Medical Manager
Resume:
TERESA PICA, LCSW
** **** ****** *** *****, New York 10573
Email ********@*****.***
PROFESSIONAL EXPERIENCE
SBH HEALTH SYSTEMS, Bronx NY
Social Worker 3/25/13 to
present
Provides social work services to Pediatric. Adult, Oncology, Orthopedic,
Geriatric and Diabetic Clinics.
Responsible for referrals to mental health providers. Links patients to
home health care and visiting nurse services. Insures that patients have
durable medical equipment. Completes HRA 2010e housing applications. Co-
lead of the Patient Centered Care Labor Management Project. Member of two
DSRIP work projects Work Force Team for the PPS and the Behavioral
Health Redesign Team
Clinical Supervisor Health Home Provides clinical supervision
to 10 Health Home patient navigators and 6 case managers.
Approves all clinical documentation required by the Bronx
Accountable Health Network and Patient Centered Medical Home.
Provides training and education to the patient navigators and
case managers.
Clinical Supervisor Care Coordination Program @DAC Provides
supervision to 6 Care Coordinators. Facilitated a Woman's
support group.
Clinical Coordinator/Supervisor 11/14/11 to
Present
Supervises 25 ( 10 CASACS in MMTP, 5CASACs and 2 CASAC-Ts in
detoxification unit, and 1 CASAC, 1 LMSW /CASAC, 1 LCSW and 3CASAC-Ts in
Outpatient Substance abuse Clinic .) Organized and participates in-services
for staff development. Participated in Quality Improvement Committee,
oversaw clinical care and charting to include case conference, psychosocial
evaluations, treatment plans and discharge planning. Assured compliance
with all regulatory agencies such as JCAHO and OASAS. Monitored patient's
charts for accuracy and completeness. Assumed clinical management of the
Outpatient substance abuse Clinic from Administrative Director after failed
OASAS site visit. Completed plan of correction, implemented OASAS
compliant paper work . Trained all counselors on all aspects of new OASAS
regulations to insure compliance. Worked collaboratively with IS
department to implement OASAS required documentation into the electronic
medical record system(Eclipys). Implemented group and individual
supervision in the methadone maintenance clinic. Trained counselors in
the methadone maintenance clinic about evidence based treatment. Prepared
inpatient detoxification unit for JCAHO and OASAS site visits in 2013.
Wrote new policies for department of addiction medicine in preparation
for JCAHO visit. Implemented new OASAS paperwork for inpatient
detoxification unit. Established and maintained relationships with HMOs,
BHO and aftercare programs. Evaluated staff job performance and training
needs. Administrative Supervisor to 4 Physician Assistants. Worked
collaboratively within Addiction Medicine and other Departments to ensure
appropriate referrals. Responsible for all aspects of Health Home in the
Department of Addiction Medicine. Supervisor to Columbia University
Social Work Interns.
Social Worker 1/18/11 to
11/12/11
Primary Social Worker for sixteen patients on two psychiatric units.
Completed psychosocial assessments, formulated, initial individualized
treatment plans and weekly updates. Consulted with team psychiatrist
regarding treatment decisions, medical and psychopharmacological issues,
evaluation of risk factors and legal issues. Executes all charting
requirements and devise appropriate discharge plans. Provided individual
and family counseling and psycho-education. Developed and maintained
collaborative relationship with patient, family, referent, payer and
external support/health care team. Supervised MSW interns from Columbia
University
SOCIAL WPRK PRN
Temporary Social Worker 11/29/10 to
1/15/11
Primary Social Worker for 16 patients on two psychiatric units. Completed
psychosocial assessments, formulated, initial individualized treatment
plans and weekly updates. Consulted with team psychiatrist regarding
treatment decisions, medical and psychopharmacological issues, evaluation
of risk factors and legal issues. Executes all charting requirements and
devise appropriate discharge plans. Provided individual and family
counseling and psycho-education. Developed and maintained collaborative
relationship with patient, family, referent, payer and external
support/health care team
MHN/HEALTHNET, Shelton CT
Care Manager 11/14/05 to
12/9/08
Made medical necessity determinations and refer to appropriate level of
care utilizing the MHN LOC guidelines. Performed telephonic clinical
assessments to determine immediate clinical needs of members and to arrange
emergent/urgent services as needed. Authorized in-patient, alternative
and/or outpatient treatment according to benefit plan and limitations.
Clearly and completely documented all initial concurrent and discharge
reviews, including, but not limited to, diagnosis, symptoms, interventions,
goals and plan for next review and/or after care. Closed all cases
according to the defined case closure procedure and in accordance with
guidelines established by MHN. Participated in training of other Care
Managers as necessary. Trained HLOC Care Managers on LLOC computer
procedures(how to do authorizations). . Care Coordination of patients with
psychiatric illness who had HealthNet Medicare. Performed Risk
Management Activities as needed. Maintained confidentiality of member
specific data. Attended Administrative and Clinical meetings. Performed
special audits, projects, etc. as required
The Connecticut Hospice, Branford CT
Social Worker 9/3/02 to 11/11/05
Primary Social Worker to 20 home care patients. Completed psychosocial
assessments; formulates individual treatment plans and bimonthly updates.
