ERIKA Smith MSN RN CMDN

• Provided telephonic case management for Medicaid members, facilitating access to behavioral health referrals and community resources. Conducted authorization reviews and coordinated provider outreach for targeted case management requests, ensuring timely access to necessary services.
• Assessed behavioral health needs and developed individualized care plans aligned with member goals.
• Coordinated referrals, services, and follow-up with providers to support continuity of care.
• Reviewed clinical documentation and authorized appropriate levels of behavioral health support.

• Provided telephonic case management services to DC Medstar Family Health Choice plan members with complex health needs.
• Coordinated complex case management services for medically and socially vulnerable members across care settings.
• Completed comprehensive assessments to identify health, behavioral, and social needs.
• Developed individualized care plans aligned with member goals, benefits, and clinical priorities.

• Delivered telephonic triage, assessment, care guidance, and incident reporting for occupational-related injuries.
• Managed occupational injury triage and urgent care coordination for employees across onsite clinics.
• Conducted pre-placement, respirator, and health surveillance screenings using standardized nursing protocols.
• Coordinated return-to-work plans with providers, managers, and employees to support safe reintegration.

• Medical case management of ill and injured workers for an onsite employer occupational health clinic.
• Delivered occupational health triage and coordinated treatment plans for work-related injuries and illnesses.
• Managed workplace accommodation requests, conducted ergonomic evaluations, and completed various tasks/projects as assigned.

• Medical case management of injured worker’s compensation claims including field visits to medical offices and homes, medical referral coordination, status report composition and other tasks as assigned by the insurance adjuster or attorney.

• Direct patient care and case management of clients with reproductive and sexual health concerns. Pediatric immunization record review, vaccination, and VFC management responsibilities. Pandemic response experience in Covid-19 testing and leadership responsibilities as an operations chief for Baltimore County testing site locations.

• Direct nursing care of medical-surgical clients on the total joint replacement and ortho/neuro/trauma units.

In Progress