Resean Lighty
Pawtucket,RI
Summary
Responsive Health Advocate with demonstrated case management experience to provide outreach and support services to community residents. Establishes trusting relationships with patients and families while offering education, assessment and social support to manage health conditions. Works closely with medical providers to support comprehensive and coordinated care while facilitating ongoing follow-up and goal setting with patients and families.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Health Advocate
Blue Cross Blue Shield of Rhode Island
09.2023 - Current
- Respond to member phone calls and conduct outreach calls to identified members; facilitate problem
resolution through research. Refer call to appropriate resources in a timely manner.
Promote behavioral health management programs and provide community resources available to
members; utilize engagement skills and motivational interviewing techniques to enroll members in
programs.
Perform behavioral health assessments with members and caregivers.
Assist with coordinating patient care, e.g., transportation arrangements, medical appointment
reminders, referrals, and preventive care education and/or follow-up care adherence. Refer and assist
clients in accessing needed resources to meet identified needs, including grant applications, medication
assistance, transportation, behavioral and substance abuse treatment, etc.
Maintain supportive communication with the member via the member’s channel preference (phone,
web, e-mail, mail); provide education, monitor and reporting compliance, identify gaps in care, and
adjust the plan as needed.
Consult with internal clinical staff as needed when assessment or gaps in care indicate increasing
severity of the member’s condition requiring more intense monitoring and intervention.
Consult with other clinical staff (dietician, nurses, behavioral health clinician, medical director) on an as
needed basis.
Participate in ongoing quality improvement initiatives and overall department efficiencies.
Participate in clinical rounds with behavioral health case management, behavioral health utilization
management and medical director.
Assist team with department initiatives and projects.
Perform other duties as assigned.
Behavioral Health Specialist III
Bradley Hospital
10.2016 - Current
- Responsible for milieu management i.e
- Coordinate milieu treatment oversee implementation of behavior management plans monitor documentation of BHS Is and IIs in electronic medical record
- In concert with Clinical Nurse Manager/Program Director supervise Behavioral Health Specialists regarding job performance and achievement of expected professional development goals
- Establish goals for milieu staff performance and professional growth along with recommending and carrying out hospital disciplinary policies as necessary
- Responsible for the orientation of new staff including the development of orientation materials and experiences pertaining to the milieu
- Interview prospective staff members for employment
- Evaluate qualifications and recommend qualified individuals for consideration
- Participate in the ongoing process of consultation with the treatment team family outside agencies etc
- Responsible for scheduling milieu staff i.e
- Vacations personal days and earned days etc.
Case Manager Supervisor
Action Based Enterprises
04.2012 - 05.2017
- Prepared and maintained records and case files detailing clients' personal and eligibility information, services provided and relevant correspondence
- Handled caseload of more than 15 clients
- Mobilized case management system to document service delivery and case progress
- Liaised with community partners to enhance employment opportunities for individuals with disabilities
- Keep projects on schedule by managing deadlines and adjusting workflows
- Onboarded new employees with training and new hire documentation.
Education
Bachelor of Science - Psychology
Capella University
MN, Unknown09.2023
High School Diploma -
East Providence High School
East Providence, RISkills
- Verbal and Written Communication
- Documentation And Reporting
- Leadership
- Customer Relationship Management Systems
- Microsoft office suite
- Data Driven Decision Making
- Creative Problem Solving
Certification
- CPR and First Aid
- Community HealthCare Worker
- Health and Wellness
Timeline
Health Advocate
Blue Cross Blue Shield of Rhode Island
09.2023 - Current
Behavioral Health Specialist III
Bradley Hospital
10.2016 - Current
Case Manager Supervisor
Action Based Enterprises
04.2012 - 05.2017
Bachelor of Science - Psychology
Capella University
High School Diploma -
East Providence High School
- CPR and First Aid
- Community HealthCare Worker
- Health and Wellness
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