Summary
Overview
Work History
Education
Skills
Timeline
Generic

Ericka Blaney

Huntington Beach,CA

Summary

  • Dependable Utilization Reviewer promoting over 7 years of expertise in Substance Abuse Industry. Knowledgeable in all areas of UR. Educated on Ethical issues and Client’s rights, HIPPA, Case Administration, Crisis Intervention, Referrals, Group Dynamics, Physiological effects and Pharmacology of Alcohol and Drugs, Substance Abuse treatment In Children and Adolescence, Co-occurring disorders, SUD Treatment and Recovery, and 12 step. Incredible strong passion to help others.

Overview

7
7
years of professional experience

Work History

UR Coordinator

Laguna Treatment Hopsital
06.2021 - Current
  • Managed Caseloads of 25-30 patients
  • Maintained strict adherence to HIPAA regulations, safeguarding sensitive patient information throughout all aspects of the utilization review process.
  • Streamlined utilization review processes by collaborating with interdisciplinary teams to develop individualized care plans.
  • Demonstrated strong analytical skills by interpreting complex medical records and synthesizing relevant information for utilization review purposes.
  • Reduced wait times for essential services by effectively managing utilization review caseloads and prioritizing urgent requests.
  • Improved patient care quality by efficiently reviewing and analyzing medical records for utilization review purposes.
  • Conducted pre-certification, inpatient, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria.
  • Refer potential high-risk cases which will benefit from case management services to the case management team.


Operations Manager

Clear Life Recovery
02.2021 - 06.2021
  • Oversee all Behavioral Technicians and Case Manager
  • Responsible for hiring and training
  • Developed and implemented new protocols and compliance trainings
  • Clinical Documentation
  • Concurrent Review Documentation
  • Coordinate new intakes and communicate with our MD and medical team
  • Crisis interventions with clients
  • Alleviated staff concerns and work dynamics.

Multiple Promotions- Quality Assurance/Case Manager

Healing Path Detox
09.2017 - 12.2020
  • Leadership Role, Trainings, Crisis Interventions, Chart Auditing, Case Management, Discharge Planning, ASAM Documentation, Utilization Review

Supervised Intern for SUD Counseling

Yellowstone Recovery
09.2019 - 03.2020
  • Intake Assessments
  • Facilitated groups with 25+ client’s
  • Treatment Team
  • Treatment Planning
  • SOAP and DAP documentation
  • Parolees and probation clientele.

Education

Associate of Science - Drug And Alcohol

Saddleback College
Mission Viejo, CA
05.2020

Skills

  • Highly qualified in building strong rationale for maximum authorization approvals
  • Always able to maintain professionalism in interactions with payors, maintain good working relationships and exercise maturity of judgment with boundaries
  • Proficient in Medical Necessity Criteria-ASAM guidelines- ICD 10
  • Attention to Detail
  • Compassionate and Caring
  • Critical Thinking
  • Competent in Kipu, Best notes, Allevia, Microsoft Word, Google Docs, Aura, Salesforce ect
  • Confident in learning new procedures, punctual, and maintain a positive attitude

Timeline

UR Coordinator

Laguna Treatment Hopsital
06.2021 - Current

Operations Manager

Clear Life Recovery
02.2021 - 06.2021

Supervised Intern for SUD Counseling

Yellowstone Recovery
09.2019 - 03.2020

Multiple Promotions- Quality Assurance/Case Manager

Healing Path Detox
09.2017 - 12.2020

Associate of Science - Drug And Alcohol

Saddleback College

Similar Profiles

CREATE PROFILE
Ericka Blaney