Jenny Culbertson
Castle Rock,CO
Summary
Brings proven track record of success in determining eligibility and resolving complex cases. Works professionally with clients to develop and implement successful strategies for maximizing services and benefits. Skilled in problem-solving and identifying solutions meeting clients' needs.
Overview
23
23
years of professional experience
Work History
Case Management Eligibility Specialist
Developmental Pathways, Inc.
07.2023 - Current
- Develop, distribute, and manage service plan (SP) and billing data for service providers
- Enter SP data into state databases as needed; support and resolve billing issues
- Work with clients to determine initial and continuing eligibility for programs such as Food Assistance, Medicaid, CHP+, Colorado Works, Aid to the Needy Disabled, Old Age Pension, and other identified programs
- Interface with state and county computer systems in client application/approval process
- Research participants' service utilization and previously provided services and supports and follow up
- Analyze work completed to identify and report on trends
- Collaborate effectively on projects; support teams in developing and improving work processes
- Provide professional level feedback and follow up to other professional level staff regarding mistakes or missed steps in department processes and procedures (i.e., for SP and revision completion and entry into PAR system)
- Communicate and coordinate with external partners professionally and thoroughly
- Support the purchasing of products for individuals in service, Long-Term Home Health review, provider relations, and RFP management, as assigned
- Keep up to date on all state policies and procedures related to their tasks and responsibilities
- Operate independently, using Health Care Policy and Financing rules, regulations, policies, and procedures, as well as directives from the Associate Directors, Program Managers, and other senior leadership to provide technical guidance to internal and external stakeholders to generate solutions to problems, or coordinate with case management staff for resolution
- Perform database maintenance related to assigned aspects of Program Quality Department responsibilities
- Gather, organize and review information supplied by applicants and recipients regarding financial and non-financial criteria relevant to the initial and continuing eligibility for public assistance programs as identified
- Inform applicants and recipients of the relevant requirements and benefits of programs for which they have eligibility
- Clarify and interpret for clients their appeal rights and procedures
- Assist and guide applicants in completing forms, securing documents and other verifications needed in completing their application
- Approve or deny applications and inform applicants of results within the appropriate time frame and in a manner that can be understood by the client
- On an ongoing basis, inform recipients of changes in the law or regulations affecting eligibility and/or amount of grant
- Provide information and assesses need for referral to services staff and other community agencies for available assistance
- Interface on a daily basis with statewide computer system requiring accurate and complete data entry of information
- Interpret and evaluate computer generated data to determine application to individual case processing for approvals, changes, denials and discontinuations
- Utilize computer daily for inquiry and data entry for preparation of complex correspondence, spreadsheet development and record maintenance and research
- Maintain client records within the Colorado Benefit Management System (CBMS) and electronic case file in the Department’s electronic document management system
- Document all actions taken on applications and cases within CBMS
- Perform complex calculations and tabulates figures
- Maintain computer-based records.
Mental Health Case Manager
AllHealth Network
04.2022 - 07.2022
- Worked closely and collaborate within a team-based model to ensure effective and efficient delivery of care coordination and case management services which included telephonic and face-to-face contact; as well as traveled to hospitals, provider offices, community-based organizations and/or home visits
- Provided vocational services to individuals with disabilities ensuring they remain gainfully employed
- Motivated clients to participate in the program by establishing a therapeutic relationship
- Maintained a caseload of clients in accordance with department policy, to gain optimal functioning and sustain improvements in health management
- Knowledge of personal computer word and data processing, use of computer calendars, email systems and of general office equipment
- Utilized all appropriate software, technology, and resources including, but not limited to, Automated Child Support Enforcement System (ACSES), Word, Excel, Legal Math, Department of Labor, Department of Motor Vehicle, ICON, Internet, CBMS, Trails, COVIS and Outlook.
