Kimberly James
Social Worker
Midlothian,TX
Summary
Compassionate Clinical Social Worker with 8 years of experience counseling and advocating for clients in Community organizations. Successful at providing both personalized and group psychotherapy and social support in hospital settings. Encouraging and empowering clients toward improved self-esteem and decision making. Specializing in working with diverse populations to locate necessary resources. Obtains authorizations, presents cases and coordinates intervention strategies.
Overview
8
8
years of professional experience
7
7
years of post-secondary education
Work History
QMHP Adult Intensive
Metrocare Services
Dallas, TX
2023.07 - Current
- Provide overall service coordination, psychosocial rehabilitation, emergency services/assessment, referrals.
- Transportation, linkage and advocacy to individuals with varying needs.
- Perform duties in concert with other members of an interdisciplinary treatment team.
- Ensure authorization for clinical services.
- Formulate individual recovery plan based on assessment findings on all new admissions
- Develop measurable objectives and goals agreed upon by the individual
- Actively assist in obtaining and modifying goals as needed
- Document all attempts to involve individual, service providers, and caregivers (unless
opposed by the individual) in service plan process - Review service plans every 180 days or as clinically indicated
- Participate in interdisciplinary team staffing
- Present psychosocial assessment findings
- Update team on progress or lack of progress in reaching agreed upon goals
- Provide relevant information that might affect course of treatment
- Follow-up with assigned individuals who miss a scheduled clinic appointment
- Document attempts to contact individual
- Report repeated unsuccessful efforts to contact the treatment team
- Oversee and assist assigned individuals with medication adherence
- Provide medication training, arrange transportation to scheduled office-based appointments, and prompt needed refills
- Document clinical services by close of next business day
- Perform follow-up hospital assessments the same day as requested by the hospital and report assessment outcome to the Clinical Manager
- Provide crisis intervention/on-call services during the work week and by weekend rotation
- Make home and hospital visits, initiate mental illness warrants, work with police and other public servants as needed to address crises for assigned clients
- Facilitate inpatient admission upon request of the treatment team and/or hospital
- Provide continuity of services throughout inpatient stay
Actively participate in discharge planning with hospital - Meet with the individual within 2 days of discharge in the community
- Evaluate progress of clinical session, solicit feedback from individual(s), and consult with colleagues and team leaders when dealing with unfamiliar/uncomfortable issues
- Co-facilitate family education workshops
- Identify and assist individuals in obtaining entitlements by providing referrals, advocacy, and negotiation as needed
- Participate in a required on-call rotation
- Perform other duties as assigned
Social Worker PRN
Haven Behavioral Hospital
Frisco, TX
09.2020 - Current
- Facilitated individual and group therapy sessions to solve problems, set and achieve goals and improve communication skills.
- Compiled socio-psychiatric case histories to facilitate accurate diagnoses.
- Maintained confidential case documentation.
- Coordinated mental health assessments for children, adolescents and adults.
- Administered conflict resolution strategies to help families resolve disputes.
- Maintained lists of resources helpful to clients.
- Refer patients to community resources for mental health treatment, child protective services and assistance for people with developmental disabilities.
- Interview clients individually and in family groups to determine services to best address specific needs.
- Practice cognitive behavioral therapy, motivational enhancement
Clinician II/Therapist
Compass Health
Everett, WA
04.2022 - 03.2023
- Provided a range of clinically indicated services, including but not limited to individual psychotherapy, group therapy, family therapy and case management services for children with behavioral health conditions and their families and natural supports.
- Responsible for assessing client/family functioning and needs and partnering with the client/family to develop an individually tailored care plan designed to address the
client/families goals. - Complies with all accurate and appropriate charting, coding and billing procedures as required by the regulatory organizations.
- Documents delivery of services in the medical record. Completes all paperwork to agency standard and within required timelines.
- Meets and Exceeds service hour expectations and/or response time exceptions established by the agency.
- Completes client assessments in accordance with the DSM and other external and internal requirements, and qualifications allow.
- Accepts primary responsibility for the treatment of a caseload of clients.
- Establishes a treatment plan and goals with client/family and evaluates progress throughout treatment.
- Follow Mandated Reporting protocols
- Participates in regularly scheduled supervision and team meetings.
- Established appropriate course of treatment and implemented interventions.
Medical Social Worker
InnovAge Colorado PACE
Lakewood, CO
01.2022 - 04.2022
- Coordinated psychosocial assessments, treatment plans and progress notes.
- Documented services and collected required data for evaluation.
- Guided clients in development of skills and strategies for dealing with individual problems.
- Collaborated with other professionals to assess client needs.
- Referred client or family to appropriate community resources to obtain support for mental or physical illness.
- Educated clients on options to assist in making informed decisions.
- Modified treatment plans to accommodate changes in clients' health or progress.
Service Coordinator (Social Worker)
Aetna Medicaid Administrators LLC
Arlington, TX
10.2017 - 12.2021
- Developed and incorporated community-based programs to meet various needs and monitored each program's effectiveness.
- Partnered with similar organizations to meet greater needs, preventing duplication and optimizing resource utilization.
- Collaborated with team members to identify and accomplish agency objectives.
- Coordinated referrals to community services by advocating for individual needs and addressing roadblocks.
- Assessed each member's psychosocial needs.
