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Overview of the Department of Managed Health Care and Help Center

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Description

Mary Watanabe, Deputy Director, Health Policy and Stakeholder Relations, with the California Department of Managed Health Care (DMHC) will provide an overview of DMHC, the government agency dedicated to regulating 121 plans and protecting the health care rights of over 25 million consumers. The webinar will focus on the DMHC Help Center, which has helped more than 1.7 Californians understand their health care rights and to resolve complaints with their health plans. The webinar will include information on the following:

  • Overview of the Independent Medical Review (IMR) and Complaint Process and how to submit the form to the DMHC Help Center.
  • Tips and best practices for assisting a client with access, coverage or billing issues, including denials of physical therapy services
  • The importance of the IMR and Complaint process in informing policy, legislative and regulatory actions.
  • Overview of DMHC’s Provider Complaint Unit and Provider Complaint process.

Contributors

  • Mary Watanabe,Deputy Director of Health Policy and Stakeholder Relations, DMHC

    Mary Watanabe is the Deputy Director of Health Policy and Stakeholder Relations at the Department of Managed Health Care (DMHC), where she is responsible for fostering proactive and effective relations between the DMHC and its stakeholders, while serving as primary advisor to the Director on critical issues and providing strategic planning and policy direction on emerging issues and industry trends.

    Prior to her appointment at the DMHC, Mary served as Deputy Director for the Sales Division at Covered California, where she oversaw the implementation of the Navigator Grant Program, Outreach and Education Grant Program and the engagement of community organizations to educate consumers and small business owners about the health care options available through Covered California.

    Prior to joining Covered California, Mary served for 12 years with the Managed Risk Medical Insurance Board (MRMIB) in the areas of contract development, eligibility and enrollment, and benefits administration and quality monitoring of several public health care programs, including the Healthy Families Program. She also participated in the implementation of the Pre-Existing Condition Insurance Plan (PCIP), a federally funded high-risk pool that offered health coverage to medically uninsurable Californians.

    She holds a bachelor’s degree in Psychology from California State University, Sacramento