Intensive Mental Case Manager
Jefferson Center for Mental Health
01.2019 - 04.2022
- Developed, distributed, and managed service plan (SP) and billing data for service providers
- Provided case management services including service planning, monitoring, follow-up, linkage, and crisis management for consumers
- Provided therapeutic crisis intervention and emergency services as required
- Provided services to meet need: office based, community based, or in the consumer's home
- Provided clinical and case management services to adults, adolescents and children and their support systems utilizing evidence based best practice models
- Provided vocational services to individuals with disabilities ensuring they remain gainfully employed
- Must be timely and detail oriented in relation to case management requirements
- Provided developmental disabilities/long-term services and supports
- Maintained confidentiality of consumer records
- Provided case management services to consumers as needed
- Documented intervention and program activity according to Jefferson Center for Mental Health policies and procedures
- Maintained accurate and timely clinical records consistent with Center standards
- With all progress notes entered within one day of providing the service
- Maintained communication with referral agencies, family members, workplace supervisors and other involved parties
- Consulted with other therapists and related professional and paraprofessional staff, as appropriate
- Referred clients to appropriate service agencies as required
- Made appropriate referrals to and acts as liaison with community agencies, service providers, and natural support systems
- Provided assessment of daily living skills (ADL's), coordination, monitoring, planning, referral and follow-up with comprehensive community services and supports
- Resourced acquisition and assistance with application for benefits and entitlements in collaboration with Benefits/Navigation Team
- Provided individual, group, and family case management counseling services as indicated and identified in the treatment plan
- Assisted consumers with basic needs such as housing, food, clothing, medical and dental care, legal, vocational, and psychiatric services
- Participated in team meetings, clinical staffings, and clinical consultation as scheduled
- Participated in meetings and acted as liaison with nursing homes and other community providers
- Participated in Evidence Based Practices on the team and in the Center (i.e.: IDDT, DBT, CBT, psychoeducation, Motivational Interviewing, etc.)
- Utilized clinical practice guidelines, Center and State Division of Mental Health standards for appropriate service delivery.
Social Services Manager Assistant
Morningstar Assisted Living and Memory Care at Applewood
01.2018 - 01.2019
- Assessed, diagnosed and treated mental, behavioral and emotional illnesses or problems
- Provided group or individual therapy and helped patients adjust to the changes related to their illness
- Helped residents on my caseload to deal with grief, loss, life changes or depression
- Provided developmental disabilities/long-term services and supports
- Developed a treatment plan that was individualized to the patient
- Helped people solve problems by focusing on patient education
- Made referrals for mental health services and coordinated discharge planning when discharge was an option
- Assisted patients with obtaining a variety of services in the home, such as physical therapy, home health care or housekeeping services and meal preparation
- Supplied services related to end of life care by assisting a client to make a will or arrange a trust for family members as well as the completion of advanced directives and the successful resolution to unfinished business among estranged family members
- Provided advocacy and collaborated with other staff and medical professionals to ensure a patient's wishes was carried out
- Protected the patient from abuse and improve the quality of life whenever possible.
Service Coordinator and Visitation Facilitator
Maple Star Colorado
05.2016 - 01.2018
- Coordinated court ordered therapeutic supervised visitation for families referred to Maple Star through Department of Human Services across regional counties
- Provided counseling, therapy to consumers and families prepares treatment plans, discharge plans, and followup
- Maintained communication with referral agencies, family members, workplace supervisors and other involved parties
- Coordinated and supervised all scheduled visitations on a caseload and provided ongoing therapeutic modalities and interventions
- Provided therapeutic crisis intervention and emergency services to Adolescents as required
- Provided clinical services to individuals and their support systems utilizing evidence based best practice models
- Provided developmental disabilities/long-term services and supports
- Maintained confidentiality of consumer records
- Provided case management services to consumers as needed
- Documented intervention and program activity according to Community Reach Center policies and procedures
- Maintained accurate and timely clinical records consistent with Center standards
- Communicated with Case Workers, DHS, Family, and other professionals as needed for each case
- Provided crisis management whenever called to a family's home
- Consulted with other therapists and related professional and paraprofessional staff, as appropriate.
Case Service Manager
D&S Community Services, Inc.
