Mary Lou Morales
Healthcare executive with expertise in Behavioral Health operations in inpatient and outpatient settings.
About
Education
University of Southern California
Masters, Social Work / August, 2021
Webster University
Masters, Health Administration / December, 2012
Park University
Bachelors, Social Psychology / December, 2009
Experience
Hospice of El Paso
Chief Administrative Officer / March, 2023 — Present
Maximon Behavioral Health
Chief Operating Officer / February, 2021 — February, 2023
As member of the leadership team, work closely with the team to ensure performance expectations are met across the company. Coach and develop the team to ensure they are delivering against key business metrics. Look for methods to improve quality, efficiency and productivity, reduce costs, increase profits, or improve control measures. Work collaboratively to develop and/or improve systems, processes, and procedures that improve the overall efficiency to ensure excellent client service. Provide timely, accurate and complete reports. Lead and develop a team across multiple locations and over various functions. Motivate and lead a high-performance team. Attract, recruit, and retain required members of the team. Provide mentoring as needed. Collaborates with the management team to develop and implement plans for the operational infrastructure of systems, processes, and personnel design to accommodate the rapid growth objectives of our organization. Demonstrate a willingness to take on new tasks with a general attitude that no task is too small, impossible, or cannot be improved. Work autonomously while ensuring CEO expectations are readily met and exceeded. Foster a success-oriented, accountable environment within the company.
Acadia Healthcare
CEO in training / August, 2019 — November, 2020
Work with all hospital departments to increase productivity, teamwork, and communication. Collaborated with the Governing Body in the development of facility-specific annual operating capital budgets and strategic business plans. Work closely with the Hospital Medical Director. Assist in the management of day-to day operations and staff so that the facility achieved its goals with patient care outcomes, fiscal management, accreditation and regulatory requirements. Organize day-to-day management and operations of the facility through delegation and alignment of responsibilities to meet the facility's patient care and business objectives. Create and maintain a network of local government agencies, local businesses, affiliate health providers in the community. Appraise leadership team performance, both of individual members and the team as a whole, assess competencies, and provides coaching/corrective action as appropriate. Ensure participation of staff in facility/program wide in- service and continuing education programs. Participate in the recruitment of allied health professionals and psychiatrists to increase the scope of service offerings at the facility. Effectively manage and direct contract negotiations and contract compliance with the commercial payer community to include rate negotiations and services offered. Oversee contract relationships to include regular reporting on contract performance as well as new revenue generation and growth. Lead development of continuum of care to include comprehensive outpatient services and community-based programs. Ensure an effective survey readiness plan was active at all times to include a comprehensive auditing plan, corrective actions to address noncompliant areas, and preventative actions to maintain continuous accreditation and regulatory compliance.
El Paso Behavioral Health System
Director of Utilization Review/ Admissions / February, 2009 — August, 2019
Direct request for services process for the hospital, including the initial response, the assessment and referral process, the designation of appropriate level of care, initiating of services, and follow up activity. Review the effectiveness and comprehensiveness of the interface with external reviewers, communicate with external reviewers and managed care organizations to assure timely and appropriate interactions, monitor outcomes of reviews and provide consultation as needed. Review the quality of documentation provided at all levels of care to assure adequacy and clinical appropriateness. Assure patients were receiving effective and appropriate treatment based on the level of care. Maintain awareness of mental health activities in the community. Participate in clinical treatment team and evaluation of services offered at the facility. Remain current on all clinical techniques and provide direction to staff and facility personnel. Consult with facility management in the development and facilitation of program activities, which assured an optimal therapeutic experience for all patients. Participate with ensuring that individual patients and their families were involved in the development of individualized treatment plans. Maintain an active involvement and awareness of all patient admissions, discharges, and transfers. Meet regularly with treatment teams to ensure compliance with program goals and objectives. Develop and maintain a system to minimize and address denials and consult with the facility Business Office Manager and CFO on a weekly basis. Assure adequate orientation for new employees of the Case Management Department. Create a structure that best meets the needs of the organization, particularly department organization related to supervision and assignment of staff. Routinely review job assignments and utilization of staff. Conduct department meetings on a regular basis. Work with clinical leadership to ensure interdisciplinary treatment planning was organized with participation of all appropriate clinical disciplines. Ensure all patient, families, and referral complaints are promptly handled. Ensure the department meets Joint Commission, Medicare, and Federal and State regulatory requirements. Develop and implement a Performance Improvement tracking system, evaluated the results monthly, and report results to the Performance Improvement Committee in a timely manner. Ensure that all deficiencies identified through the performance improvement analysis were addressed with appropriate problem-solving actions. Review all department risk management occurrences and ensure that reports are submitted to Risk Management timely. Analyze statistical data to include Length of Stay and respond to trends accordingly. Responsible for the implementation and supervision of the discharge planning. Work with the treatment team regarding the Continuum of Care. Plan and collaborate with the team when changes are needed. Ensure that patients attend the appropriate level of care or program as indicated on the treatment plan or as needed when there are changes in patients’ status. Maintain necessary documentation of all services and the quality of care. Assure proper tracking of all reviews. Initiate and update the denial log statistics on an ongoing basis maintaining current information at all times, and initiate appeals through telephone or written communication until determination of outcome is reached.
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