Director of Denials and Appeals• Manage the denials and appeals department in Centene Advanced Behavior Health’s (CABH) Clinical Administration department. • Develop policies and procedures for pre and post service reviews of behavioral health service requests for markets managed by CABH.• Developed effective processes to effectively manage reviews of member and provider requests for appeals to be reviewed within appropriate timeframes. • Create strategic initiatives that align with Centene’s yearly goals for departmental goals. • Measure department alignment of strategic initiatives and goals on a quarterly basis• Ensured all processes followed all state and national guidelines. • Ensured all processes met and exceeded NCQA standards. • Audit staff files monthly to ensure that they are meeting all standards to ensure quality audits and accreditation audits will be passed. • Manage a staff of 50+ staff including a leadership team of 5 staff. • Complete monthly/weekly/daily/quarterly/annual reports for compliance and quality.

I provide clinical supervision to individuals seeking licensure for LPC. I utilize a mixed format of 1:1 and group to offer both experiences. I also provide mental health and substance abuse treatment and assessment. Conduct anger management, domestic violence, marriage and family, and mental health counseling and groups. Conduct cognitive/intellectual assessments, intervention, and consultation.

Provided oversight to clinical and administrative functions. Supervised staff while maintaining a therapeutic relationship with the clients. Developed treatment plans and regimens to meet the individual needs of the clients. Worked with families and community members to coordinate support and transition of our clients upon completion of the program. Reviewed policies and procedures to maintain their appropriateness. Wrote curriculum for specific needs of clients that were not per the usual client to enter treatment.

• Provide consultation and supervision for staff. • Conduct assessment and diagnosis for new agency clients. • Conduct individual and family therapy for adolescents and adults with mental disorders and co-occurring disorders. • Develop and implement treatment plans. • Conduct quality assurance for managed caseload.

• Provide personal, career, and academic counseling for participants on a one-to-one and group basis. • Organized practicum/internship program to provide mental health services to participants each summer. • Provide guidance for high school students interested in attending post secondary education.• Develop and maintain ISP (Individualized Service Plans) for each student to help meet career and academic goals.• Maintain documentation of counseling contacts with parents, teachers, and high school counselors. • Assist in recruitment and development of individualized education plans for higher education.

• Assessment and Screening for adults and adolescents with addiction, mental health, and behavior problems. • Provided counseling services for a very diverse group of clients. • Conducted psychoeducational, life skills, and anger management groups. • Conducted family groups to engage families in the treatment process. • Developed and implemented treatment plans for each client. • Conducted individual and family psychotherapy sessions.

• Conducted needs assessments for clients with acute mental illness. • Conducted psycho-education groups for clients. • Conducted family groups to educate families of the disease process. • Determined placement and aftercare needs for each client• Played an intricate part in the treatment team.