Tamara Bernard, LMSW
Wichita,KS
Summary
Dedicated Licensed Master Social Worker with over 20 years of experience in clinical case management, utilization review, and team leadership within health care settings. Expertise in coordinating comprehensive care plans, navigating Medicaid and commercial insurance processes, and leading improvement initiatives. Recognized for ability to manage complex caseloads and deliver results and organizational efficiency. Committed to fostering team development, meeting contractual requirements while improving client outcomes.
Overview
27
27
years of professional experience
1
1
Certificate
Work History
Clinical Case Management Team Lead
Aetna Better Health of Kansas
Wichita , Kansas
01.2023 - Current
- Served as the primary contact for clinical decisions and case escalations, ensuring swift resolution.
- Managed daily operations, optimizing team workflows for efficiency.
- Triaging statewide BH referrals.
- Interact daily with multiple managers, BH Supports Director, statewide stakeholders.
- Led multiple project initiatives, enhancing team productivity and service delivery.
- Responsible for developing and facilitating weekly Team Meetings.
- Attend Complex and PRTF Case Rounds.
- Provide guidance to team members, ensuring contract requirements are met.
- Manage a small caseload of chronic SUD/BH high utilizers of treatment.
Behavioral Health Utilization Review Clinician
Anthem
Albany , New York
01.2019 - 01.2023
- UM Clinician for a commercial health plan.
- Complete initial and concurrent stay reviews for all levels of BH care.
- Manage high volume admissions call center.
- MCG guidelines.
- Present in daily Medical Director Rounds.
- Collaborate with an integrated team of nurses, case managers, EAP reps, and acct managers to meet standards of care.
- Send denials for peer review.
- Provide ongoing support and education to new hires.
- Account Audits.
Behavioral Health & SED Waiver Case Manager
Amerigroup of Kansas
Wichita , KS
03.2016 - 12.2018
- SED Waiver Coordination
- Manage inpatient caseload of adults and children
- Advocate, assess, coordination of services, and benefits.
- PRTF screening/admission/dc planning
- Participate in Medical Director Rounds.
- IDD Waiver consultation.
- Facilitated communication between clients, families, caregivers, social services, CMHC, and other agencies to ensure client needs were met.
Infant Mental Health Specialist
Rainbows - Wichita, KS
11.2010 - 03.2016
- Coordinate care with developmental pediatricians.
- Provide at-risk infant mental assessments.
- Create and implement behavior plans.
- Lead Social Skills groups.
- Engage families and teachers in the change process.
- Provide BH assessments and recommendations at Child Find.
Social Work Case Manager PRN
Via Christi - St Francis Hospital - Wichita, KS
01.2015 - 02.2016
- Coordinate discharge planning to SNU, home health, rehabilitation, adult psychiatric inpatient, and other transitions of care.
- Daily MD Huddle.
Adoption Specialist
St. Francis Community Services - Garden City, KS
01.2005 - 08.2010
- Manage adoption permanency case load
- Represent adoption team in court hearings
- Develop child social histories, adoption home studies.
- Lead adoptive family selection process.
- Provide in-home therapy to families at risk of adoption disruption.
Supervisor/Mobile Crisis Case Manager
COMCARE of Sedgwick County - Wichita, KS
03.1998 - 01.2004
- Supervised a team of 8 Homeless SPMI Case Managers.
- Manage HUD homeless prevention grant.
- Provide telephonic and mobile crisis assessments.
- Provide mobile crisis services in the community
- Member of the Sedgwick County Homeless Coalition.
- Facility in patient admissions and discharge planning.
- Case management for homeless SPMI, SUD clients.
- Treatment planning.
Education
Master's of Social Work -
Newman University - Wichita, KS
05.2004
Skills
- MCO experienced
- Crisis Intervention & Triage
- Person Centered Care Planning
- MCG/medical necessity requirements
- Present/Facilitate Team Meeting
- Knowledgeable of all Waivers
- Regulatory Compliance
- Performance Improvement
- Coaching and Mentoring
- Audit Preparation
- Medical Director Rounds
- Special Population: PRTF, Foster Care, NFMH, Comorbidities, Maternal Health, Substance Abuse, Eating Disorders, SPMI, Homelessness, Institutional TOC
Certification
Licensed Master Social Worker, 11/2005- present
Motivational Interviewing Certified, 06/2023 -present
Quote
Be more concerned with your character than your reputation, because your character is what you really are, while your reputation is merely what others think you are.
John R. Wooden
Timeline
Clinical Case Management Team Lead
Aetna Better Health of Kansas
01.2023 - Current
Behavioral Health Utilization Review Clinician
Anthem
01.2019 - 01.2023
Behavioral Health & SED Waiver Case Manager
Amerigroup of Kansas
03.2016 - 12.2018
Social Work Case Manager PRN
Via Christi - St Francis Hospital - Wichita, KS
01.2015 - 02.2016
Infant Mental Health Specialist
Rainbows - Wichita, KS
11.2010 - 03.2016
Adoption Specialist
St. Francis Community Services - Garden City, KS
01.2005 - 08.2010
Supervisor/Mobile Crisis Case Manager
COMCARE of Sedgwick County - Wichita, KS
03.1998 - 01.2004
Master's of Social Work -
Newman University - Wichita, KS
Licensed Master Social Worker, 11/2005- present
Motivational Interviewing Certified, 06/2023 -present
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