Provided counseling to patients and families related to hospice care,
anticipated grief, bereavement, and death and dying. Worked
collaboratively with Hospice MD and nurses regarding treatment decisions,
medical and psychopharmacological issues. Attended weekly interdisciplinary
team meetings. Monthly peer chart review to insure compliance with
Medicare.. Linked patients to community agencies and resources. Covered
inpatient hospice every Wednesday evening and every other Saturday.
Provided monthly on-call coverage for all 5 home care offices and inpatient
unit. Lead a death awareness seminar for hospice volunteers.
NEW YORK PRESBYTERIAN HOSPITAL, White Plains, NY
Treatment Coordinator 12/19/99 - 8/30/02
Served as primary therapist for a caseload of seven in-patient psychiatric
patients. Completed psychosocial assessments; formulated initial
individualized treatment plans and weekly updates. Consulted with team
psychiatrist regarding treatment decisions, medical and
psychopharmacological issues, evaluation of risk factors and legal issues.
Executed all charting requirements and formulated appropriate discharge
plans. Provided individual and family counseling and psycho-education.
Developed and maintained collaborative relationship with patient, family,
referent, payer and external support/health care team. Facilitated a
spirituality group with a Baptist pastor. Worked evenings in the
evaluation center - responsible for all aspects of admission paper work
including initial psychiatric assessment. Identified as a Super User for
electronic medical record and trained unit social workers on emr went it
went live on the unit.
NETWORK BEHAVIORAL HEALTH, Harrison, NY
Care Coordinator 6/6/97 -
12/16/99
Assessed NBH client member/beneficiaries and refer them to the most
appropriate level of care or to a mental health/substance abuse
practitioner. Assured quality of care and cost effective treatment by using
clinical policy and medical necessity criteria in the evaluation
procedures. Protected the use of the members mental health/substance abuse
benefit for medically necessary treatment Trained all new Care
Coordinators on the computer system and how to do authorizations for all
levels of care.
UNITED HOSPITAL MEDICAL CENTER, Port Chester, NY
Social Worker Department of Psychiatry and Substance Abuse
4/3/95 - 6/3/97
Completed psychosocial assessments for a dual diagnosis unit with a
caseload of ten MICA patients. Completed initial treatment plans and weekly
updates. Served as liaison between treatment team and managed care
companies. Provided individual and family counseling and psycho-education.
Facilitated dual diagnosis process groups, twelve step, women's and ACOA
groups. Linked patients to appropriate level of care upon discharge.
Researched, developed and presented a highly effective educational program
for staff members including doctors on HIV transmission and the disease
process after discovering that the majority of the staff had little or no
practical knowledge of the virus and treatment protocols Completed chart
audits in preparation for JCAHO and OMH audits when there was no Social
Work Supervisor. The unit passed both of these audits.
.
WESTCHESTER COUNTY DEPT. Of COMMUNITY MENTAL HEALTH, White Plains, NY
Program Specialist/Case Manager- Mental Health Alternatives to
Incarceration 1/4/95 - 3/30/95
Managed a caseload of ten MICA clients who were involved with the criminal
justice system. Developed treatment plans for clients, linking clients to
psychiatric day treatment, long-term care and alcohol/substance abuse
programs. Secured entitlements for clients acted as liaison between client
and criminal justice systems and advocated for clients during court
proceedings. Worked collaboratively with the Department of Probation,
community based organizations and treatment facilities. Updated treatment
plans and kept accurate records.
STATEN ISLAND UNIVERSITY HOSPITAL, Staten Island, NY
Social Worker/Case Manager 7/5/93 -
12/20/94
Served as a case manager for two adult primary care clinics for the
treatment of substance abusers and non-substance abusers infected with HIV.
Completed psychosocial assessments, linked patients to services advocacy
and acted as liaison between patients and other services. Completed
quarterly re-assessment and treatment plans for patients, coordinated and
participated in weekly interdisciplinary rounds. Provided psychotherapy,
supportive and bereavement counseling for individuals, families and groups.
Educated patients and family members on HIV transmission and the disease
process. Worked collaboratively with medical staff and community based
organizations.
METROPOLITAN HOSPITAL, New York, New York
Social Worker 6/1/92 to
7/1/93
Served as Case Manager for inpatient and outpatient units for those
infected with HIV disease. Completed psychosocial assessments, linked
patients to services advocacy and acted as liaison between patients and
other services. Completed quarterly re-assessment and treatment plans for
patients, coordinated and participated in weekly interdisciplinary rounds.
Provided psychotherapy, supportive and bereavement counseling for
individuals, families and groups. Educated patients and family members on
HIV transmission and the disease process. Worked collaboratively with
medical staff and community based organizations.
EDUCATION
COLUMBIA UNIVERSTIY, New York, NY
School of Social Work,
SIFI Certification
NEW YORK UNIVERSITY, New York, NY
SILVER SCHOOL OF SOCIAL WORK
Masters in Social Work - May 1992
MANHATTANVILLE COLLEGE, Purchase, NY
Bachelor of Arts in Political Science - May 1986
COMPUTER SKILLS
Windows, Microsoft Word, Excel, WordPerfect, Eclipsys, InterQual
VOLUNTEER WORK
Sunday School Teacher, Youth Group Leader, Confirmation Teacher
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