- Produced and updated organizational records and reports, including documentation.
- Provided excellent service and attention to customers when face-to-face or through phone conversations.
- Improved customer satisfaction by finding creative solutions to problems.
- Maintained updated Texas Star Kids Program knowledge through weekly trainings and learning center instruction.
- Improved operations by working with team members and customers to find workable solutions.
- Worked closely with team members to deliver project requirements, develop solutions and meet deadlines.
- Attended departmental meetings, providing feedback to enhance future performance.
- Maximize member's health, well-being, and independence.
- Work with the member's PCP to coordinate services.
- Health risk assessments and screening of administrative data.
- Utilization of medical resources for members with special health care needs.
Customer Service Advocate
Aetna Medicaid Administrators LLC
Arlington, TX
12.2016 - 10.2017
- Stayed on top of changing internal policies, company offerings and promotions to effectively serve every customer.
- Encouraged customers to become self-sufficient with web-based and mobile support tools.
- Consulted with customers to determine best methods to resolve service and billing issues.
- Handled escalated calls for front-line associates to address complex issues and restore customer satisfaction.
- Capitalized on opportunities to enhance customer experiences and bring in repeat business.
- Prepared, completed and processed customer account forms and database changes.
- Informed customers about billing procedures, processed payments and provided payment option setup assistance.
- Consulted with customers regarding medical plan needs, addressing benefit concerns.
- Trained 10 new employees each quarter in procedures and policies in order to maximize team performance.
- Delivered fast, friendly and knowledgeable service for routine questions and service complaints.
- Evaluated customer account information to assess current issues and determine potential solutions.
- Worked with external medical facility representatives to address customer needs.
- Upheld privacy and security requirements established by HIPPA regulatory agencies.
- Completed continuing education and training programs for professional development.
- Evaluated benefits for each caller to determine service needs and address concerns.
- Documented conversations with customers to track requests, problems and solutions.
- Displayed a high level of empathy and patience.
- Reviewed claim history to ensure accuracy of benefits, co-insurance and deductibles.
Therapist Intern
Green House Addiction Center
Grand Prairie, TX
08.2015 - 05.2016
- Utilized empathy and active listening to build relationships with clients.
- Promoted client awareness and growth with therapeutic interventions.
- Maintained clinical documentation of goals and progress.
- Supported practice efficiency by answering telephone calls, making appointments and organizing records.
- Improved operations by working with team members and customers to find workable solutions.
- Created agendas and communication materials for team meetings.
- Provided excellent service and attention to customers when face-to-face or through phone conversations.
- Improved customer satisfaction by finding creative solutions to problems.
- Attended departmental meetings, providing feedback to enhance future performance.
- Worked closely with team members to deliver project requirements, develop solutions and meet deadlines.
- Client intake and assessment
- Facilitated group therapy, monitored individual therapy
- Partnered with outside resources to coordinate client care
- Observed protocol for utilization review
Education
Master of Science - Social Work
The University of Texas At Arlington
Arlington, TX 01.2014 - 05.2016
Bachelor of Arts - Criminal Justice/Sociology
St. Leo University
St Leo, Florida 01.2004 - 06.2008
Skills
- Verbal and Written Communication
- MARX/CMS, ASD, RUMBA, FIS, MEDHOK, AVATAR,
- Microsoft XP, MS Word, Excel, Outlook, PowerPoint
- Gather Referrals
- Coordination of care for clients
- Patient Evaluation
- Discharge Planning
- Conducting Assessments
- Group therapy
- Treatment Plan
- Modification Cultivate strategies to coordinate services for members
- Policy/Procedure development /enforcement
- Community Resource Referral
- Client-focused service
- Psychosocial evaluations
- Member service and support
- Individual service plans
- Crisis Resolution
- ANSA Certified
- Assist Certified
- BLS Certified
- LSWAIC Credential (Washington State Department of Health)
Affiliations
- Volunteer for Jubilee Theater 2020 - Present
- United States Navy Veteran 1996-2003
Timeline
QMHP Adult Intensive
Metrocare Services
2023.07 - Current
Clinician II/Therapist
Compass Health
04.2022 - 03.2023
Medical Social Worker
InnovAge Colorado PACE
01.2022 - 04.2022
Social Worker PRN
Haven Behavioral Hospital
09.2020 - Current
Service Coordinator (Social Worker)
Aetna Medicaid Administrators LLC
10.2017 - 12.2021
Customer Service Advocate
Aetna Medicaid Administrators LLC
12.2016 - 10.2017
Therapist Intern
Green House Addiction Center
08.2015 - 05.2016
Master of Science - Social Work
The University of Texas At Arlington
01.2014 - 05.2016
Bachelor of Arts - Criminal Justice/Sociology
St. Leo University
01.2004 - 06.2008
Similar Profiles
Jim NanceJim Nance
Adult Clinical Manager at Metrocare ServicesAdult Clinical Manager at Metrocare Services
Timmisha JacksonTimmisha Jackson
Enrollment Wavier Service Coordinator at MetroCare ServicesEnrollment Wavier Service Coordinator at MetroCare Services
Devin FosterDevin Foster
Complex Trauma Therapist/Mentor at Metrocare ServicesComplex Trauma Therapist/Mentor at Metrocare Services