Molly Cooper
Valley Village,CA
Summary
Licensed Clinical Social Worker seeking a position in Behavioral Health Utilization Review, Care Management, and/or Clinical Evaluation/Assessment.
Overview
27
27
years of professional experience
1
1
Certification
Work History
Utilization Review Specialist/LCSW
CA Billing, LLC
10.2022 - Current
- Conduct managed care utilization reviews for an independent behavioral health billing company and review organization. Provide utilization review for residential substance abuse and mental health facilities, completing both precertification and concurrent reviews for adults and adolescents. Review clinical cases to justify medical necessity for managed care authorizations and approvals, conduct peer to peer appeal level reviews, and facilitate care coordination. Fully remote position.
Utilization Review Specialist/LCSW
R & O Consulting
09.2014 - 05.2022
- Conduct managed care utilization reviews for an independent behavioral health billing company and review organization. Provided utilization review for residential substance abuse and mental health facilities, completing both precertification and concurrent reviews. Reviewed clinical cases to justify medical necessity for managed care authorizations and approvals, conducted peer to peer appeal level reviews, and facilitated care coordination. Fully remote position.
Licensed Clinical Social Worker
WellQor Psychological Services
03.2020 - 03.2022
- Conducted individual therapy with geriatric clients in an assisted living facility. Completed patient intakes and assessments and diagnostic evaluations. Engaged in short and long-term supportive therapy and crisis management, as well as case management with families as needed.
Director of Social Services
San Fernando Valley Adult Day Health Care (Community Based Adult Services)
11.2012 - 11.2014
- Conducted psychosocial assessments, cognitive testing, and individual & group therapy for mentally ill and dually-diagnosed adults and geriatric clients. Oversaw Social Services Department and provided training and education for staff members. Completed quarterly and 6-month patient re-evaluations to facilitate managed care Medi-Cal billing.
Behavioral Health Care Manager/Utilization Review
HIP – Health Insurance Plan of New York
05.2002 - 08.2004
- Care coordination for inpatient psychiatric and substance abuse admissions for members of regional managed care company. Duties include telephonic case management of members’ assessments and direction of their continued care, as well as consultations with the Medical Director to guide appropriate care.
EAP Care Manager/Utilization Review
Managed Health Network
04.2001 - 05.2002
- Telephone case management for inpatient psychiatric and substance abuse admissions for health plan members of a national managed care organization. Duties include initial assessment, concurrent reviews, confidential assessments, and referrals for members in the employee assistance program.
Clinical Social Worker
Century City Hospital Psychiatric Institute
03.1999 - 03.2001
- Daily performance of biopsychosocial assessments, discharge planning, group therapy, and crisis intervention - Adult and Geriatric Psychiatric Units.
Education
Masters of Social Work - Mental Heath
UCLA
05.1998
Bachelor of Arts Degree, B.A - Psychology and French Literature, Business Administration Minor
Washington University
St. Louis, Missouri06.1995
Skills
- Extensive clinical and mental health experience
- Effective time management
- Dependability, meets commitments, stays focused under pressure
- Problem solving skills-anticipates and prevents problems
- Communicates well both verbally and in writing, shares information with others
- Collaborative problem-solving
- Effective interpersonal communication
Certification
CA State Licensed Clinical Social Worker (2003-Present)
Timeline
Utilization Review Specialist/LCSW
CA Billing, LLC
10.2022 - Current
Licensed Clinical Social Worker
WellQor Psychological Services
03.2020 - 03.2022
Utilization Review Specialist/LCSW
R & O Consulting
09.2014 - 05.2022
Director of Social Services
San Fernando Valley Adult Day Health Care (Community Based Adult Services)
11.2012 - 11.2014
Behavioral Health Care Manager/Utilization Review
HIP – Health Insurance Plan of New York
05.2002 - 08.2004
EAP Care Manager/Utilization Review
Managed Health Network
04.2001 - 05.2002
Clinical Social Worker
Century City Hospital Psychiatric Institute
03.1999 - 03.2001
Bachelor of Arts Degree, B.A - Psychology and French Literature, Business Administration Minor
Washington University
Masters of Social Work - Mental Heath
UCLA
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