Shamika Sims, LMSW
Simpsonville,SC
Summary
Competent and well-qualified Licensed Medical Social Worker experienced in providing clients with necessary education, coordinating program referrals and determining appropriate treatment plans. Proficient in documenting changes, maintaining records and working with insurance companies. Prepared to apply 6 years' experience in the field and continue to build relationships with exceptional skills in planning, resolving conflicts and solving diverse problems. Experienced in working with clients from diverse cultural and religious backgrounds. Offers crisis intervention to help individuals navigate through traumatic experiences.
Overview
5
5
years of professional experience
Work History
Behavioral Health Care Manager
Amerihealth Caritas
11.2023 - Current
- Enhanced patient care by implementing evidence-based behavioral health interventions and strategies.
- Improved client outcomes through the development of comprehensive, individualized care plans.
- Collaborated with interdisciplinary teams to provide integrated care for patients with complex needs.
- Streamlined service delivery by effectively managing caseloads, prioritizing urgent cases, and delegating tasks when appropriate.
- Ensured compliance with industry standards and best practices, conducting regular audits of clinical documentation and processes.
- Facilitated successful discharge planning efforts for high-risk individuals transitioning from residential treatment back into community living environments.
- Strengthened referral relationships with local service providers to ensure timely access to appropriate levels of care for clients experiencing acute behavioral health concerns.
Medical Social Worker/Patient Advocate
Proactive MD
11.2022 - 11.2023
- Process referrals to specialists for patients and choose best specialist for the patient
- Help patients understand their insurance coverage and explain medical information clearly
- Help patients understand their treatment and diagnosis; Follow up with patients regularly after doctor appointments
- Assist team members and management as needed to help the department operate efficiently
- Perform service recovery as needed to resolve issues; Help rectify denied claims patients receive from insurance
- Coordinate communication between patients and medical professionals
- Have critical thinking, problem solving, decision-making, and active learning skills
- Provide emotional support to patients in difficult times
- Create reports, monitor trends, and implement action plans.
Social Worker
The Dream Center
08.2021 - 11.2022
- Accomplishes clients' care assessing treatment needs; Provide counseling to clients every week
- Building the program by researching, creating and implementing proper legal forms
- Developing, monitoring, and evaluating treatment plans and progress
- Facilitating interdisciplinary approaches; Establishes treatment programs by setting schedules and routines
- Coordinating services being provided
- Maintains clients' records by reviewing case notes, documenting events and progress
- Determine clients' needs by performing Biopsychosocial Assessment and interviewing potential clients for the program
- Improves treatment results by studying, evaluating, and re-designing and building processes, implementing changes to procedures
- Enhances organization policies and procedures by accomplishing new and different requests.
Case Manager
Department of Social Services
12.2018 - 12.2020
- Manage caseload of 40-45 individuals under the age of 18
- Perform monthly visits with children and their families or foster families
- Administer reunification services to 250 court ordered, penal code children and their families, including supervision of weekly visitation
- Advise families on community resources, referral programs and services, and develop and implement realistic treatment plans to improve the care and well-being of the children
- Maintain thorough case history records and write detailed and accurate reports in order to successfully review in court.
Education
Master of Social Work in Social Work -
Limestone University
Gaffney, SC12.2021
Bachelor of Social Work in Social Work -
Limestone University
Gaffney, SC12.2018
High School Diploma -
Mauldin High School
Mauldin, SC06.2004
Skills
- Improving Well-Being
- Team Collaborating
- Conducting Assessments
- Coordinating Services
- Patient Assistance
- Medicaid and Medicare Paperwork
- Crisis Resolution
- Community Health Services
- Problem-Solving
- Critical Thinking
- Medical Advocacy
- Case Management
Timeline
Behavioral Health Care Manager
Amerihealth Caritas
11.2023 - Current
Medical Social Worker/Patient Advocate
Proactive MD
11.2022 - 11.2023
Social Worker
The Dream Center
08.2021 - 11.2022
Case Manager
Department of Social Services
12.2018 - 12.2020
Master of Social Work in Social Work -
Limestone University
Bachelor of Social Work in Social Work -
Limestone University
High School Diploma -
Mauldin High School
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