Summary
Overview
Work History
Education
Skills
Certification
Volunteer Experience
Timeline
Generic

Michelle Kraynack Faux

Stow

Summary

Licensed Mental Health Counselor with 15+ years of experience in patient care, care coordination, and insurance utilization management. Extensive experience collaborating with healthcare providers and insurance companies to evaluate authorization requests, coordinate treatment across the continuum of care, and ensure appropriate access to services. Skilled in-patient advocacy, benefits navigation, clinical case management, and multidisciplinary care coordination. Known for delivering compassionate, patient-centered support while resolving complex coverage and treatment access issues.

Overview

25
25
years of professional experience
1
1
Certification

Work History

Integrated Behavioral Health Clinician

Post Road Pediatrics
Sudbury
01.2020 - Current
  • Provide behavioral health services within a multidisciplinary pediatric care setting
  • Collaborate closely with pediatricians, families, schools, and community providers to coordinate care and ensure continuity of treatment
  • Delivered short-term therapy for patients ages 4-23 to address immediate behavioral health needs
  • Managed patient care coordination and support services within a clinical setting.
  • Ensure behavioral health access to all patients in the practice
  • Facilitated referrals and navigation of behavioral health services and insurance coverage for families
  • Coordinate outpatient referrals for ongoing therapy
  • Coordinated transition care for patients aging out of the practice at 23 to ensure continued support
  • Advocate for patients by preparing clinical documentation supporting educational and healthcare accommodations (504 plans and IEPs)
  • Provide patient advocacy
  • Collaborate with administrative team on benefits verification
  • Maintain HIPAA-compliant documentation within electronic health systems
  • Post Road Pediatrics – Integrated Behavioral Health Clinician

Licensed Mental Health Counselor

Private Practice
Sudbury
07.2018 - Current
  • Perform clinical work utilizing Cognitive Behavioral Therapy
  • Provide clinical services to individuals and families
  • Completed clinical documentation accurately to maintain compliance and support effective treatment planning
  • Ensured adherence to HIPAA regulations
  • Coordinated insurance collaboration and benefits verification to ensure client access to necessary services
  • Submit online billing for services

Licensed Mental Health Counselor

Private Practice
Cambridge
02.2011 - Current
  • Applied Solution-Focused Brief Therapy and Cognitive Behavioral Therapy to address client needs and promote positive mental health outcomes
  • Delivered clinical services to individuals and families, fostering emotional well-being and resilience
  • Provided individual and group counseling to diverse clients in private practice.
  • Developed personalized treatment plans based on client assessments and goals.
  • Conducted psychological evaluations to identify mental health issues and needs.

Utilization Reviewer

TaraVista Behavioral Health
Devens
01.2018 - 12.2019
  • Conducted utilization review for child and adolescent units to ensure appropriate care and resource allocation
  • Evaluate clinical information on-site and telephonically regarding requests for authorization for payment of care
  • Obtain preauthorization for psychiatric care and coordinate hospital length of stay
  • Collaborate and coordinate with physicians, patients, and the treatment team to evaluate clinical appropriateness of treatment and interventions
  • Assist with the management of treatment across the continuum of care
  • Served as liaison between insurance companies and clinical team to facilitate effective communication and authorization processes
  • Authorized after-care services and coordinated step-down levels of care for patients transitioning from intensive treatment to enhance continuity of care
  • Work closely with physicians and nurses to obtain information pertaining to medical necessity for care
  • Work with commercial insurance companies and MassHealth/Medicare
  • TaraVista Behavioral Health – Utilization Reviewer

Counselor

Counseling Collaborative
Lexington
07.2012 - 07.2018
  • Executed clinical work using Solution-Focused Brief Therapy and Cognitive Behavioral Therapy to facilitate client progress
  • Delivered clinical services to individuals and families, addressing diverse mental health needs
  • Collaborated in group practice settings to enhance and implement comprehensive treatment plans.

