Experience

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  Homeward bound inc.

  Jan 2008 - Jan 2009

  Outpatient counselor

  • Facilitated group counseling to substance abuse clients 3 times a week • Managed an outpatient caseload of 25-45 clients• Held individual counseling sessions for dual diagnosis clients daily (4 clients a day)• Completed intake procedures which included orientation, screening, assessments & treatment planning • Maintained complete documentation of treatment plans, progress notes, discharge summaries, & referrals• Consulted with other professionals including LCDC’s, RN’s, and case managers to assure comprehensive and quality care for the clients Show less

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  Nexus recovery center

  Jan 2009 - May 2010

  Residential counselor

  • Facilitated group counseling to substance abuse clients which included didactic, educational & process groups up to 3 times a week • Managed a caseload of 8-13 residential female clients• Held weekly individual counseling sessions for all clients • Maintained complete documentation of treatment plans, individual progress notes, insurance extension requests, discharge summaries, & referrals• Consulted with other professionals including counselors, psych department staff and clinical directors to assure comprehensive and quality care for the clients• Attended all state required trainings Show less

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  Humana

  May 2010 - Oct 2011

  Clinical advocate

  • Performed telephonic case management with a focus on behavior change• Completed psychological & psychosocial assessments & developed treatment plans• Identified through internet research & consulting with others in the field, resources for members in their communities & made referrals• Collaborated with nurses, other departments & other community social service workers to best serve the members• Utilized Motivational Interviewing & Solutions Oriented approaches to help facilitate change in members Show less

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  Beacon health options

  Oct 2011 - Oct 2016

  Clinical care manager

  • Performed concurrent and retrospective reviews on inpatient & outpatient mental health & chemical dependency facilities• Monitored level and quality of care. Proactively managed acutely and chronically ill patients with the objective of improving quality outcomes and decreasing costs • Addressed any care issues with management and Chief Medical Director as appropriate • Coordinated an interdisciplinary approach to support continuity of care. Provided utilization management, transfer coordination, discharge planning, and issuance of all appropriate authorizations for covered services as needed for members • Consulted with physicians, health care providers and outside agencies regarding continued care/treatment or hospitalization • Assisted in the identification and reporting of Potential Quality of Care concerns. • Work as an interdisciplinary team member • Provided back up for other members of the UM team when needed. • Performed other duties as assigned. Show less

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  Blue cross and blue shield of illinois, montana, new mexico, oklahoma & texas

  Oct 2016 - now

  Clinical care mana

  • Perform concurrent and retro reviews on inpatient & outpatient (including ABA) levels of care• Monitor level and quality of care• Addressed any care issues with management and Medical Director as appropriate• Coordinate an interdisciplinary approach to support continuity of care. • Consult with physicians, health care providers and outside agencies regardingcontinued care/treatment or hospitalization• Assisted in the identification and reporting of Potential Quality of Care concerns Show less