices
- InterQual expertise
- NCQA standards adherence
Certification
- NBCOT Certification
- Licensed Occupational Therapist, Michigan
Timeline
Associate Director of Clinical Operations
SAGILITY
06.2024 - Current
Associate Director, Medical & Clinical Operations
OPTUM - Home & Community Care
04.2019 - 05.2024
Director of Rehabilitation
SELECT REHABILITATION
08.2013 - 04.2019
Master of Science - Health Services Administration
Central Michigan University
Bachelor of Science - Occupational Therapy
Western Michigan University