02.2015 - 03.2016
- Oversaw delivery of all Home and Community Services program services in the group homes, day habs, nursing homes, hospital and ACFs in adherence with regulatory principles, and state and federal laws (including HIPAA Privacy Laws) concerning confidentiality
- Worked to create an environment that met the needs, wants and interests of residents, promoting all areas of group and 1-1 programming, as well as promoting desirable interaction and independence
- Monitored to ensure all medical services are provided in accordance with the consumer's treatment plan of care
- Maintained communication with referral agencies, family members, workplace supervisors and other involved parties
- Referred clients for treatment and help them access those services as well as followed up with outreach to see clients have made it to treatment and are succeeding
- If they are not, problem solved around potential barriers
- Provided short term, evidence-based therapy to clients
- Independently reviewed client needs in support of successful exiting from homelessness
- Provided access to services offered by municipal county, non-profit and faith-based systems otherwise unattainable by client's efforts alone
- Provided business support for programs related to these efforts including assisting with the creation and development of programs, compiling, and managing data for programs and special projects
- Developed and provided written materials and presentations about best practices in field of trauma informed care and how it relates to people experiencing homelessness
- Provided developmental disabilities/long-term services and supports
- Assessed the needs of the person receiving services through completion of periodic assessments and documentation, such as the following: MRRC, Implementation Plan, Bi-monthly Implementation Plan review
- Completed needed Individual Plan of Care revisions, Restraint Risk Assessment, Money Management Assessment, Onsite Inspection, Individual Emergency Evacuation Plan, Financial/Room and Board Disclosure, Suicide Assessment
- Maintained ongoing communication with local, state and federal entities, including but not limited to the Local Authority, guardians, LARs, family members, Foster Care Providers, Volunteers and a wide variety of professionals in the community.
Community Living Assistance and Support Services - C.L.A.S.S. Case Manager
ResCare Home Health Care, Inc.
11.2011 - 12.2014
- Provided routine case management services in the client's home and community to eligible individuals as an effective alternative to institutional placement for their developmental disabilities
- Recruited, trained and supervised volunteers and new staff for those on hospice, the disabled and elderly
- Created and implemented Person Centered support plans, lead site training while processing all necessary forms, conducted quarterly treatment plans, annual paperwork, Medicaid/Medicare applications and other payment documents to support services for clients
- Maintained case files on each client, documenting progress towards established goals and prepared monthly status reports by completing client related data entry, forms for adaptive aids/minor home modifications and maintaining confidential records
- Provided developmental disabilities/long-term services and supports
- Worked to create an environment that met the needs, wants and interests of residents, promoting all areas of group and 1-1 programming, as well as promoting desirable interaction and independence to individuals in foster group homes, day habs, private residences, hospitals and alternative care facilities
- Provided direct caregiver services and activity coordination.
Family Based Safety Services Caseworker
Collin County Children’s Advocacy Center
08.2008 - 10.2011
- Regularly monitored and mentored less experienced professional staff, completed audits in CAPS data base
- Provided comprehensive case management services for approximately 24 new and on-going cases referred by CPS
- Investigated possible abuse, neglect, and exploitation and conducted assessment of the client's physical, cognitive decisional capacity, social environment, and mental health functioning
- Advocated on their behalf, knowing when to intervene or how to involve family if they were a minor or other professional
- When appropriate, initiated court intervention based on investigative findings and assessments including removal from the at-risk environment and initiating guardianship proceedings, or other legal interventions
- Communicated with attorneys, probate magistrate, families and community support agencies, and provided expert witness testimony to offer recommendations to the court with respect to resolving risk
- Provided developmental disabilities/long-term services and supports
- Served as care management liaison between children and adults and their healthcare providers/schools and facilitated communication to coordinate proper care and placement
- Assisted clients with finances (as rep-payee), locating appropriate housing, end of life decisions, appropriate facilitation and supervision of caregiver and child interactions
- Coordinated multidisciplinary support to ensure that the individual's everyday functioning remains optimal and attend to changes in their physical, mental health, cognition, behavior and nutrition
- Established and maintained productive professional relationships with both internal and external customers based on open communication and a high quality, client-driven practice
- Maintained comprehensive case files, input data into the state system and comply with mandatory reporting requirements.
