Lesley Malus Reed, MHSA, President
Lesley Malus Reed, MHSA, President of Integral Healthcare Solutions, has audited and helped to restructure over 100 PPOs and HMOs and 50 other health care entities. Her operations focus is in the areas of quality improvement, network management, credentialing, customer service, and information systems. She is one of the nation’s leading experts in provider credentialing and has extensive experience in restructuring and organizing departments.
In the midst of working in the Canadian Health Care system, she attained an MHSA in the United States with a specialty in hospital mergers. She played a key role in the merger of the first department of McGill’s five teaching hospitals. Ms. Malus Reed returned to the United States and worked for Aetna of the Mid-Atlantic in operations, working in information systems with an emphasis on statistical data tracking and trending. Ms. Malus Reed continued her tenure with Aetna in operations as a network manager in contracting, quality management and credentialing. In running the credentialing department, she helped to establish a national Credentialing Verification Unit.
Ms. Malus Reed then moved from Aetna to URAC, one of the “Big Three” managed care accreditation organizations. As Manager of URAC's HMO, PPO, Credentials Verification Organization and Worker’s Compensation Network accreditation programs, Ms. Malus Reed helped to create and lead implementation of the standards. She conducted numerous workshops to assist applicants prepare for accreditation. While at URAC, Ms. Malus Reed also participated in a number of government relations projects with both federal and state policymakers. Ms. Malus Reed has also held a position as Director of Marketing for URAC with responsibilities that included re-branding, campaign outreach and began a sponsorship program. Subsequently, Ms. Malus Reed moved to ADP Medical Claims Services to start a quality assurance program for its Maryland and Florida locations.. In addition to preparing ADP’s URAC accreditation application, her primary functions were to assess operation workflows, institute quality controls to promote consistency in clinical decisions, and to meet client and regulatory requirements.
- Accreditation Preparation (URAC, NCQA)
- Strategic planning
- Contracting/Network Management
- Practitioner Credentialing
- Quality Improvement
- Mergers
- Corporate Restructuring
- Information Systems
- Worker’s Compensation
- Policy Analysis