Intensive Clinical Manager

Massachusetts Behavioral Health Partnership
Boston
01.2011 - 07.2012
  • Coordinated complex clinical cases for insurance authorization and care across multiple levels of care
  • Collaborated with providers, members, and treatment teams to determine medical necessity and appropriate treatment authorization
  • Streamlined communication between healthcare providers and insurance payers to ensure timely access to services
  • Assisted in managing treatment transitions and continuity of care across inpatient, outpatient, and community services (CBHI-Child Behavioral Health Initiative)
  • Evaluated clinical documentation and implemented established utilization management guidelines

Care Manager

Massachusetts Behavioral Health Partnership
Boston
09.2009 - 01.2011
  • Managed prior authorization requests to secure necessary treatments.
  • Conducted utilization reviews to assess service necessity for clients.
  • Facilitated care coordination efforts to enhance patient support and outcomes.
  • Implemented case management strategies to support client health needs.
  • Navigated insurance processes for clients, ensuring access to essential services.
  • Conducted daily telephonic assessments with social workers and physicians to gather data for referral and certification decisions.
  • Made clinical decisions related to assessment, referral, coordination of care, and appropriateness of care for members accessing their benefits for mental health or substance abuse services at all levels of care covered by contracts using established criteria, guidelines, and policies.
  • Performed triage, management, and referral of cases requiring higher levels of care management.
  • Authorized community support programs (CSP) coverage, enhancing client care access.

School Counselor

Dearborn Academy
Arlington
10.2008 - 06.2009
  • Conducted crisis intervention for students, ensuring immediate support and guidance during critical situations
  • Collaborated with teachers, counselors, and administrators to mediate and resolve student conflicts, fostering a supportive school community.
  • Facilitated behavior management strategies in classrooms, promoting a positive learning environment
  • Provide clinical services to individuals, families, and groups

Clinician

Walden Street School, Justice Resource Institute
Concord
07.2007 - 10.2008
  • Facilitate individual, group, family therapy
  • Implement and maintain DBT clinical model
  • Complete assessments and differential diagnosis
  • Collaborated with multidisciplinary treatment team to enhance patient care and treatment outcomes
  • Design and facilitate group therapy program
  • Clinical case management
  • Managed emergency situations, utilizing CPI restraint techniques to ensure patient and staff safety
  • Coordinated with state agencies and public school systems to streamline service integration for improved access to care

Assistant Program Director

YOU Inc., Wetzel Center, Latency Unit
Worcester
12.2005 - 07.2007
  • Assisted Program Director with administrative tasks, including staff hiring, training, and ensuring client and staff safety
  • Assumed Program Director responsibilities when Program Director was on maternity leave
  • Fulfill Program Director duties in her absence
  • Oversee and assist clinical staff on the unit
  • Conducted individual and family treatment sessions and coordinated discharge planning
  • Facilitated case conferences with collaterals to assess client treatment needs and evaluate progress
  • Develop and implement behavioral interventions
  • Determine appropriate client intakes for the current milieu
  • Complete utilization reviews with insurance company
  • Participate in administrative meetings
  • Provided on-call support for staff regarding medication consultations, crisis interventions, and intake approvals
  • Managed comprehensive client case files

Latency Unit Clinician

YOU Inc., Wetzel Center, Latency Unit
Worcester
08.2005 - 12.2005
  • Collaborated with clinical treatment team to assess client diagnosis, treatment options, and ongoing needs
  • Facilitated case conferences to evaluate client treatment needs and monitor progress against treatment plan
  • Coordinated with family members and collateral providers to assess client needs, track progress, and finalize discharge plan
  • Conduct individual treatment and discharge planning
  • Develop and implement behavioral interventions
  • Perform case management
  • Managed clinical case files to ensure comprehensive care

Counseling Intern

Dearborn Academy
Arlington
09.2004 - 06.2005
  • Provide individual counseling with children and adolescents
  • Lead psycho-education groups
  • Executed crisis intervention with students, ensuring safety and emotional support during critical situations.
  • Developed treatment plans and conducted clinical assessments to guide therapeutic strategies for clients.
  • Collaborated with multidisciplinary team, consulting with educators and administrators to resolve conflicts and promote student well-being.
  • Participate in team review meetings and educational planning meetings
  • Maintain contact with family members and collateral providers of clients

Preschool Assistant Teacher

Jewish Community Center
Brighton
09.2003 - 08.2004
  • Organized and implemented lesson plans to foster student learning and development
  • Assisted lead teacher in planning and implementing daily lesson plans.
  • Supported children's social and emotional development through interactive activities.
  • Facilitated engagement in art and religious projects to promote creativity and deeper understanding.
  • Organized classroom materials and maintained a clean, safe environment.

