Renee Campbell
Cary,NC
Summary
Utilization management professional prepared to bring deep understanding of healthcare regulations and efficient case management to role. Proven ability to streamline processes and improve member care coordination, fostering collaborative team environment that adapts to evolving needs. Recognized for problem-solving skills and effective communication in high-pressure scenarios.
Overview
27
27
years of professional experience
1
1
Certification
Work History
Utilization Management MHSUD Clinical Care Special
Alliance Health
07.2012 - Current
- Conducted thorough reviews of clinical documentation, ensuring compliance with regulatory requirements and industry standards.
- Managed complex cases involving multiple stakeholders, expertly navigating sensitive situations while maintaining a focus on member outcomes.
- Proactively identified potential barriers to effective service delivery, working closely with stakeholders to address issues.
- Reduced wait times for essential services by effectively managing utilization review caseloads and prioritizing urgent requests.
- Collaborated with interdisciplinary teams to develop customized care plans tailored to individual member needs.
- Ensured proper documentation and coding of medical treatments, enhancing billing accuracy and reimbursement rates.
- Assisted in the development of targeted strategies aimed at reducing unnecessary service usage without compromising quality of care.
Utilization Review Manager
Value Options
08.2010 - 06.2012
- Maintained confidentiality of sensitive member information while adhering to HIPAA regulations during the utilization review process.
- Facilitated productive relationships with stakeholders including physicians, nursing staff, case managers, social workers, payers, members, families to promote a collaborative approach towards care coordination.
- Ensured consistent application of admission criteria among team members through ongoing education and feedback sessions.
- Contributed to multidisciplinary meetings discussing appropriate level of care determinations, discharge planning and post-acute care services.
Outpatient Therapist/Supervisor
Easterseals UCP
04.2005 - 07.2010
- Maintained records of each member and kept up-to-date on progress.
- Maintained strong partnerships with referral sources through regular communication updates on member progress and successful reintegration into the community.
- Strengthened communication between members, families, and medical professionals by collaborating with multidisciplinary teams for comprehensive care.
- Implemented a diverse range of therapeutic modalities to address members' varied needs and preferences, including cognitive-behavioral therapy, dialectical behavior therapy, and solution-focused brief therapy.
Care Manager
FYI/ASAP
11.2003 - 04.2005
- Assisted families with daily living needs to maintain self-esteem and general wellness.
- Educated families on community resources, treatment options and health care services to better manage conditions.
- Assessed children/families and developed plans to meet needs.
- Developed strong rapport with families through empathetic listening and compassionate communication techniques.
- Managed complex caseloads, ensuring timely assessment, intervention, and documentation for optimal care outcomes.
- Facilitated family meetings to address concerns, establish goals of care, and provide psychosocial support.
- Established and maintained relationships with children, families and community partners to coordinate services to meet client's needs.
Professional Foster Care Social Worker
FamiliesFirst, Inc.
03.1999 - 06.2002
- Provided transportation for children and parents to and from visits and court.
- Advocated for foster children by facilitating access to community resources and services to maximize safety and well-being of child.
- Assisted families in developing problem-solving and coping skills by providing counseling and referring to appropriate community agencies.
- Collaborated with case managers and community partners to deliver effective treatment and case collaboration.
- Conducted home, school and community visits to assigned clients to assess childrens' level of care and provide guidance towards meeting treatment goals.
- Increased placement stability by closely monitoring foster home environments and addressing any concerns promptly.
- Provided on-going support to resource parents through coaching, training and crisis intervention techniques.
- Provided crisis intervention services to address immediate safety concerns and prevent further escalation of issues within the family unit.
- Improved family reunification rates by conducting regular home visits and providing support to foster parents.
Clinical Intern
Florence Crittendon Agency
08.1997 - 11.1998
- Participated in regular supervision sessions, receiving feedback to improve professional skills and knowledge continually.
- Conducted thorough member assessments to identify needs and provide appropriate interventions.
- Utilized critical thinking skills when encountering challenging situations that required immediate attention or intervention.
- Collaborated with case managers to ensure appropriate utilization of resources for complex cases requiring additional support services.
- Fostered an inclusive environment where all residents felt respected regardless of their cultural background or personal beliefs.
Education
Master of Science - Counseling
University of Tennesse
Knoxville12.1998
Bachelor of Arts - Psychology
University of North Carolina
Chapel Hill12.1994
Skills
- HIPAA Compliance Understanding
- Critical thinking abilities
- Professionalism and Ethics
- Documentation accuracy
- Time management mastery
- Resourcefulness and Initiative
- Goal Oriented Approach
- Utilization Review Expertise
- Clinical assessment
Certification
- North CarolinaLicensed Clinical Mental Health Clinician #4486 12/5/2003-6/30/2025
Timeline
Utilization Management MHSUD Clinical Care Special
Alliance Health
07.2012 - Current
Utilization Review Manager
Value Options
08.2010 - 06.2012
Outpatient Therapist/Supervisor
Easterseals UCP
04.2005 - 07.2010
Care Manager
FYI/ASAP
11.2003 - 04.2005
Professional Foster Care Social Worker
FamiliesFirst, Inc.
03.1999 - 06.2002
Clinical Intern
Florence Crittendon Agency
08.1997 - 11.1998
- North CarolinaLicensed Clinical Mental Health Clinician #4486 12/5/2003-6/30/2025
Master of Science - Counseling
University of Tennesse
Bachelor of Arts - Psychology
University of North Carolina
Similar Profiles
Shandi LansdaleShandi Lansdale
RN at Alliance HealthRN at Alliance Health
Carleigh MannCarleigh Mann
Medical Assistant at Alliance HealthMedical Assistant at Alliance Health
Reginald WoodReginald Wood
ER Registered Nurse at Alliance HealthER Registered Nurse at Alliance Health