Justin Blake
Miami
Summary
I am a Licensed Clinical Social Worker with a background in Medical Social Work and Case Management. My experience includes working with adults and families in different clinical settings such as: acute care, corrections and managed care. My experience comes with a working knowledge of different mental health treatment modalities which have allowed me to create and implement effective, individualized plans considering the unique structure and culture of the individual and family. I am seeking a position that will allow me to continue grow professionally and clinically, while being able to effectively put into practice the knowledge I already have.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Behavioral Health Care Advocate
Optum, UnitedHealth Group
10.2022 - Current
- Researched issues and took appropriate action to resolve issues within turnaround time requirements and quality standards.
- Documented activities and progress in electronic medical record per defined policy and procedures.
- Contacted third-party payors to obtain and confirm authorization for services and communicated necessary related clinical information.
- Prepared documents and reports for clinical reviews and discharge plans.
- Collaborated with healthcare providers to facilitate smooth transitions of care for patients across different settings.
Behavioral Health Utilization Management Professional
Tricare – Humana Health Plan
03.2022 - 10.2022
- Perform review of emergent/urgent and continued stay requests for appropriate care and setting, following guidelines and policies, and approve services or forward requests to the appropriate Physician or Medical Director with recommendations for other determinations
- Complete medical necessity and level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings
- Collaborate with various staff within provider networks and discharge planning team electronically, or telephonically to coordinate member care
- Manage inpatient and outpatient behavioral health cases throughout the entire treatment
Telephonic Behavioral Health Social Worker
Humana – Care Plus Health Plan
01.2021 - 03.2022
- Receive, screen, triage, and respond to telephone calls from members requiring Behavioral Health clinical direction and advice
- Link members/family to appropriate community resources such as information/referral to sources of financial assistance, transportation, support groups and other community services
- Co-developing the Prescription Assistance Program (PAP) which will provide intervention for members who are in a coverage gap or lack funding for necessary medications
Licensed Health Services Counselor
Jackson Health System – Corrections Health Services
08.2020 - 10.2021
- Conduct intake assessments for newly incarcerated persons to determine appropriate level of care in custody
- Assist Psychiatrist with crisis management of violent, suicidal and/or psychotic inmates
- Provide consultation to the Correctional staff to effect emergency or involuntary transfer or placement of an inmate in need acute psychiatric care
- Conduct individual and group counseling session that were referred by Psychiatrist
- Coordinate discharge planning needs prior to an inmates release, connecting them with medical, housing, and vocational resources
Care Coordinator
South Miami Hospital
05.2018 - 08.2020
- Functioned as a Case Manager and Utilization Review specialist to coordinate authorization and/or delivery of acute and post-acute services and coordinate follow-up care to ensure plans for continuity of care and adherence to quality standards
- Interact with facility staff, primary care teams and other treatment team members to evaluate transition of care needs and prepare member and family for discharge
- Engage in clinical rounds as an active treatment team member providing guidance on level of care recommendations, transition of care recommendations and providing feedback on what will be needed for authorization of clinically indicated services and to decrease peer to peers
- Cross trained to perform Social Work duties in different acute care specialties– Critical Care Units, Emergency Room, Med/Surg, Pulmonary, Oncology, Neuro/Ortho, Mother Baby
Education
No Degree - Practical Nursing
Mercy Hospital, School of Practical Nursing
Miami, FL04-2025
Masters - Social Work
Barry University
05.2018
Bachelor of Science - Health Science
Florida Agricultural And Mechanical University
Tallahassee, FL05-2015
Skills
- Problem-solving
- Multitasking and organization
- Team collaboration
- HIPAA compliance
- Verbal and written communication
- Patient education
- Electronic health records
- Relationship building
- Phone and email etiquette
- Medical terminology
- Policy understanding
- Quality assurance
Certification
- Licensed Clinical Social Worker, FL, SW 17317
- Certified Case Manager (CCM), 4256435
Timeline
Behavioral Health Care Advocate
Optum, UnitedHealth Group
10.2022 - Current
Behavioral Health Utilization Management Professional
Tricare – Humana Health Plan
03.2022 - 10.2022
Telephonic Behavioral Health Social Worker
Humana – Care Plus Health Plan
01.2021 - 03.2022
Licensed Health Services Counselor
Jackson Health System – Corrections Health Services
08.2020 - 10.2021
Care Coordinator
South Miami Hospital
05.2018 - 08.2020
No Degree - Practical Nursing
Mercy Hospital, School of Practical Nursing
Masters - Social Work
Barry University
Bachelor of Science - Health Science
Florida Agricultural And Mechanical University
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