Monique Lewis
Chesterfield,VA
Summary
Passionate, highly skilled and dedicated case management professional with 13+ years of experience in the field and an extensive background in case management, analysis and assessing the needs of vulnerable families aging adults to develop care plans, discharge planning, managing members health issues, abuse and neglect prevention and investigation, leading interdisciplinary team meeting, and identifying needs. SME in Medicaid, Medicare, Grievances and case management. Skilled in active listening, interviewing, problem solving, investigation, customer service, conflict resolution, knowledge of health and social services systems, and knowledgeable of available resources and policies for government assistance.
Overview
20
20
years of professional experience
2
2
years of post-secondary education
Work History
SOCIAL SERVICE DIRECTOR
Canterbury Rehabilitation & Health
Henrico, VA
11.2021 - 11.2025
- Managed Care to Traditional Medicare Conversions
- Care Navigation meetings
- Insurance Authorizations
- Bed Management
- MDS
- UAI certified
- Assessed the Biopsychosocial needs of insured dual Medicaid/Medicare members to improve their circumstances. Evaluate members needs and care to ensure they are free from neglect or abuse.
- Analyzed the health and social needs of those with disabilities, elderly, and children.
- Identified and resolved high risk factors and service needs that may impact member outcomes and care planning
- Responded to time sensitive issues that may arise and worked towards a resolution by reviewing all details and using proper channels of communication.
- Discharge planning, Nursing facility placement, and developed care plans for each member.
- Coach, Train, and onboard staff provide case management using case management tools and reviewing and assessing for eligibility
- Serve as the facility's grievance officer (investigate and resolve)
- Collaborate with external resources to initiate referrals for home health and community providers.
- Conduct comprehensive social service assessments to include cognition, mood, and behaviors
- Organize and run Interdisciplinary team meeting for care plans that include resident's physical and mental health needs.
- Lead and work collaboratively with the department team members to ensure Medicare and Medicaid guidelines are followed.
- Conduct assessments evaluating memory, cognitions, and mood. Discharge planning
- Maintain an electronic database of client documentation and records.
- Discharge planning and transfers
- Assist in the investigations of all allegations of abuse or neglect of residents
- Supervise department staff to include provide training, hiring of new team members, provide performance evaluations, implementation of corrective action plans, and assignment of workload duties.
CASE MANAGER COORDINATOR (MEDICAID/CCC PLUS/EDCD/MANAGED CARE)
Aetna Better Health of Virginia
Richmond, VA
06.2017 - 11.2021
- Assisted with finding placement for admission to Skilled Nursing Facility placement.
- Assessed the Biopsychosocial needs of insured dual Medicaid/Medicare members to improve their circumstances.
- Insurance authorizations for services
- Evaluated member needs and care to ensure they are free from neglect or abuse.
- Assisted with discharge planning from skilled nursing facility and hospital stays
- Analyzed the health and social needs of those with disabilities, elderly, and children.
- Identified and resolved high risk factors and service needs that may impact member outcomes
- Care plans
CASE MANAGER
City of Hampton Social Services
Hampton, VA
01.2012 - 06.2016
- Conducted interactive interviews with clients to determine eligibility, award benefits, for SNAP, TANF, and/or Medicaid, followed by an explanation of eligibility.
- Interpret and maintain an extensive knowledge of state TANF, SNAP, Medicare, and Medical
- Assistance policies and regulations at the federal and state level.
- Provided ongoing case management by completing monthly renewals, care planning, interim reports, changes, and data analysis in a timely and accurate manner.
- Participate in care meetings, as a result coordinate necessary appoints and referrals to external agencies. Tracked school attendance and assisted with re-engaging teen client back
- into high school . Attended Family Assessment & Planning Meeting (FAPT)
- In addition to caseload management and daily responsibilities, served as a team member onspecial projects such as the Medicaid Renewal Catch-Up Project.
- Provided quality control by reviewing reports and case files for accuracy and competency of individual counselors. Conducted Ready by 21 Assessments for students & families.
CASE WORKER
El Paso County Department of Human Services
Colorado Springs, CO
09.2008 - 09.2009
- Completed intake process for new clients to establish eligibility using Federal, State, and County guidelines for TANF, Medicaid, and SNAP.
- Performed re-evaluations for TANF cases on a monthly basis, and six to twelve months for SNAP and Medicaid.
- Made referrals on behalf of clients to appropriate community based resources, which included contacting external agencies and coordinating appointments.
- Provided ongoing case management using CBMS system, ensuring accuracy and all requests and updates were completed in a timely manner.
- Tracked school attendance and assisted with re-engaging teen client back into high school.
FULL-TIME SUBSTITUTE TEACHER
Department of Defense Dependents Schools- Europe
10.2005 - 01.2008
- Led the instruction of various lesson plans created by assigned teachers in their absence at Schweinfurt (American) Middle School.
- Served as a permanent substitute teacher for 7th grade level science which included developing a 10 week lesson plan.
- Supervised students to ensure safety upon arrival to/departure from facility and during lunch periods.
- Responsible for managing electronic records of student grades and attendance.
Education
MASTER OF SCIENCE - Clinical Mental Health Counseling
Walden University
02.2024 - 02.2026
BACHELOR OF SCIENCE - Social Science, Psychology/Sociology
University of Maryland University College
FULL-TIME SUBSTITUTE TEACHER -
Department of Defense Dependents Schools- Europe
Skills
- Time Management
- Strong Leadership
- Strong Communication
- Training
- Microsoft Office
- Database Management
- Insurance Authorizations
- Strong Case Management
- Project Management
- Effective customer communication
- Written and verbal communication
- Multicultural sensitivity
- Discharge planning
- Team collaboration
Timeline
MASTER OF SCIENCE - Clinical Mental Health Counseling
Walden University
02.2024 - 02.2026
SOCIAL SERVICE DIRECTOR
Canterbury Rehabilitation & Health
11.2021 - 11.2025
CASE MANAGER COORDINATOR (MEDICAID/CCC PLUS/EDCD/MANAGED CARE)
Aetna Better Health of Virginia
06.2017 - 11.2021
CASE MANAGER
City of Hampton Social Services
01.2012 - 06.2016
CASE WORKER
El Paso County Department of Human Services
09.2008 - 09.2009
FULL-TIME SUBSTITUTE TEACHER
Department of Defense Dependents Schools- Europe
10.2005 - 01.2008
BACHELOR OF SCIENCE - Social Science, Psychology/Sociology
University of Maryland University College
FULL-TIME SUBSTITUTE TEACHER -
Department of Defense Dependents Schools- Europe