For the past five years, I have worked with Local Management Entities/Managed Care Organizations (LME/MCOs), focusing on ensuring that individuals with developmental disabilities and co-occurring mental health diagnoses receive optimal services. In my current role at Partners Health Management, I facilitate the meticulous review of service plans and authorization requests, ensuring that individuals receive the most appropriate services tailored to their unique needs. My work is underpinned by my Care Manager Certified credentials and extensive experience in care management.With over 16 years in the behavioral health care industry, I have developed a robust skill set that includes leadership, motivational interviewing, crisis intervention, and managed care practices. My expertise includes a comprehensive understanding of the NC Innovations Waiver (1915(c)) and Clinical Coverage Policy 8P, which guide the provision of services for individuals with intellectual and developmental disabilities. I continually update my skills and knowledge through online courses and certifications, ensuring I am well-versed in the latest best practices.## Key Skills and Expertise:- Client-Centered Advocacy: Focused on ensuring individuals receive timely and appropriate services tailored to their unique needs.- Knowledge of NC Innovations Waiver (1915(c)): In-depth understanding of the waiver's provisions and its application in facilitating access to necessary services.- Familiarity with Clinical Coverage Policy 8P: Proficient in navigating this policy to ensure compliance and quality in service delivery for individuals with developmental disabilities.- Experience with LME/MCOs: Extensive experience working within the framework of Local Management Entities and Managed Care Organizations, addressing the unique challenges they face.- Leadership & Collaboration: Proven ability to lead and collaborate effectively within interdisciplinary teams to enhance service delivery and client outcomes.- Crisis Intervention: Skilled in employing crisis intervention techniques to support clients during challenging situations.- Evidence-Based Practices: Committed to utilizing evidence-based methods to ensure the highest quality of care.- Lifelong Learner: An advocate for continuous professional development, I actively seek opportunities to expand my knowledge and enhance my capabilities.I am passionate about improving the well-being and quality of life for those I serve, believing that everyone deserves access to high-quality care. My approach is rooted in teamwork and innovation.
