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Crystal Cauthen Recognized for Quick Contract Work

Cardinal Innovations Healthcare — julio 26, 2019 — 4 min de lectura

When Crystal Cauthen needs to turnaround a contract quickly, she imagines the member it affects and gets it done as soon and as efficiently as possible, she says.

“I have a duty to ensure that we facilitate this quick turnaround so that our members are not without needed services. No member should spend one additional night in a hospital due to an unreasonable contracting delay," said Cauthen, Network Contracts Manager for Cardinal Innovations Healthcare. “We must be ready at all times to react to these requests."

Cauthen oversees three contract coordinators, one senior contract coordinator and a project support professional. Her team works to meet all critical deadlines and enforce Division of Medical Assistance (DMA), National Committee for Quality Assurance (NCQA), Home and Community Based Services (HCBS), and statutory requirements when contracting with new providers or amending existing contracts.

“We have to ensure that our providers are properly qualified, insured, licensed, competent, accountable, ethical and able to ensure the health and safety of our members before they enter our network," she said.

Cauthen is currently working on various projects to verify and correct data in Cardinal Innovations CI database. She also is developing a workflow and forms for new software and is working on a Lean Six Sigma (LSS) initiative to improve efficiencies and provider experience within the contracting process. (LSS is a team effort to improve performance by systematically removing waste and reducing variation.) 

Jennifer Johnson, Compliance Manager in Cardinal Innovations' Network Management Department, has worked closely with Cauthen and said she deserves to be recognized for going above and beyond in everything she does at work.

“Crystal worked for me as a Contract Coordinator when I was Contract Manager," Johnson said. “I work with Crystal in connection with certain contract compliance issues, as well as, currently, in relation to the contracting of block grant deliverables. She is quietly a whiz at her work and at helping contracting staff with their work."

Before joining Cardinal Innovations in November 2015, Cauthen practiced criminal and family law in Harnett County, where she grew up.

“I actually never intended to enter a courtroom after law school. I wanted to work for the Legislative Drafting Division of the North Carolina General Assembly," she said. “I had it all planned out, but what I didn't plan on was graduating during the worst recession of my lifetime. Any highly competitive job became even more competitive at that time. But as life generally does, it has a way of working itself out and leading you to where you should be." 

Hartnett County maintained an indigent defense list, as opposed to a public defender's office, and the bulk of Cauthen's work was representing clients appointed to her. 

“The clients that had the most profound impact on me were the parents I represented in abuse, neglect and dependency cases," she said. “The emotional investment in these clients, and their children, became so overwhelming at times and most often the two were at odds. Most of these parents were suffering from mental illnesses and substance abuse issues and were not getting the help that they needed and their children were suffering as a result. Many of these parents were barely adults themselves."

Cauthen made the decision to move to Charlotte, N.C., to work in a temporary position while she searched for a permanent job. That move coincided with the MeckLink transition and she joined the Network Operations Command Center (NOCC) temporary staff for several months.

“I knew that this was where I wanted to end up working," she said. “I knew I wanted to do something that helped to improve the lives of others."

Cauthen said both her personal and professional experiences made her aware of the need for improved behavioral health care and the need to remove the stigma surrounding it. “I feel like I have found the most effective way that I can help through an occupation, but I am also so encouraged and determined to do more outside of that," she said.

Cauthen said she has met some of the most incredible, hardworking and selfless people working at Cardinal Innovations who are all working for the same common goal – to provide the best for the members. 

“It is so rewarding to feel, each and every day, that you are accomplishing something that benefits someone who truly needs it," she said. “I am given the opportunity, week in and week out, to try and make sure that we have the high quality providers our members deserve and to assist other departments with ensuring that members get the care they need. Knowing that this is the goal each and every day, keeps me going."

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