Zarius Merritt
Memphis,TN
Summary
Professional advocate with track record of enhancing provider relations and ensuring efficient communication channels. Known for collaborative efforts and achieving tangible results within dynamic environments. Reliable and adaptable, leveraging skills in conflict resolution and strategic planning to drive success.
Overview
10
10
years of professional experience
Work History
Senior Provider Relations Advocate
UnitedHealthcare Group
Memphis, TN
05.2023 - Current
- Leads strategic coordination of Behavioral Health provider relations, ensuring operational compliance with federal, state, and organizational regulations across United Health Group.
- Resolve complex claim and service delivery issues while maintaining strict adherence to HIPAA, CMS, and TN Medicaid guidelines.
- Drive provider experience excellence by implementing quality assurance protocols, monitoring call center performance, and promoting secure use of provider portal tools.
- Develop and execute provider engagement strategies that align with compliance standards and contractual obligations, fostering ethical partnerships and promoting sustainable network growth.
- Conduct network integrity assessments to identify compliance gaps in provider composition, initiate corrective actions, and support audit readiness.
- Oversee onboarding and credentialing processes for TN Medicaid Behavioral Health providers, ensuring full documentation and regulatory alignment.
- Facilitate statewide provider education programs, including BESMART and MAT training, ensuring content meets state-mandated compliance requirements.
- Utilize QHBS and CSP Facets systems to perform data-driven compliance reviews, support operational audits, and inform strategic decision-making.
- Mentor team members on compliance best practices, aligning departmental initiatives with enterprise risk management goals.
- Lead cross-functional claims resolution initiatives, ensuring timely, accurate, and compliant outcomes through collaborative process improvement.
ECF Support Coordinator
United Healthcare Group
Memphis, TN
09.2021 - 05.2023
- Created person-centered care planning and support services for those with developmental and intellectual disabilities.
- Assessed member's physical, behavioral, functional, and psychosocial needs.
- Managed care plans to ensure that members were engaged with community involvement, including employment based on members' abilities.
- Facilitated outside services to ensure that they meet members' needs based on lifestyle and goals.
- Finalized and recommended level of care based on results of assessments.
- Generated appropriate diagnoses based on information gathered during the assessment.
- Developed rapport and provided members with emotional support as needed.
- Attends frequent team meetings to stay up-to-date with protocols and clinical practices.
- Provided customer service skills when communicating with members, families, and support staff, with a 50% satisfaction rate within the first year.
Behavior Specialist
Shelby County Schools- North East Prep Academy
Memphis, TN
08.2018 - 09.2021
- Designed, implemented, & monitored behavioral intervention/prevention plans.
- Developed and maintained cooperative working relationships with resources and agencies for the treatment of children with behavioral/mental health issues.
- Facilitated planning meetings and training sessions with the support team.
- Planned diagnostic, educational, and therapeutic services to support positive behavior, emotional, and co-dependency with a 15% improvement rate.
- Provided professional development and assistance to support staff, including positive behavior support, verbal de-escalation skills, mental health issues, and medical management.
- Provided referrals to families that require intense and ongoing services.
Behavior Therapist
Youth Dimensions Inc.
Memphis, TN
07.2015 - 08.2018
- Designed, implemented, & monitored behavioral intervention/prevention plans for 45 clients.
- Developed and maintained cooperative working relationships with resources and agencies for the treatment of children with behavioral/mental health issues.
- Facilitated planning meetings and training sessions with the support team.
- Observed students in both classroom & school environments who have been referred for behavior.
- Planned diagnostic, educational, and therapeutic services to support positive behavior, emotional, and co-dependency.
- Provided professional development and assistance to support staff, including positive behavior support, verbal de-escalation skills, mental health issues, and medical management.
- Provided referrals to families that require intense and ongoing services.
Education
Master of Science - Clinical Psychology
Capella University
Minneapolis, MN06.2018
Bachelor of Arts - Criminal Justice
LeMoyne Owen College
Memphis, TN05.2014
Skills
- Relationship Management
- Strategic business relationships
- Educational presentations
- Policy interpretation
- On-site visits
- Problem-solving
- Time management
- Provider network development
- Compliance review
- Internal and external audits according to policy/guidelines
- Provider quality training
Timeline
Senior Provider Relations Advocate
UnitedHealthcare Group
05.2023 - Current
ECF Support Coordinator
United Healthcare Group
09.2021 - 05.2023
Behavior Specialist
Shelby County Schools- North East Prep Academy
08.2018 - 09.2021
Behavior Therapist
Youth Dimensions Inc.
07.2015 - 08.2018
Master of Science - Clinical Psychology
Capella University
Bachelor of Arts - Criminal Justice
LeMoyne Owen College