Rehabilitative Case Manager
Gulf Coast Center MHMR
05.2005 - 05.2008
- Identified a current and discreet caseload as part of an interdisciplinary team
- Served as a member of the treatment team coordinating and providing services, as needed
- Actively participated in team meetings as evidenced by discussion that is not only specific to assigned caseload
- Provided initial screening to determine priority population by conducting an intake interview and appropriate assessment to gather required information within average timeframe of 30 minutes
- Coordinated and tracked patient workflow
- Completed crisis screening to determine level of risk
- Completed referrals to internal/external resources as clinically indicated
- Coordinated with Patient Services Specialist for completion of financial screenings
- Coordinated with Eligibility Advisor for completion of benefits screening and Medicaid application where applicable
- Developed a person-centered recovery plans based on patient's needs and preferences
- Provided developmental disabilities/long-term services and supports
- Provided self-management strategies and clinical coordination to individuals, groups, and family members as defined by the agency using evidence-based strategies within the (TRR) model of care
- Provided crisis services to consumers and walk-ins to the clinic as needed
- Provided monthly documented face to face hours of direct service per month to GCC consumers and/or family members according to the current Direct Service Agreement.
Hairstylist
The Vision of Beauty
01.2001 - 05.2005
- Performed hair services including hair design, haircuts, color, texture, hair treatments, makeup applications, and ear piercing (where applicable)
- Built personal and professional rapport with all guests
- Provided professional product recommendations as part of all services
- Met/exceeded all individual sales and productivity goals
- Attended mandatory educations events and workshops
- Assisted in store duties (e.g., filling Salon retail displays and shelves.) Adhered to all Salon standards for guest service and cleanliness
- Attended manager led monthly business development meetings to support personal business growth.
Education
Master of Science Degree in Family Studies - Community Counseling
AMBERTON UNIVERSITY
05.2014
Bachelor of Science Degree in Behavioral Science - Psychology -
UNIVERSITY OF HOUSTON - CLEAR LAKE
05.2004
Skills
- Data Entry
- Effective communication skills
- Microsoft Office
- Telephone Etiquette
- Documentation And Reporting
- Interviewing
- Application Review
- Public Assistance
- Resource information
- Cultural Competency
- Social Services
- Eligibility Determination
Technology Proficiencies
- MS Office
- MS Outlook
- MS Word
- MS PowerPoint
- MS Excel
- CAPs / Database Systems
- Child Find and other Part C laws and regulations
- Knowledge of the developmental disability system, rules and regulations
- EHR / EMR and HIPAA Compliance
- SharePoint Spreadsheets
- OneNote organization
- CPR and First Aid Training
- Smart Care Database Experience
- Senior Safety Training and Common Sense for Families
- Certified SAMA Behavioral Health training
- Colorado Medicaid’s Program
- Consumer Direct Care Network Colorado
- MedCompass
- Telligen
- PeakPro
Timeline
Case Management Eligibility Specialist
Developmental Pathways, Inc.
07.2023 - Current
Mental Health Case Manager
AllHealth Network
04.2022 - 07.2022
Intensive Mental Case Manager
Jefferson Center for Mental Health
01.2019 - 04.2022
Social Services Manager Assistant
Morningstar Assisted Living and Memory Care at Applewood
01.2018 - 01.2019
Service Coordinator and Visitation Facilitator
Maple Star Colorado
05.2016 - 01.2018
Case Service Manager
D&S Community Services, Inc.
02.2015 - 03.2016
Community Living Assistance and Support Services - C.L.A.S.S. Case Manager
ResCare Home Health Care, Inc.
11.2011 - 12.2014
Family Based Safety Services Caseworker
Collin County Children’s Advocacy Center
08.2008 - 10.2011
Rehabilitative Case Manager
Gulf Coast Center MHMR
05.2005 - 05.2008
Hairstylist
The Vision of Beauty
01.2001 - 05.2005
Master of Science Degree in Family Studies - Community Counseling
AMBERTON UNIVERSITY
Bachelor of Science Degree in Behavioral Science - Psychology -
UNIVERSITY OF HOUSTON - CLEAR LAKE