Heidi Strater LCSW

• Provide individual psychotherapy to adult and geriatric clients in a private office setting.
• Deliver compassionate psychotherapy to diverse adult and geriatric clients, fostering emotional well-being and personal growth in a private practice setting.
• Conduct thorough assessments and develop tailored treatment plans, addressing complex mental health challenges for a wide range of adult clients.

• Reviewed and analyzed patient treatment plans for medical necessity.
• Developed utilization review processes to enhance efficiency and compliance.
• Monitored trends in utilization data to identify areas for improvement.
• Conducted utilization review activities including concurrent reviews, retrospective reviews, and discharge planning.

• Coordinated with healthcare providers to gather relevant patient information.
• Conducted utilization review activities including concurrent reviews, retrospective reviews, and discharge planning.

Supervised utilization management team to ensure compliance with healthcare standards.

• Participated in provider appeals when necessary including gathering evidence from medical records or other sources.

• Lead utilization specialists, enhancing team efficiency and service quality.
• Collaborated with clinical and billing directors to enhance documentation accuracy and maximize revenue.
• Drive measurable improvements in service identification and revenue maximization.
• Lead utilization management team, overseeing specialists and collaborating with clinical services to optimize chart documentation and revenue generation.
• Analyze insurance industry trends to develop strategic negotiation tactics, enhancing staff's ability to secure maximum covered days for patients.
• Spearheaded interdepartmental collaboration, integrating clinical services, medical records, and billing to streamline processes and improve operational efficiency.
• Drove continuous improvement in utilization management practices, enhancing documentation quality and increasing revenue.
• Forecast industry shifts, proactively adapting department strategies to maintain competitive edge and ensure optimal patient care coverage.

• Conduct initial and concurrent reviews with insurance companies for substance abuse/mental health clients to determine medical necessity based on ASAM criteria.
• Conducted peer reviews and negotiated single case agreements to enhance patient care and ensure compliance with policies.
• Served as liaison to facilitate collaboration between utilization review department and clinical/nursing teams for streamlined operations.
• Monitored charts to uphold compliance and maintain integrity of client treatment protocols.
• Work with the admission coordinators to screen for appropriate clients.
• Mentored and trained new employees while providing staffing for complex cases.
• Provide training on documentation for the clinical team.
• Developed protocol for medical referrals.

• Educating and upgrading the behavioral health case management team using INTERQUAL computer program criteria to determine medical criteria for inpatient hospitalization.
• Conduct clinical reviews with managed care representatives to determine medical necessity and write appeal letters on behalf of hospital when patients days have been denied.
• Provide discharge planning for patients with severe mental illness and substance abuse and dually diagnosed patients allowing for a safe transition back to the community.
• Responsible for training and mentoring new employees.
• Registered Supervisor for MSW Interns from Florida Atlantic University, Barry University and Florida International University.
• Conduct Physician rounds three times per week with a multidisciplinary team consisting of physicians, nurses, therapists and other key team members.

• Provide individual and group psychotherapy to adult and geriatric clients in an inpatient hospital setting.
• Skilled in utilizing advanced theories and techniques needed to work with patients with severe mental illness, chemical dependency and dually diagnosed patients.
• Responsible for training and mentoring new employees.

• Taught human behavior and social development to bachelor level students.

• Taught advanced interventions for children and adolescents to masters level students.

• Conducted psycho-social patient assessments and chart reviews to inform treatment plans.
• Trained facility staff through educational in-services to enhance patient care.