Caroline Carney

Currently working with a talented team to build differentiated, industry-leading clinical programs and services that strive to lead humanity to healthy, vibrant lives. In this role, she is broadly responsible for supporting MagellanRx in developing differentiated, industry‐leading clinical pharmacy programs and services, and for leading the division’s clinical mission, vision and product innovation. Dr. Carney also served as chief medical officer for Magellan Complete Care of Arizona, where she led Magellan’s behavioral health and medical initiatives and programs serving the Arizona Health Care Cost Containment System (Medicaid).

Oversight of clinical team providing behavioral health services in a federally qualified health center in rural Indiana. The team provides medication management and therapy services across adult and child & adolescent populations, including SMI, SED, and SUD.

Responsible for supporting Magellan in developing and supporting the clinical mission, vision, products and strategies—both behavioral and specialty. Current duties include strategic development of behavioral health and medical programs and products, such as opioids and chronic pain endeavors, oversight of medical director quality and performance, and data analytic design and interpretation with clinical translation for clinical, quality, VBP, workflow, and other outcomes. I oversee the national policy and clinical guidelines team that is responsible for creating and maintaining Magellan's proprietary guidelines. I am forward facing with sales and account executive teams. Closely working with Magellan's government affairs teams, I influence Magellan and public policy for opioids, utilization management, parity, and pharmacy. I work closely with our innovations team in creating programs that incorporate the use of digital technologies into clinical care.

Led development of Tenet Health Plans in AZ, TX, MI. Oversaw all clinical areas, including case management, quality improvement, disease management, and utilization management. Covered populations included Medicaid, Duals, Medicare Advantage, and Exchange. Oversaw pharmacy program, psychopharmacology quality interventions, and led teams working on 5-star and HEDIS initiatives.

Chief Medical Officer for managed care health plan and delivery system model serving Indiana's Medicaid program including Hoosier Healthwise, Healthy Indiana Plan (HIP), and Care Select. Served the Healthcare Marketplace. CMO role oversaw quality, case management, disease management, utilization management, policy development, public facing roles, leadership in accreditation activities (NCQA), and interaction with state government officials.Oversaw pharmacy program, including selection of PBM, psychopharmacology quality interventions, and led teams working on HEDIS initiatives.

Directed Healthcare outcomes, evaluation, research, and quality; liaison to other agencies including mental health, aging, and development disability; designed and implemented state’s mental health transformation with mental health division; created and implemented value-based performance program for MCE’s; redesigned medical review team for disability determinations, redesigned approach to traumatic brain injury.

Award winning clinician, researcher and educator for Departments of Internal Medicine and Psychiatry, grant-funded researcher (how much??) at the interface of behavioral health and physical health delivery of services; developed and implemented psychosocial oncology program, including administrative and clinical services.

Reported to CMO to serve in medical policy, accreditation, credentialing, quality, and special products for 1.5 million lives.

Clinical and research award winning clinician, educator, and researcher; directed Medical Psychiatry residency program, co-director of innovative inpatient med/psych unit, consultation liaison psychiatrist; course director for school of public health’s psychiatric epidemiology program; faculty senate.