SEQUOIAH FUENTES
Summary
Experienced Master of Social Work (MSW) with over 5 years in case management and care coordination. Specializes in biopsychosocial assessments and person-centered service plans for individuals with behavioral health and developmental disabilities. Skilled in resource coordination and advocacy within Medicaid-funded services, ensuring ethical care. Bilingual in English and Spanish, enhancing collaboration across multidisciplinary teams.
Overview
1
1
Certification
2027
2027
years of professional experience
Work History
Supports Planner
MMARS, Inc
2026 - Current
- Conduct comprehensive, person-centered assessments to identify participant strengths, needs, preferences, and goals.
- Developed and maintained individualized Person-Centered Plans with participants, families, and interdisciplinary providers to align supports with personal goals.
- Coordinate Medicaid waiver and community-based services to ensure participants receive appropriate supports and resources.
- Monitored participant progress through ongoing communication, home and community visits, and timely reassessments, ensuring responsive adjustments to services.
- Maintain accurate, compliant documentation in LTSS and other required systems while adhering to Maryland Department of Health (MDH) and MMARS policies.
- Collaborated with healthcare providers, community agencies, and service vendors to advocate for participants, facilitating access to essential resources and continuity of care.
- Educate participants and families on available services, benefits, and self-advocacy while promoting informed decision-making.
- Manage a caseload while maintaining productivity, quality, and compliance standards in a fast-paced remote environment.
Corps Case Manager - Care Coordination
The Salvation Army
01.2022 - Current
- Conduct comprehensive biopsychosocial assessments to evaluate clinical need against established guidelines for specialty populations experiencing homelessness, behavioral health challenges, and substance use disorders.
- Implement individualized, goal-directed care plans focused on housing stability, recovery, and transition to independent status, utilizing evidence-based clinical practice guidelines.
- Coordinated care across continuum by partnering with members, families, physicians, and community providers, ensuring optimal benefit utilization and access to shelters, healthcare, and treatment programs.
- Monitored member care activities and outcomes across multiple sites, analyzed variances, and escalated complex cases to appropriate internal resources, ensuring quality and appropriateness of care.
- Manage an active caseload with crisis intervention services, ensuring care for mandated non-compliant members through consistent utilization monitoring.
- Maintain accurate, comprehensive documentation of member progress, interventions, and outcomes in compliance with standards of practice and HMIS requirements.
- Supervised volunteers and supported program operations, maintaining continuity and enhancing quality of service delivery.
Residential House Manager
Mrs. Wilson's Treatment Center for Women
09.2019 - 01.2022
- Conducted intake assessments to identify member clinical needs, substance use history, and personal goals, and used findings to inform care planning decisions.
- Developed individualized care plans incorporating SMART goals aligned with evidence-based standards, supporting members' progress toward self-care outcomes and long-term recovery.
- Facilitated referrals to community resources, support groups, and housing assistance programs, coordinating access across the continuum of care.
- Partnered with members to develop comprehensive aftercare plans, including relapse prevention strategies, ongoing therapy, and community support networks to support transition to independent status.
- Documented client progress, goal attainment, and care activities in accordance with organizational policies and standards of practice.
Housing Manager - Residential Program Operations
Community Access Unlimited
05.2017 - 01.2019
- Oversaw daily operations of a residential group home serving adults with mental health and developmental disability needs, ensuring high-quality, person-centered care.
- Conducted assessments and developed individualized service plans with SMART goals to support resident progress toward independent living.
- Monitored and documented client treatment goals, progress, and outcomes to support continuity of care and quality improvement.
- Coordinated transportation and facilitated member access to appointments, employment, and community resources, supporting utilization of appropriate services.
- Created staff schedules and managed program supplies to maintain operational excellence and appropriate service coverage.
Teacher Assistant - Special Education
1st Cerebral Palsy of New Jersey
09.2013 - 01.2017
- Recorded daily activities and tracked student progress in a special education program, supporting data-driven individualized goal attainment.
- Provided direct support for students in achieving life skills goals, including assistance with Physical Therapy, Occupational Therapy, and Speech services.
- Engaged community resources to provide hands-on job coaching and vocational support for students with developmental disabilities.
Education
Master of Social Work (MSW) - Clinical Social Work
Rutgers University, New Brunswick
New Brunswick05-2026
Bachelor of Social Work (BSW) -
Rutgers University, Newark
NewarkAssociate of Science (A.S.) -
Essex County College
Skills
- Care Coordination & Case Management
- Continuum of Care Transition Planning
- Biopsychosocial & Needs Assessments
- Community Resource & Referral Coordination
- Individualized Care Planning (SMART Goals)
- Interdisciplinary Team Collaboration
- Specialty Population Care Management
- HMIS Data Collection & Documentation
- Utilization Management & Benefits Navigation
- Quality Improvement & Outcome Monitoring
- Crisis Intervention & De-escalation
- Microsoft Office Suite (Word, Excel, Access)
Certification
- CPR & First Aid Certified
- Mental Health Awareness
- Crisis Management
- CHAP: Promoting Child & Adolescent Wellbeing
- ServSafe Manager Certification
- HMIS Data Collection & Reporting
Languages
- English
- Spanish
Timeline
Corps Case Manager - Care Coordination
The Salvation Army
01.2022 - Current
Residential House Manager
Mrs. Wilson's Treatment Center for Women
09.2019 - 01.2022
Housing Manager - Residential Program Operations
Community Access Unlimited
05.2017 - 01.2019
Teacher Assistant - Special Education
1st Cerebral Palsy of New Jersey
09.2013 - 01.2017
Supports Planner
MMARS, Inc
2026 - Current
Master of Social Work (MSW) - Clinical Social Work
Rutgers University, New Brunswick
Bachelor of Social Work (BSW) -
Rutgers University, Newark
Associate of Science (A.S.) -
Essex County College