Cheryl E. Email & Phone Number

Berkley, Michigan, United States

Columbus, Ohio

Columbus, Ohio Area

Kirkland, Washington

Partnered with managed care and Medicaid providers to conduct timely concurrent reviews for members hospitalized on the Dual diagnosis and Detox Unit for average of twenty patients concurrently. Coordinated with the interdisciplinary team for continued and length-of-stay purposes and acted as liaison between insurance and treatment team. Ensured appropriate and accurate documentation of all pre-certification, concurrent review, and denial information. • Conducted initial and concurrent reviews with insurance companies and established excellent working relationships with physicians, nurses, and case mangers improving quantity of days approved and decrease denial rate.• Utilized documentation, information from treatment team members, and strong clinical knowledge in increasing approved length of stay for patient for optimal treatment to minimize readmission rates.• Composed appeal letters to increase reimbursement rates

Utilization Review (2015 – 2016) Partnered with managed care providers to conduct timely concurrent reviews for members hospitalized on the Adult and Geriatric Psychiatric Unit for average of thirty patients concurrently. Coordinated with the interdisciplinary team for continued and length-of-stay purposes and acted as liaison between insurance and treatment team. Ensured appropriate and accurate documentation of all pre-certification, concurrent review, and denial information. • Conducted initial and concurrent reviews with insurance companies and established excellent working relationships with physicians improving quantity of days approved and decrease denial rate.• Utilized documentation, information from treatment team members, and strong clinical knowledge in increasing approved length of stay for patient for optimal treatment to minimize readmission rates.• Maintained census reports and data for the Utilization Review Department improving communication.Case Manager (2014 – 2015) Leveraged field knowledge and experience to assess, treat, discharge, and support residents on the hospital’s Adult & Geriatric Psychiatric Unit as well as their families. Maintained case load of ten patients at a time. Partnered with the interdisciplinary team to provide best patient care. • Coordinated after-care services with external agencies and residential placement providers to ensure continuity of care and fewer readmissions.• Directed Dialectical Behavior Therapy (DBT) and Processing groups to help patients build their skills to apply on an outpatient basis and minimize repeated admissions.• Completed Short Term Certifications and coordinated with appropriate county courts to ensure patients’ rights were upheld.

Offered community and in-home clinical counseling, case management, diagnostic assessment, crisis intervention, services for children, adults, and geriatric clients with mixed intellectual abilities. Maintained case load of 15-20.• Utilized a comprehensive approach to determine each client’s psychiatric, medical, health, and goal planning needs to ensure proper care and well-being. • Provided mental health counseling to individuals with barriers to traditional outpatient therapy.

-Conducted clinical counseling and case management for children, adults, and geriatric clients with diverse diagnoses; completed initial psychiatric and needs assessments for all clients-Coordinated and led weekly staff meetings for interdisciplinary team of professionals-Managed and distributed the agency's financial resources to clients determined eligible for assistance-Provided resources, made referrals, and answered questions for individuals in and helping the geriatric population-Coordinated weekly staff meetings-Managed financial resources-Assisted the Senior community with service navigation -Member of Interdisciplinary team

-Conducted discharge and financial planning with residents and coordinated after care services with outside agencies-Completed Preadmission Screening and Resident Reviews (PASSRs)-Led weekly, interdisciplinary team staff meetings-Provided emotional support to residents and families-Supervised Masters of Social Work Level I student intern

-Conducted individual, family, and group therapy with clients ages 11-21-Completed client diagnostic assessments; provided case management, treatment, and discharge planning-Assisted with crisis intervention with all clients-Supervised Bachelor of Social Work student intern

Masters, Social Work

Bachelors, Social Work

Activities and Societies: Student Association of Social Work-Co-President