Customer Service
Resume:
Craig M. Ramsey
TAYLORSVILLE UTAH, 84129
1-801-***-**** HOME PHONE
************@********.***
Profile
Experienced professional with over 23 years of experience in customer service, case management and utilization review, hiring, training, supervising and directing reviewers, therapists, discharge planners and customer service representatives, performing case management duties for intensive and lesser levels of care populations. I supervised the Utilization Management Department at several different agencies working with numerous Residential Treatment Facilities, Inpatient Acute Hospitals and various programs from Wilderness, Sub acute, Partial and Intensive Out-Patient. I monitored clinical care services related to complex mental health and substance abuse treatment to optimize clinical outcomes. I provided information to clients and their families, doctor’s and various providers regarding mental health and substance abuse benefits, community treatment resource, mental health managed care programs and policies and procedures. Facilitated appropriate discharge planning and aftercare follow up for patients stepping down to lower levels of care. I reviewed utilization trends by insurance company, days authorized, days used and any underutilized days and the results were reported monthly to the vice CEO. I also negotiated single case agreements between our facilities and non-contracted insurance companies.
Work Experience
Utilization Management Coordinator for Odyssey House in Millcreek, Utah October 2018 to May 2019.
Director of Utilization Management for Maple Mountain Recovery, Mapleton, Utah March 2017 to October 2018.
Director of Utilization Management for Denials Management, Salt Lake City, January 2016 to February 2017.
Syracuse RTC LLC, Director of Utilization Management, April 2014 to January 2016.
Aspen Education System a division of CRC Health Director of Utilization Management, November 2012 to April 2014.
Aspen Education System a division of CRC Health, Coordinator of Utilization Management at Aspen Institute Hospital and Island View RTC, March 2012 to November 2012.
Salt Lake Behavioral Health, Director of Utilization Management, Salt Lake City, Utah November 2010 to March 2012
Aetna Behavioral Health Senior Care Manager, Sandy, Utah 2006 to November 2010
Aetna Behavioral Health Care Manager, Sandy, Utah 2002 to 2006
Magellan Health Care Systems Supervisor for the Specialty Accounts Operations Department, Sandy, Utah 1999 to 2002
Education
Azusa Pacific University, Azusa, California. Master of Arts in Marriage and Family Therapy 1983 University of Utah, Salt Lake City, Utah. Bachelor of Science in Psychology 1981
Skills
Internet Computer Experience, Microsoft Office, Word, Excel, Spreadsheets, Typing, Ten Key
References
Anne Murray, Billing and Coder, 727 E. 1100 South, Mapleton, Utah 84664. 801-***-****
Cliff Simpson, M.S., CMHS, 3195 South Main, Suite 190, Salt Lake City, Utah 84115. 385-***-****.
Michelle Lindsey, M.S., LPC, Executive Director, 280 North, 300 East, Escalante, Utah 84726, 435-***-****
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