Provider Resources
Managed Care
Operations
DWIHN Managed Care Operations coordinates the clinical, quality, compliance, and residential functions that ensure every provider in our network delivers high-quality, person-centered care to Wayne County residents.
Coordinating quality care across Wayne County's behavioral health network.
About the Department
Coordinating Quality Across the Network
The Managed Care Operations (MCO) department at DWIHN is responsible for overseeing the clinical programs, quality improvement initiatives, compliance activities, and residential services that support our provider network and the members they serve.
MCO works in close partnership with providers, members, and state agencies to ensure that care is delivered in accordance with MDHHS contracts, NCQA standards, and DWIHN's commitment to ethical, person-centered service.
- Prior authorization and service review coordination
- Quality performance monitoring and accreditation
- Regulatory compliance and fraud prevention
- Residential services standardization and oversight
- Provider credentialing, contracts, and policy resources
Our Departments
Four Areas of Managed Care
Each department within Managed Care Operations plays a distinct role in delivering accountable, high-quality behavioral health services to Wayne County residents.
Utilization Management & Claims
The Utilization Management team oversees clinical programs and service delivery for individuals in Wayne County with mental health and developmental needs. They ensure quality care through policy development, benefit coordination, service review, and more.
Learn MoreQuality Improvement
The Quality Improvement team ensures DWIHN's provider network delivers high-quality, effective care. They oversee performance, compliance, and accreditation, develop annual improvement plans aligned with MDHHS and NCQA, and partner with providers to enhance outcomes and services.
Learn MoreCompliance
The Compliance Office ensures DWIHN delivers ethical, high-quality services that meet state and federal standards. Guided by the motto "Do the Right Thing," the team promotes integrity, provides required compliance training, and upholds safeguards against fraud, waste, and abuse.
Learn MoreResidential Services
The Residential Services department oversees and standardizes care for members receiving Community Living Support and Personal Care Services. The team sets benchmarks, manages provider processes, coordinates facility transitions, and ensures consistent, high-quality support for over 3,000 members.
Learn MoreFor Providers
Provider Support Services
DWIHN insures that members have choice, opportunities, access to services and valuable resources. Provider support services include contracting, credentialing, and policy resources to help you deliver the best care.
Questions About MCO?
Our Managed Care Operations team is here to support you. Contact us for questions about prior authorizations, quality standards, compliance, or residential services.