Chelsey Manzella
Waterford,NY
Summary
Utilization Review Specialist at Charlie Health specializing in regulatory compliance and effective communication. Streamlined reimbursement processes by collaborating with insurance companies, resulting in enhanced patient care quality. Proven track record in patient advocacy and meticulous documentation, reflecting strong organizational capabilities and dedication to clinical standards.
Overview
7
7
years of professional experience
Work History
Utilization Review Specialist
Charlie Health
02.2022 - Current
- Educated clinical staff on proper documentation to enhance reimbursement and compliance.
- Served as a resource for guidance on care levels and insurance coverage.
- Increased efficiency of utilization review through proactive communication with insurance providers.
- Maintained confidentiality of patient data, complying with privacy laws and regulations.
- Ensured regulatory compliance by maintaining accurate documentation for utilization review activities.
- Obtained authorizations from various insurance carriers for IOP level of care.
- Supervised utilization review documentation through software management-Salesforce.
Behavioral Health Care Manager
Concert Health
04.2021 - 02.2022
- Educated patients on common mental health and substance use disorders to clarify treatment options.
- Developed strong relationships with local service providers, enhancing collaboration for client recovery.
- Maintained confidentiality in accordance with HIPAA guidelines, ensuring trust and privacy in therapy.
- Documented client progress meticulously to enable seamless transitions between providers when necessary.
- Recorded patient progress and treatment recommendations for sharing with medical and psychiatric providers.
- Applied evidence-based techniques, including behavioral activation and motivational interviewing, to behavioral interventions.
- Provided timely crisis intervention services to minimize risks and ensure safety for all involved.
- Conducted assessments to identify individual needs and crafted personalized care plans addressing objectives.
Child and Family Therapist
Bloom Behavioral Therapy
01.2021 - 06.2021
- Conducted intake assessments to formulate treatment plans and manage client records.
- Established rapport with diverse clientele, fostering a safe environment for open dialogue.
- Rendered mental health services to clients, focusing on development of healthy relationships.
- Implemented crisis intervention strategies for families, leading to stabilization and improved functioning.
- Utilized play therapy and PCIT techniques to facilitate emotional expression in children.
- Increased parental involvement through education on child development and effective parenting strategies.
- Mediated family conflicts to clarify and resolve underlying issues effectively.
- Enhanced coping skills through cognitive-behavioral therapy interventions and TF-CBT, promoting resilience.
Child and Family Therapist
A Child’s Haven
09.2019 - 12.2020
- Developed and implemented personalized treatment plans addressing individual mental health needs and goals.
- Assessed client mental health requirements, creating tailored strategies to monitor progress.
- Utilized play therapy techniques to facilitate emotional expression in children.
- Increased parental involvement through education on child development and effective parenting strategies.
- Conducted thorough assessments for accurate diagnoses to formulate appropriate treatment strategies.
- Utilized motivational interviewing techniques to help clients identify barriers to change and actionable steps.
- Maintained high-quality care by managing full caseloads through effective time management strategies.
- Continuously updated professional knowledge through research, training, and participation in industry events.
Clinical Therapist
The Carolina Center for Behavioral Health
05.2019 - 06.2020
- Facilitated group therapy sessions to create a supportive environment for sharing experiences and developing coping skills.
- Implemented preventative measures by identifying risk factors that could trigger crises in recovery progress.
- Provided psychoeducation on coping mechanisms, equipping patients with practical tools to manage stressors.
- Delivered comprehensive clinical services aligned with patient needs, ensuring quality care.
- Collaborated with multidisciplinary teams for integrated care, optimizing patient progress through coordinated efforts.
Clinical Therapist- Adult and Adolescent Units
Marshall I. Pickens Hospital
07.2018 - 09.2019
- Established strong client rapport, fostering trust and open communication for effective therapy sessions.
- Developed individualized treatment plans to enhance client well-being based on specific needs.
- Implemented evidence-based therapeutic techniques, improving patient outcomes and coping mechanisms.
- Provided individual and group therapy sessions, promoting resilience and healthy coping strategies.
- Documented patient information meticulously, ensuring continuity of care across providers.
- Collaborated with multidisciplinary teams to create comprehensive treatment plans for optimal care.
- Advocated for client needs within healthcare systems, participating in treatment teams.
Education
Master of Arts - Social Work
University of South Carolina
Columbia, SC05.2018
Bachelor of Arts - Interdisciplinary Studies
University of South Carolina Upstate
Spartanburg, SC12.2014
Skills
- Regulatory compliance (HIPAA)
- Utilization management strategies
- Medical necessity evaluation
- Application of InterQual guidelines
- Commercial and Medicaid insurance policy knowledge
- Clinical assessment techniques
- Knowledge and experience in various levels of behavioral health treatment; Inpatient, PHP, IOP and Outpatient
- Effective communication skills
- Team collaboration and building
- Problem-solving strategies
- Time management abilities
- Attention to detail
- Multitasking proficiency
- Reliable performance standards
- Critical thinking and judgment
- Organizational skills
- Adaptability to change
- Decision-making processes
- Patient and family advocacy
- Clinical documentation proficiency
- Task prioritization methods
- Self-motivation and initiative
- Accuracy in documentation tasks
- Professional demeanor
Licensure
LISW-CP
LMSW
Timeline
Utilization Review Specialist
Charlie Health
02.2022 - Current
Behavioral Health Care Manager
Concert Health
04.2021 - 02.2022
Child and Family Therapist
Bloom Behavioral Therapy
01.2021 - 06.2021
Child and Family Therapist
A Child’s Haven
09.2019 - 12.2020
Clinical Therapist
The Carolina Center for Behavioral Health
05.2019 - 06.2020
Clinical Therapist- Adult and Adolescent Units
Marshall I. Pickens Hospital
07.2018 - 09.2019
Master of Arts - Social Work
University of South Carolina
Bachelor of Arts - Interdisciplinary Studies
University of South Carolina Upstate
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