Developed and maintained positive relationships with customers through courteous interactions and prompt resolution of issues.
Conducted initial assessments and screenings of clients to determine their eligibility for services.
Provided psychosocial assessment, evaluation and diagnosis for individuals seeking mental health services.
Provided crisis intervention services when needed to address urgent mental health issues or suicidal ideation.
Attended weekly clinical meetings with other clinicians to discuss case management strategies and best practices.
Regularly communicated with referral sources about client progress and any changes in treatment plans.
Participated in continuing education activities related to clinical practice guidelines and evidence-based treatments.
Adhered to HIPAA regulations regarding confidentiality of patient information at all times.
Utilization Management Senior Analyst
Cigna Healthcare
Nashville, TN
06.2020 - Current
Performed concurrent reviews of inpatient admissions, ensuring appropriate level of care was provided.
Conducted pre-certification reviews for elective services to ensure appropriateness of care.
Collaborated with physicians, hospitals, and other providers to facilitate timely resolution of utilization management issues.
Participated in interdisciplinary meetings to discuss patient care plans and review medical records.
Maintained accurate documentation of all utilization management activities.
Attended professional development seminars related to industry best practices in healthcare resource management.
Determined medical necessity and cost-effectiveness of services through utilization review processes.
Collaborated with providers to obtain required clinical information, supporting prior authorization determinations and individual inquiries.
Responded to emergency situations with speed, expertise and level-headed approaches to provide optimal care, support and life-saving interventions.
Advocated for patient needs with interdisciplinary team and implemented outlined treatment plans.
Maintained strict patient data procedures to comply with HIPAA laws and prevent information breaches.
Utilized computerized Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) system.
Intake Specialist
Parkwood Behavioral Health
Olive Branch, MS
05.2016 - 01.2020
Conducted initial intake interview to obtain client information, including biographical data, medical history, presenting problem, legal status, and other pertinent information.
Assessed patient needs through review of medical records and interviews with patients and their families.
Provided crisis intervention services as needed to clients in distress.
Reviewed referral sources for appropriateness prior to admission into program.
Provided education about mental health issues to individuals, families, and community groups.
Maintained accurate records of all client interactions according to agency policies and procedures.
Masters Level Residential Counselor
Youth Villages
Memphis, TN
08.2015 - 06.2019
Provided guidance and support to clients in need of assistance with daily living skills.
Facilitated group meetings, activities, and workshops for clients to help them develop social and interpersonal skills.
Monitored client progress, documented observations, and reported changes in behavior to supervisors.
Assisted with crisis intervention services when needed.
Educated family members about the importance of following through with treatment plans.
Developed therapeutic relationships by providing emotional support and positive reinforcement to clients.
Implemented behavioral interventions designed to modify or reduce problematic behaviors.
Maintained accurate records of client information including medical histories, medications administered, counseling sessions attended.
Education
Master of Science - Mental Health Counseling
Freed-Hardeman University
Henderson, TN
08-2015
Bachelor of Arts - Applied Psychology/Criminal Justice
Christian Brothers University
Memphis, TN
05-2009
Skills
Product Knowledge
Complaint Resolution
Inbound and Outbound Calling
Data Collection
Data Entry
Information Security
Follow-Up Skills
Prioritization
Documentation
Critical Thinking
Microsoft Office Suite
Problem Resolution
Research
Timeline
Admissions Service Specialist Acute
Acadia Healthcare
03.2023 - Current
Utilization Management Senior Analyst
Cigna Healthcare
06.2020 - Current
Intake Specialist
Parkwood Behavioral Health
05.2016 - 01.2020
Masters Level Residential Counselor
Youth Villages
08.2015 - 06.2019
Master of Science - Mental Health Counseling
Freed-Hardeman University
Bachelor of Arts - Applied Psychology/Criminal Justice