ELIZABETH GJONOVICH

• Utilization Review Manager at a Substance Abuse and Mental Health facility providing Residential Detox, RTC, PHP and IOP services
• Manages teams of employees including Utilization Review, Direct Admit Referrals, Clinical Auditing and Operational Auditing
• Increased staff efficiency with effective delegation, supervision, and performance evaluation of team members.
• Obtained authorizations from multiple insurance carriers for various levels of care.
• Completes Peer-to-Peer Reviews with insurance company's clinicians
• Manages retro-authorizations and appeals needed for the UR team.
• Streamlined communication between interdisciplinary teams, fostering collaboration for improved patient outcomes.
• Ensured consistent application of admission criteria among team members through ongoing education and feedback sessions.
• Implemented evidence-based practices in the utilization review process, improving overall decision-making accuracy and effectiveness.
• Established key performance indicators for the department, monitoring progress toward goals and driving continuous improvement.
• Oversaw internal audits to ensure compliance with regulatory bodies such as DHCS and CARF within the utilization review department.
• Performed prior authorization review of services requiring notification.

• Detox of Director for a Detox Residential Treatment Facility
• Assisted in original Joint Commission Certification and maintenance of certification
• Maintained a professional and positive attitude when working with clients and team members of the operations, clinical and admissions departments
• Developed and maintained rapport with clients and family members
• Managed KIPU as the Super User for the company
• This included creating forms and utilizing KIPU's new features to assist the techs, therapists and case managers in their charting responsibilities
• Audited KIPU on a daily basis to make sure that all documentation was being completed
• Hired and managed all new staff including detox technicians, therapists, case managers and group facilitators
• Staff development and related communication in order to ensure that all services being provided were in compliance with HIPAA , CFR 42, DHCS and Joint Commission standards
• Provided staff training in medication observation, infection control, fire drills and emergency preparedness.

See Sheer Recovery's Director of Detox summary.

• Program Manager for a Detox Residential Treatment Facility
• Assisted the Detox Director in any capacity that was needed
• Was promoted into the Director of Detox position (see above).

• Utilization Review/Admissions Manager/Intake Coordinator/Program Manager/Client Care Coordinator for a residential treatment center that admitted 150-200 clients per month
• Fielded live inbound calls and web leads for incoming admission inquiries including the sales of programs and answering pre-admission/general questions from potential clients, family members, friends or professional referents
• Screened individuals for appropriateness and eligibility for treatment and coordinated admission to the appropriate level of service
• Data entry in SalesForce, BestNotes and KIPU with accurate, detailed information
• Coordinated admissions by working closely with call center management, to ensure proper execution of the admission process
• Maintained a professional and positive attitude when working with callers/potential clients, members of the call center team, clinical and/or facility departments
• Developed and maintained rapport with clients, family members and professional referents
• Created, negotiated and maintained financial agreements
• Provided ongoing feedback to management about inbound lead and campaign quality
• Ensured that all services being provided were in compliance with HIPAA , CFR 42, CARF and DHCS standards.

• Registered Nurse (RN) in an acute care facility
• Worked on the medical/surgical floors and critical care units
• Utilized critical thinking skills to prioritize nursing interventions based on patients'' acuity levels and individual needs.
• Conducted thorough patient assessments to identify changes in condition, promptly notifying physicians and initiating appropriate interventions when necessary.
• Administered medications safely according to established guidelines while closely monitoring for side effects or adverse reactions requiring intervention.
• Enhanced patient satisfaction by providing compassionate, holistic nursing care that addressed physical, emotional, and spiritual needs.
• Assisted in the training and mentorship of new nursing staff members, contributing to a positive work environment and high-quality patient care.

• Full-time counselor in a residential treatment facility for adolescents ages 14 to 17
• Problems treated include depressive disorders, childhood disorders, addictive disorders, anxiety disorders and relationship disturbances
• Interacted with residents from the time they were admitted until discharged
• Oriented new residents to the treatment program and familiarized them with rules, expectations, program intent, and treatment routine
• Lead group counseling sessions daily and took part in individual sessions weekly
• Monitored residents' course of treatment to track their improvement and to identify and rectify any problems that might compromise their progress
• Determined whether a resident has any special needs and, if there are, makes sure they are met
• Intervened in situations where a resident's safety may be at risk and documented every intervention.