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As regulatory shifts, such as HR1, increase the proportion of members with behavioral health conditions, plans face rising pressures that must be managed to maintain financial sustainability. In response, Magellan Health delivers clinical programs, data-driven oversight, and operational support—including utilization management, provider engagement, care coordination support, fraud, waste, and abuse review, claims auditing, and reporting and analytics—to help plans manage costs, maintain compliance, and improve outcomes. Magellan’s approach combines national provider access, community-based partnerships, and practical operational capabilities with flexible, plan-centric models that emphasize collaboration, clinical quality, and evidence-based outcomes.

Magellan is a clinician-led behavioral health organization that supports health plans, employers, government agencies, and other partners with behavioral health and related operational services. For Medicaid, dual-eligible, and Marketplace plans, Magellan provides behavioral health services, employee assistance programs, counseling, autism/ABA services, and cost-of-care management. These services support populations with complex needs, including serious mental illness, substance use disorder, and co-occurring physical and behavioral health conditions. Managing these vulnerable cohorts requires specialized insight, and Magellan’s national provider access, community-based partnerships, and operational capabilities—such as claims, correspondence, and encounter management—help navigate today’s volatile healthcare landscape and effectively improve outcomes for complex members.

Contact:
Caroline Carney, MD
CEO
800.788.4005
ccarney@magellanhealth.com

13500 Riverport Drive, Suite 110
Maryland Heights, MO 63043
www.magellanhealth.com