Liala Suraleigh
Raleigh,NC
Summary
Prospective Master of Social Work student with 5+ years of healthcare, behavioral health, and care coordination experience. Background includes direct patient care, crisis support, Health Risk Assessments, utilization management, and advocacy for vulnerable populations. Committed to providing compassionate, person-centered care and pursuing clinical social work to support individuals and families through complex life challenges.
Overview
5
5
years of professional experience
1
1
Certification
Work History
Certified Nurse Assistant
Atrium Health Wake Forest Baptist
Winston-Salem, NC
01.2024 - 01.2026
- Assisted patients with daily living activities to enhance comfort and well-being.
- Provided crisis intervention and de-escalation techniques during high-stress situations.
- Engaged patients in recreational activities to promote social interaction and emotional well-being.
- Assisted medical staff with triage and patient assessments during high-pressure scenarios.
- Maintained accurate documentation of patient conditions and treatments for effective communication.
Performance Monitor Specialist
Centene
Cary, NC
12.2022 - 06.2023
- Conduct clinical audits for the Utilization Management team to ensure case documentation aligns with accrediting body standards, state guidelines, organizational policies, and documentation requirements.
- Apply knowledge to identify documentation deficiencies, compliance gaps, and opportunities for process improvement.
- Collaborate with leadership and corporate/clinical training teams to identify staff training needs and recommend refresher education.
- Modify and enhance audit tools to support accurate, relevant, and actionable data collection.
Utilization Review Coordinator
Humana
Cary, NC
06.2022 - 12.2022
- Conducted comprehensive reviews of medical necessity using CMS Articles for prior authorization requests.
- Managed case documentation to maintain accuracy and adherence to regulatory standards.
- Communicated with patients, to ensure timely delivery of Durable Medical Equipment
- Collaborated with healthcare providers to ensure compliance with CMS guidelines.
- Analyzed utilization trends to identify opportunities for cost containment and care optimization.
- Facilitated interdisciplinary meetings to discuss complex cases and establish treatment plans.
Care Management Support Assistant
Humana
Cary, NC
06.2021 - 06.2022
- Completed 20+ Health Risk Assessments daily to identify member needs, psychosocial barriers, health concerns, and opportunities for care coordination support.
- Supported Medicaid and Medicare members by gathering relevant information, documenting member needs, and assisting care teams with individualized service planning.
- Demonstrated strong patient advocacy by helping identify barriers related to access, transportation, social support, behavioral health needs, and continuity of care.
- Applied trauma-informed and culturally responsive communication when engaging members experiencing medical, behavioral, social, or financial challenges.
- Helped strengthen quality of care by identifying gaps in documentation, member engagement, and follow-up needs during the care management process.
Education
Bachelor of Arts - Psychology
North Carolina A&T State University
Greensboro, NC05-2026
Skills
- Transition of Care Coordination
- Behavioral Health Support
- Crisis Intervention Support
- Trauma-Informed Communication
- Psychosocial Assessment Support
- Health Risk Assessments
- Community Resource Navigation
- Case Management Support
- Utilization Management
Certification
- CNA - Certified Nurse Assistant
Timeline
Certified Nurse Assistant
Atrium Health Wake Forest Baptist
01.2024 - 01.2026
Performance Monitor Specialist
Centene
12.2022 - 06.2023
Utilization Review Coordinator
Humana
06.2022 - 12.2022
Care Management Support Assistant
Humana
06.2021 - 06.2022
Bachelor of Arts - Psychology
North Carolina A&T State University