Amelia Mayadenu, LCSW
Little Elm,TX
Summary
Highly motivated mental health professional with extensive experience in utilization review and case management. Proficient in biopsychosocial assessments and crisis intervention, I advocate for clients of all ages while using a strengths-based approach, ensuring quality care. Skilled in interdisciplinary collaboration, I develop effective treatment plans that address both psychological and social needs, enhancing client outcomes.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Owner
Prosper in Therapy, PLLC
Little Elm, TX
02.2025 - Current
- Conduct initial assessments of clients to determine presenting issues, and develop treatment plans.
- Develop individualized therapeutic interventions based on diagnosis and best practices in the field of mental health counseling.
- Utilize a variety of techniques, such as cognitive-behavioral therapy, mindfulness, and solution-focused treatment during sessions.
- Provide psychoeducation on topics such as stress management, anger management, and parenting skills.
- Monitor the client's progress throughout the course of therapy by tracking the goals set in the treatment plan.
Utilization Review Clinican
Centene
St. Louis, Missouri
11.2022 - Current
- Analyzes member treatment for mental health and substance abuse before, during, and after services to ensure care level and services align with medical appropriateness
- Reviews prior authorization requests related to mental health and substance abuse to verify medical appropriateness in alignment with regulatory guidelines and criteria
- Performs concurrent review of behavioral health (BH) inpatient to determine overall health of member, treatment needs, and discharge planning
- Provides education to providers members and their families regrading BH utilization process
- Interacts with BH healthcare providers as appropriate to discuss level of care and/or services
- Engages with medical directors and leadership to improve the quality and efficiency of care
- Formulates and presents cases in staffing and integrated rounds
- Performs other duties as assigned
Case Management Lead Analyst
Evernorth Behavioral Health
St Louis, Missouri
12.2016 - 11.2022
- Obtained clinical assessment data from providers and recommended initial treatment authorizations and concurrent authorizations based on parameters from Cigna Medical Necessity Criteria for Mental Health, Substance Abuse, and Eating Disorders.
- Reviewed the clinical status and therapeutic progress of clients with providers periodically to determine the need for continuing treatment, as appropriate.
- Negotiate alternative levels of care if the criteria for inpatient or partial care are not met. Refers to physician advisor(s) as needed for consultation/appeal(s).
- Consulted with Medical Directors, Supervisors, and Team Leads as appropriate for escalation guidelines, peer review/consult and case management.
- Attend monthly Credentialing Committee meetings.
Behavioral Health Care Advocate
UnitedHealth Group
Maryland Heights, MO
11.2015 - 12.2016
- Provided case management and utilization review of behavioral health and substance abuse cases.
- Utilized clinical and analytical skills to determine the appropriate level of care.
- Collaborated with facilities to identify psychosocial needs and barriers to treatment.
- Coordinated benefits and recommended transitions between levels of care.
- Consulted with Medical Directors, Supervisors, and Team Leads as appropriate for escalation guidelines, peer review, and case management.
Integrated Health Specialist
Crider Health Center
Wentzville, MO
10.2012 - 11.2015
- Advocated for improved access to quality healthcare for underserved communities.
- Utilized evidence-based practices when creating treatment plans for clients.
- Served as a resource person for staff regarding integrated health concerns.
- Advised families about community resources available for individuals with chronic illnesses.
- Provided referrals for additional supportive services such as housing or financial assistance programs as needed.
- Assisted in developing patient-centered treatment plans that addressed both physical and psychosocial issues.
- Completed biopsychosocial assessments.
- Facilitated and coordinated voluntary and involuntary hospitalization.
Education
Master of Social Work
Saint Louis University
St. Louis, MO08-2010
Master of Science - Criminology
Indiana State University
Terre Haute, IN08-2005
Bachelor of Arts - Psychology / Criminology
University of New Mexico
Albuquerque, NM05-1999
Skills
- Telehealth experience
- Biopsychosocial assessments
- Diagnostic evaluations
- Treatment planning
- Cognitive behavioral therapy
- Motivational interviewing
- Solution-focused therapy
- Utilization review
- Psychoeducation
- Case management
- Interdisciplinary collaboration
- Patient advocacy
- Crisis intervention
Certification
- Illinois - Licensed Clinical Social Worker, License Number 149016341; First Issued 12/02/2013 Expiration 11/30/2025
- Missouri - Licensed Clinical Social Worker, License Number 20144010304, First Issued 04/03/2014 Expiration 09/30/2025
- Texas - Licensed Clinical Social Worker, License Number 114761, First Issued 11/19/2024 Expiration 04/30/2027
Timeline
Owner
Prosper in Therapy, PLLC
02.2025 - Current
Utilization Review Clinican
Centene
11.2022 - Current
Case Management Lead Analyst
Evernorth Behavioral Health
12.2016 - 11.2022
Behavioral Health Care Advocate
UnitedHealth Group
11.2015 - 12.2016
Integrated Health Specialist
Crider Health Center
10.2012 - 11.2015
Master of Social Work
Saint Louis University
Master of Science - Criminology
Indiana State University
Bachelor of Arts - Psychology / Criminology
University of New Mexico
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