Quality Assurance Mental Health

CHUNG THI PHAM

Address: *** *. ****** **., ***# *78, Santa Ana, CA 92703 Email: **********@*****.***

EDUCATION

Ohio University, Athens, OH. Master of social work (MSW), June 2002.

License: LCSW 25985

EXPERIENCE

7/2010 – present: Utilization Review Clinician, Beacon Health Strategies, Orange, CA

• Determine appropriateness of outpatient (OP) behavioral health services for members based on medical necessity criteria

• Analyze specific utilization problems, plan and implement solutions that directly influence quality of care and financial liability.

• Interact with physicians and other members of the provider clinical team for authorization decisions.

• Perform telephonic case review as needed.

• Provide information to members and providers regarding mental health and substance abuse benefits, and community treatment resources.

• Interact with clinical managers to discuss clinical authorization questions and concerns regarding specific cases.

• Interact with providers and facilities in a professional and respectful manner that facilitate the treatment process.

• Authorize treatment for medical necessity for mental health and substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and appropriateness of care.

• Propose alternative plans of treatment when requests for services do not meet medical necessity criteria.

• Comply with Beacon’s standards for documentation of clinical information, clinical contacts and authorization of care.

• Do targeted chart reviews

• Manage requests from members and providers for out of network services

• Conduct site visits to providers re: quality issues and training

• Do other duties as assigned, including telephone triage, crisis intervention and emergency authorizations if required (vacation back-up, etc.)

10/2009 – 7/2010: Senior Program Manager, Skid Row Housing Trust, Los Angeles, CA

• Provide clinical/social services, crisis, relapse prevention for homeless adults disabled by mental illness, substance abuse, co-occurring disorders, AIDS, and chronic disabilities in downtown of Los Angeles

• Be responsible for program direction and implementation, supervision of case management staff and program coordination with outside agencies.

• Provide individual clinical supervision to all assigned staff.

• Provide coordination of services for both on-site staff and outside agencies.

• Coordinate workshops with outside agencies on relevant topics.

• Participate in and /or conduct in-service presentations on related topics.

• Participate in Quality Assurance Activities and related reports as assigned.

• Perform related duties as required

9/2008 – present: Vietnamese Interpreter, Language Line Services, Monterey, CA

4/2003 – 9/2009: Outpatient Mental Health Therapist, Asian Pacific Family Center, Rosemead, CA

• Conduct outreach/ telephone screening for potential CalWORK/ outpatient clients

• Conduct case management to coordinate linkages and provide access to resources, and to evaluate efficacy of the referrals such as arranging for transportation, assisting clients to apply for social benefits, employment training, job placement, etc.

• Do home visit to chronically severe mental health patients.

• Provide mental health treatment services, including intake, diagnostic evaluation, treatment planning and crisis intervention, individual,/family/ and group therapy, as well as the various modalities of therapy,

• Help clients enhance their capacity, meet their basic needs and empower them.

• Serve as a liaison between client, family, school, agency, and respective community

• Develop resources appropriate to client needs, and distribute educational material to them

• Document delivery of services accurately and in a timely manner, according to DMH guidelines

• Update and maintain clients' charts.

8/2002 - 4/2003: Community Education Coordinator, Asian Pacific American Legal Center, Los Angeles, CA

• Do outreach to Cambodian, Chinese, Vietnamese communities in Southern CA.

• Increase knowledge of different welfare and health care programs and immigrant rights

• Assess needs of immigrants and address barriers to access to benefits

• Develop community education materials on welfare and health care

• Build up and strengthen working network among different service providers, who serve immigrant population

• Provide training on welfare and health care issues for service providers and community members

• Educate policy makers and other organizations of the barriers to accessing benefits

• Involve communities in policy process

9/2001-6/2002 Student Intern, Athens AIDS Task Force, Athens, OH.

• Counsel clients with HIV/AIDS and their family members via home visits, face-to-face and telephone contacts, and support group meetings.

• Conduct psychological assessment, provide resources of financial support for clients and refer them to the appropriate services as needed.

• Fill out all necessary forms, take notes, and write reports.

• Update and maintain clients' charts.

• Co-edit agency's newsletter.

HONORS & AWARDS

2001-2002 Margaret McNamara Memorial Fund World Bank Scholarship

2001-2002 Ohio University Tuition Scholarship and Graduate Assistantship

1999-2000 Ohio University Tuition Scholarship

LANGUAGES

English (fluent speaking and writing).

Vietnamese (Native speaker).

ACTIVITIES

2000-2002 Social Work Graduate Students Association.

1999-2002 Southeast Asian Students Association, Ohio University.

REFERENCES

Rochelle Scheela, PhD, RN, CNS.

Chair & Professor

Department of Nursing, Bemidji State University

Deputy Hall 105, 1500 Birchmont Dr. NE, Box 15

Bemidji, MN 56601-2699

Phone: 218-***-****

Fax: 218-***-****

E-mail: ********@************.***

Susan Sarnoff,

Assistant Professor, Graduate Chair

Department of Social Work, Ohio University

Office: Morton Hall 531

Athens, OH 45701

Phone: 740-***-****

E-mail: *******@****.***

Contact this candidate