Topic: The involvement of individuals in recovery and their families has helped drive change in the behavioral health field. Medicaid managed care organizations (MCOs) can promote meaningful involvement by empowering stakeholders at every level of the organization. Purposes: Roles for self-identified service recipients, including membership on boards, advisory committees, and grievance committees; in research and evaluation; in employment at all levels of the MCO; and in individual interactions with providers—as well as the impact of this involvement on individuals and the organization—is explored. Sources Used: Research on the implications of service user involvement is reviewed and actual practice at an MCO is highlighted. Conclusions and Implications for Practice: Research on the benefits to organizations of service user involvement is scarce. However, based on their experiences, the authors believe it is not only the right thing to do, but the smart thing to do. They challenge the field to join them in involving service users and seeking ways to measure the impact of this empowerment on managed behavioral health care.