Milieu Counselor

Dearborn Academy
Arlington
09.2002 - 06.2003
  • Performed crisis intervention with students to de-escalate situations and promote emotional stability
  • Implemented behavior management system and assisted in restraints.
  • Instructed students in various enrichment subjects to enhance learning experiences
  • Assisted during Art and Gym classes to facilitate engagement and support student participation

Assistant Teacher

Dearborn Academy
Arlington
09.2001 - 06.2002
  • Developed and implemented engaging Mathematics, Language Arts, and Social Studies lessons tailored for diverse learning needs in Special Education classroom
  • Assisted head teacher in delivering interactive Art and Gym lessons to enhance student participation
  • Executed behavior management strategies to promote a positive learning environment

Education

Master of Arts - Mental Health Counseling

Boston College
Chestnut Hill, MA
05-2005

Bachelor of Arts - Psychology, Minor in Spanish

Skidmore College
Saratoga Springs
05-2001

Skills

  • Patient Centered Behavioral Health Therapy
  • Clinical Case Management
  • Case management
  • Care Coordination
  • Treatment Continuity Management
  • Multidisciplinary Collaboration
  • Provider & Payer Communication
  • Insurance Authorization & Utilization Review
  • Benefits & Coverage Navigation
  • Clinical documentation
  • HIPAA Compliance
  • Patient Advocacy

Certification

  • SPACE (Supportive Parenting for Anxious Childhood Emotions) Therapy, Eli Lebowitz / Yale Child Study Center, 04/25
  • Integrating Solution-Focused Therapy into Clinical Practice, Boston Children’s Hospital, 04/21
  • Solution-Focused Brief Treatment, Solutions, Sudbury, MA, 04/11
  • Trauma Training (play therapy), Justice Resource Institute, 04/07
  • HIPAA annual training, Pediatric Physician’s Organization / Boston Children’s Hospital, Ongoing
  • Monthly clinical trainings, Pediatric Physician’s Organization / Boston Children’s Hospital, Ongoing
  • Maintain LMHC licensure, 30 CEUs completed regularly (Boston Children’s Hospital trainings)

Volunteer Experience

  • Hole In the Wall Gang, Volunteer Summer Camp Counselor for campers with HIV, Summer 2008
  • Hole In the Wall Gang, Volunteer Summer Camp Counselor for Sibling Campers, One week Summer 2009
  • Alliance of Therapy Dogs, Membership and Therapy Dog Certification, 04/28/25
  • Alliance of Therapy Dogs, Volunteer visits with therapy dog, in homes, schools, nursing homes.
  • Post Road Pediatrics, Volunteer therapy dog, for Needle Phobia and therapy sessions

Timeline

Integrated Behavioral Health Clinician

Post Road Pediatrics
01.2020 - Current

Licensed Mental Health Counselor

Private Practice
07.2018 - Current

Utilization Reviewer

TaraVista Behavioral Health
01.2018 - 12.2019

Counselor

Counseling Collaborative
07.2012 - 07.2018

Licensed Mental Health Counselor

Private Practice
02.2011 - Current

Intensive Clinical Manager

Massachusetts Behavioral Health Partnership
01.2011 - 07.2012

Care Manager

Massachusetts Behavioral Health Partnership
09.2009 - 01.2011

School Counselor

Dearborn Academy
10.2008 - 06.2009

Clinician

Walden Street School, Justice Resource Institute
07.2007 - 10.2008

Assistant Program Director

YOU Inc., Wetzel Center, Latency Unit
12.2005 - 07.2007

Latency Unit Clinician

YOU Inc., Wetzel Center, Latency Unit
08.2005 - 12.2005

Counseling Intern

Dearborn Academy
09.2004 - 06.2005

Preschool Assistant Teacher

Jewish Community Center
09.2003 - 08.2004

Milieu Counselor

Dearborn Academy
09.2002 - 06.2003

Assistant Teacher

Dearborn Academy
09.2001 - 06.2002

Master of Arts - Mental Health Counseling

Boston College

Bachelor of Arts - Psychology, Minor in Spanish

Skidmore College
Michelle Kraynack Faux