Experience

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  MetroPlus Health Plan

  • Medicaid Inpatient Case Manager/UR

    • Mar 2012 - Sep 2014

    Authorize psychiatric inpatient stays for Medicaid members. Use Interqual to determine if medical necessity is met. Coordinate discharge planning with treating facility.Collaborate with MetroPlus outpatient team and outside providers to insure continuity of services.

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  MHN (a subsidiary of Healthnet)

  • New York, NY

  • Care Manager, Utilization Review and Outpatient Services

    • Jun 2009 - Mar 2012
    • New York, NY

    •Conduct Utilization Review for initial admissions and concurrent treatment focused on efficacious, cost effective treatment interventions while insuring quality of care. •Educate members and assist providers in utilizing benefits in the most efficacious manner. •Coordinate behavioral health needs with major medical carriers.•Act as a liaison between Membership, Account Management and Employee Assistance Programs. •Identify geographical areas in need of provider recruitment. •Maintain a resource database that can be offered to members with special needs or who lack financial resources.•Review treatment plans and assist providers in shaping appropriate care for members.•Respond to members in crisis and offer immediate interventions.•Mentor new employees and assist in work groups to enhance employee development.

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  Prison Health Services

  • Senior Mental Health Clinician

    • Jan 1998 - Jun 2009

    • Managed mental health treatment of approximately 200 patients per month.• Coordinated patient care between the depts of Mental Health, Medicine, Nursing and Pharmacy.• Assessed and triaged mental health needs upon admission to Rikers Island.• Implement appropriate crisis intervention to prevent violence and self injurious behavior.• Assisted in the development and implementation of a group therapy program for persons suffering mental illness, chronic medical illness and chemical dependence.• Mentored psychology and social work students and trained and oriented new employees.

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  North Shore University Hospital

  • Clerical Service Associate

    • Jan 1994 - Jan 1999

    • Maintained patients’ charts and records for units consisting of 10-20 critical care patients, which serviced the departments of General Medicine, Neurology, Neurosurgery and Vascular Surgery.• Transcription of physicians’ orders and order entry of essential patient tests.• Fully assisted staff during times of emergency as needed.