Crystal Asekhauno
Richmond,Tx
Summary
I aim to secure a Utilization Management role, drawing on ten years of experience in behavioral health, focusing on acute psychiatric, adolescent, substance abuse, dual diagnosis, geriatric, medipsych, partial hospitalization, and intensive outpatient care. My expertise lies in conducting thorough utilization reviews, optimizing resource allocation, and ensuring regulatory compliance to improve patient care outcomes and operational efficiency.
Overview
13
13
years of professional experience
Work History
Lead Utilization Review Specialist
Westpark Springs Hospital
03.2017 - Current
- Demonstrated strong analytical skills by interpreting complex medical records and synthesizing relevant information for utilization review purposes.
- Participated in ongoing professional development opportunities to stay current with trends and best practices in utilization review, bringing new insights back to the organization.
- Promoted patient satisfaction through careful attention to individual needs during the review process, addressing concerns promptly and professionally.
- Supported the development of standardized policies and procedures for utilization review across multiple departments within the organization.
Interim Director of Utilization Review
Westpark Springs Hospital
01.2024 - 03.2024
- Promoted transparency by creating user-friendly reports detailing departmental metrics, trends, and areas requiring improvement.
- Collaborated with interdisciplinary teams, ensuring timely and accurate completion of utilization reviews for optimal patient care.
- Stayed abreast of industry trends and emerging best practices in utilization management, incorporating relevant insights into departmental operations.
- Coordinated efforts between clinical staff, case managers, and insurance companies to ensure efficient communication throughout the review process.
- Submitted cases for criteria failures and helped facilitate resolutions and approvals.
Case Manager
St. Joseph’s Medical Center
09.2015 - 03.2017
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
- Enhanced communication between clients and providers through consistent follow-ups and progress updates.
Utilization Management Coordinator
Hope bridge Hospital
05.2015 - 09.2015
- Collaborated with multidisciplinary teams to develop individualized care plans for patients.
- Improved workflow efficiency by collaborating with healthcare providers to ensure timely authorizations and discharge planning.
- Identified areas requiring resource optimization through trend analysis reports regularly.
- Served as a liaison between patients, families, caregivers, providers, payers, and community resources to ensure seamless transitions throughout the continuum of care.
Discharge Planner
DebLin Health Concepts
10.2014 - 05.2015
- Improved patient satisfaction by carefully evaluating their needs and developing personalized discharge plans.
- Coordinated timely discharges by effectively communicating with physicians, nurses, social workers, and other relevant stakeholders.
- Advocated for patients'' best interests, working closely with healthcare providers to develop appropriate treatment plans and interventions.
- Facilitated smooth transfers between hospital departments, minimizing delays in patient care during transition periods.
Family Based Safety Services
Texas Department of Family Protective Services
02.2012 - 09.2014
- Developed culturally sensitive therapeutic approaches tailored to meet the unique needs of diverse client populations.
- Provided crisis intervention services, preventing further escalation of conflict within families.
- Provided ongoing support for families transitioning out of therapy, ensuring continued progress and lasting improvements in overall wellbeing.
- Served as a liaison between clients and community resources, connecting families with additional support services as needed.
Education
Masters - Social Work
Capella University
Minneapolis, MN01-2027
Bachelor of Science - Criminal Justice
Sam Houston State University
Huntsville, Texas05.2011
Skills
- Availity Proficiency
- Waystar Proficiency
- Providerexpress Proficiency
- Microsoft Office
Accomplishments
Employee of the Month - Westpark Springs
2018 and 2022
References
Available upon request.
Timeline
Interim Director of Utilization Review
Westpark Springs Hospital
01.2024 - 03.2024
Lead Utilization Review Specialist
Westpark Springs Hospital
03.2017 - Current
Case Manager
St. Joseph’s Medical Center
09.2015 - 03.2017
Utilization Management Coordinator
Hope bridge Hospital
05.2015 - 09.2015
Discharge Planner
DebLin Health Concepts
10.2014 - 05.2015
Family Based Safety Services
Texas Department of Family Protective Services
02.2012 - 09.2014
Masters - Social Work
Capella University
Bachelor of Science - Criminal Justice
Sam Houston State University
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