Experienced mental health professional with 7 years of expertise in Utilization Review, behavioral health counseling, positive relationship building, and facilitating and negotiating coordination of care. Skilled in effective case management, problem solving, excellent communicator, and strong organizational skills.
Active Licensure:
California BBS Licensed Professional Clinical Counselor (LPCC)
Massachusetts Licensed Mental Health Counselor (LMHC)
Overview
12
12
years of professional experience
Work History
Behavioral Health Care Manager II
Elevance Heath- Carelon Behavioral Health
06.2022 - Current
Utilize screening criteria and clinical skills to complete acute inpatient behavioral health reviews based on medical necessity criteria.
Review cases and analyze clinical information in conjunction with medical directors to determine the appropriateness of hospitalization.
Maintain all utilization review documentation through EMR platform.
Train new staff, served as subject matter resource, providing information related to the utilization review process.
Comply with all policies, procedures and documentation standards in appropriate systems, tracking mechanisms and databases
Collaborate with providers to determine acuity of mental health concerns, barriers and progress; coordinate appropriate services
Behavioral Health Care Manager II- (Per Diem)
Elevance Health- Carelon Behavioral Health
10.2016 - Current
Utilize clinical skills to complete behavioral health medical necessity reviews.
Review cases and analyze clinical information in conjunction with medical directors to determine the appropriateness of hospitalization.
Collaborate with providers to determine acuity of mental health concerns, barriers and progress; coordinate appropriate services.
Provide telephonic support to members in crisis, assess risk for safety, provide consultation, treatment recommendation, and resources.
Program Clinical Case Manager- STARR Program
Robert F. Kennedy Children Action Corps, INC.
06.2015 - 09.2016
Provided intake and psychosocial assessments required by Department of Children and Families (DCF).
Developed and implemented individualized treatment plans addressing family relationship problems, destructive patterns of behavior and other psychosocial issues.
Provided therapy and clinical case management for full caseload
Recommended placement based on behavioral assessment and clients family dynamic.
Educated and collaborated with other providers regarding programs and services available.
Effectively function as a team to identify treatment goals, strengths, and needs relative to goals.
Crisis Clinician- Mobile Emergency Services
Community Healthlink, INC.
03.2015 - 09.2016
Provide emergency services for crisis calls/walk-ins, and mobile assessments for individuals in the community.
Provide brief, solution-focused interventions and evaluate current acuity for clients who meet criteria for higher level of care.
Engage in short-term case management services including coordination of care with insurance companies and community providers.
Maintain client records, following agency and state regulations, including knowledge of utilization management criteria.
Develop safety plans that are client centered and support a therapeutic partnership between the client and their support system.
Clinician/Outpatient Program Manager
Multicultural Wellness Center
02.2012 - 01.2015
Directly responsible for overseeing the daily operations of the Outpatient Program.
Responsible for assigning cases, training, hiring, and coaching clinicians to deliver exceptional client care through effective communication and evidence based treatment.
Trained and supervised student interns on wrap around services, case management, crisis intervention, clinical documentation, treatment planning, and medication referrals.
Facilitated weekly inter staff meetings, and functioned as a liaison between the agency and intern school sites.
Conducted individual, group, and family sessions with children, adolescents, and adults diagnosed with various mental health concerns.
Engaged with other professionals to discuss best treatment courses.
Education
M.Ed., Mental Health Counseling - Mental Health Counseling
Cambridge College
Boston, MA
06.2013
Bachelor of Arts - Art
Anna Maria College
Paxton, MA
05.2010
Skills
Utilization review
Critical thinking
Care management
Detailed documentation
Behavioral health counseling
Evidence based interventions
Aftercare planning
Leadership and training
Timeline
Behavioral Health Care Manager II
Elevance Heath- Carelon Behavioral Health
06.2022 - Current
Behavioral Health Care Manager II- (Per Diem)
Elevance Health- Carelon Behavioral Health
10.2016 - Current
Program Clinical Case Manager- STARR Program
Robert F. Kennedy Children Action Corps, INC.
06.2015 - 09.2016
Crisis Clinician- Mobile Emergency Services
Community Healthlink, INC.
03.2015 - 09.2016
Clinician/Outpatient Program Manager
Multicultural Wellness Center
02.2012 - 01.2015
M.Ed., Mental Health Counseling - Mental Health Counseling
Cambridge College
Bachelor of Arts - Art
Anna Maria College
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