clinical care management supervisor resume example with 20+ years of experience
JessicaClaire
, , 609 Johnson Ave., 49204, Tulsa, OK100 Montgomery St. 10th Floor
Home: (555) 432-1000
Cell:
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Professional Summary
Collaborative leader with dedication to partnering with coworkers to promote engaged, empowering work culture. Documented strengths in building and maintaining relationships with diverse range of stakeholders in dynamic, fast-paced settings. Encouraging manager and analytical problem-solver with talents for team building, leading and motivating, as well as excellent customer relations aptitude and relationship-building skills. Proficient in using independent decision-making skills and sound judgment to positively impact company success. Dedicated to applying training, monitoring and morale-building abilities to enhance employee engagement and boost performance. Reliable employee offering excellent communication and good judgment. Experienced clinical social worker with over 20+ years of experience in the behavioral health field. Excellent reputation for resolving problems and improving customer satisfaction. Hardworking and passionate social worker with strong organizational skills. Ready to help team achieve company goals. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Seeks real-world experience as Chaplain. Offers strong interpersonal and task prioritization skills.
Skills
Organization and Time management
Good telephone etiquette
Collaboration
Team-building
Cultural awareness
Teamwork
Adaptability
Staff Management
Behavioral assessment
Case management
Crisis Intervention
Coordinating care
Psychosocial assessments
Obtaining authorizations
Presenting cases
Behavioral Health expertise
Work History
Clinical Care Management Supervisor, 12/2000 to 12/2018 Advocates – Newton, MA,
The Clinical Care Management Supervisor is responsible for the daily supervision and oversight of clinical team members. The Clinical Care Management Supervisor ensures that services are authorized according to medical necessity criteria following the CBH mission and contractual obligations.
Trained and monitored Clinical Care Managers in the process of conducting initial, concurrent reviews for admissions into behavioral health services, using established medical necessity criteria. This includes psychiatric treatment, hospital, non-hospital detoxification, rehabilitative services, behavioral health rehabilitation services, acute partial and residential treatment.
Oversees the daily distribution of the census report for all urgent and emergent levels of care to staff based on provider assignments
Tracks by the provider and staff, initial and concurrent reviews to ensure that reviews are completed before or on the last covered day to ensure continuity of care. Supervises the Clinical Management staff in clearly documenting clinical information, ensuring that medical necessity criteria are met, and appropriate documentation.
Tracks lengths of stay by the level of care and works with the Clinical director to analyze utilization patterns and client profiles trends.
Monitors staff calls on a random basis for quality assurance, training efforts, ensuring that staff utilizes CBH protocols to authorize levels of care.
Provides clinical on-call as assigned by scheduling coordinator.
Collaborate with Intake, Member Services department, Provider Relations Consumer Satisfaction team, and other BHS Representatives to address provider complaints, access issues, the accuracy of authorizations, etc.
Other duties as assigned.
Mental Health Emergency Services Coordinator 2 , 02/1996 to 04/2018 City Of Philadelphia Office Of Mental Health – City, STATE,
This is advanced level mental health work counseling, advising, and providing mental and behavioral health crisis and suicide intervention through (24 hour/7 days a week) crisis phone lines.
To provide a facilitative service to medical and mental health professionals, other city workers, and the general public on mental health evaluations, commitments, treatments, referral services, and other related areas to ensure operational compliance to legal mandates and statutes. An employee in this class may act as a lead worker for lower-level employees responsible for managing the more complex decision-making for client behavioral health dispositions in atypical cases.
Acts as a delegate for the County Administrator, ensuring that actions of the public and professionals in the field are following established legal mandates, state law, and the office's policies and procedures
Receives calls for emergency involuntary commitments and gives instructions for the proper procedure to be followed to effectuate the commitment process.
Reviews and evaluates petitions received from Crisis Response Centers throughout the City, make a clinical assessment of the consumer's condition via telephone, approves or disapproves the request based on the assessment made and the stipulations outlined in the Mental Health procedures Act, documents reasons for decisions as required
Receives calls regarding missing persons
Dispatch crisis specialist or a mobile emergency team if it is determined that immediate care is needed or further assessment is necessary
Receives calls on the crisis and suicide phone lines attempt to determine the source of the problem, provide support to the caller, informing them of available resources. Tries to determine if a suicide attempt has been initiated or if the caller is in immediate danger of harm to self or others. May have the call traced with contact t Police depart.
Clinical Care Manager , 01/1997 to 12/2000 Community Behavioral Health – City, STATE,
The Clinical Care Manager is responsible for providing a comprehensive review of service requests submitted by providers and ensuring CBH members receive timely access to medically necessary behavioral health services. When clinically indicated, Clinical Care Managers will consult with CBH Physician Advisors to ensure the most effective treatment for the CBH member that is being authorized.
Conducts initial and concurrent reviews for admission into behavioral health services, using established medical necessity criteria.
Ascertains treatment progress since admission, identify proposed treatment plan, identify risk factors and special needs, determine whether or not the members require specialized service ad assist provider in developing appropriate discharge plans. Clearly documents the clinical rationale for each authorization, including length of stay. This information will be based on the clinical care guide and utilization management guide, both of which encompass Appendix T criteria=a and The Pennsylvania Placement Criteria.
Participates in interagency meetings for members with providers and participate in provider meetings to assess agency and resolve consumer complaints
Meets weekly with clinical team and physician advisors to review diagnostic criteria, course of treatment, and proposed discharge planning—regular consultation with Physician advisors.
Coordinates with respective Office of Mental Health, Coordinating Office of Drug and Alcohol Abuse Programs, Office of DisAbility Services, and the Department of Human Services to ensure that supplemental benefits
Psychiatric Hospital Social Worker, 10/1985 to 08/1996 Charter Fairmount Behavioral Health System – City, STATE,
Developed, implemented detailed pre-discharge plans for clients soon to be reintegrated into the community.
Updated treatment plans monthly with the latest intervention strategies and progress notes.
Formulated treatment plan strategies with multidisciplinary teams to provide comprehensive continuous care plans.
Presented clinical documentation, observations to the interdisciplinary team.
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