**** ************ ****

Randallstown Maryland

Phone 410-***-****

Daphne R. Bolden, APRN, PMH CNS.B.C. Certified Case Manager

Objective

To obtain an Administrative Position in health care in the areas of mental health. Performing diagnosis, treatment and management to the severely mentally ill patients as well as family, Utilizing individual, group, and family counseling treatment modalities. Performance improvement or utilization review to assess quality of mental health to promote advocacy and coordination of mental health and other services.

Education

2001-2003 University of Maryland at Baltimore Baltimore, Maryland

Master of Science Degree Clinical Nurse Specialist in Adult Psychiatric Nursing

1988-1990-University of Maryland Baltimore County Baltimore, Maryland

Bachelor of Science Degree Nursing

1982-1984 Fayetteville Technical Community College Fayetteville, North Carolina

Associate of Applied Science Degree in Nursing 1973-1977 Barton College Completed 101 Credits toward Nursing Degree

Wilson, North Carolina

Professional Experience

January 2,2022 -December 2023 CARE FIRST BLUE CROSS BLUE SHIELD Medicare Advantage 1501 S Clinton Street Baltimore Maryland 21224. Behavioral Health Coordinator for Medicare advantage plan. Case managing elderly and disabled population for insurance plan.

• Assessing clients’ physical and mental wellness, needs, preferences and abilities and using these to develop tailored care plans

• Working with clients, family and friend support networks and health care professionals to put care plans in place

• Listening to clients’ concerns and providing counseling or intervention as required

• Recording clients’ progress including charting referrals, home visits and other notable interactions

• Evaluating clients’ progress periodically and making adjustments as needed to improve outcomes

Coordination and Collaboration with transition services and hospital

discharge CM for appropriate d/c plan for member.

Preoperative and Postoperative teaching as needed.

Perform Behavioral health assessment to identify issues with MH concerns Make appropriate referrals to Plan in network providers for Mental health services.

• Following up with discharged clients to ensure they were satisfied with services and are able to maintain their physical and mental health post discharge.

Empower Members to participate and engage in self-Care strategies.

Provide utilization review for continued mental health inpatient hospitalization services using Milliman Guidelines to determine continued medical necessity for hospitalization. Ensure aftercare plans and HEDIS measures were followed post discharge. Members must be seen by the MH clinician in 7 days.

DYNAMIC WELLNESS LLC BALTIMORE MD. September

2020 -Present Perform Individual Counseling Perform Psychosocial Assessments Crisis Interventions using evidenced based practices. Case Management and referrals for PRP and Substance abuse services Client Centered informed Care CBT Solutions Focused Therapy Develop Treatment Plans. Motivational Interviewing Recovery Model

November 2015.-August 2020 Concerted Care Group Baltimore MD 21218.

Nurse Psychotherapist. Perform and develop Mental Health Treatment

Plans. Perform Group Therapy for Substance Abuse Clients. Perform Individual Counseling. Complete Mental Health and Substance Abuse Assessments. Coordinate and Collaborate with Primary Care providers Perform Risk assessments as needed. Complete Mental Health and Family History. Gather data from collateral sources. Obtain consents for Mental Health Treatment. Obtain consents for release of information. Maintain confidentiality per HIPPA guidelines.

November 2015- January 2019 Community Connections Washington DC 20003

Primary Care Liaison Health Home Project

Provide medical consultation to the Health Home team.

Coordinate care with external medical and behavioral health providers; and

Assist with developing effective Health Home comprehensive care management and coordination of care protocols involving community and hospital medical providers.

Assist to develop comprehensive care planning for complex patients.

Review treatment records for gaps in standard of care and preventive primary care goals.

Conduct in-service education and training for staff monthly.

Serve as a consultant for complex consumers.

Perform and lead case conferences for difficult and complex care consumers who have multiple comorbidities and difficult mental health and medical care presentation.

Develop Collaborative relationships with medical care providers.

Perform referrals as needed to specialty providers.

July 2012-2015 Perform Private Individual Counseling Mental Health Consultations for Pro-Bono counseling Project in Baltimore City.

July 2012-2013 Beacon Health Strategies, Washington, D.C MBHO for Chartered Health Plan Clinical Care Manager for Behavioral Health

Responsible for Triaging, assessing and managing members referred for Behavioral Health Case management. Responsible for the tracking and management of members identified as needing Intensive Case management Services who may be high risk, high utilizing and at significant clinical risk.

Perform Telephone Assessments of Mental Health needs

Telephonic collaboration with members

Telephonic Collaboration and Coordination with providers and State agencies regarding Case management members

Collaboration with Community Support Programs

Utilization Review for Designated Hospitalized members

Phone Coverage for urgent line and member services lines

Treatment Record Reviews

Provide members with Appropriate Community Resources

Perform reports documenting compliance with HEDIS measures

Perform chart reviews to evaluate compliance with HEDIS measures

September 2011-May 2012 Laurel Regional Hospital Dimensions Healthcare. Psychiatric Liaison Counselor

Perform Crisis Evaluations and Mental Health Assessments in the Emergency Department.

Collaborate with on call Physician

Perform Mental Status Examinations

Coordinate transfer of patients to other hospitals

Obtain appropriate signatures for patients identified as needing Involuntary Certification

Obtain appropriate insurance authorizations for treatment

Review lab studies prior to assessments

November 2009-November 2011 Value Options; Staffing ETC.

MARYLAND MEDICAID MENTAL HEALTH ADMINISTRATIVE SERVICE ORGANIZATION CLINCIAL CARE MANAGER MCO COORDINATOR

Conduct telephone assessments to collect sufficient data to make appropriate authorization determinations for emergency, urgent and routine levels of mental health care.

Perform appropriate utilization management decisions for mental health services.

Collaborate with providers to determine alternate levels of care and facilitate coordination of care with other service managers and aftercare coordinators to assure continuity of mental health care.

Evaluate clinical appropriateness of mental health treatment by using value options and mental hygiene administration medical necessity guidelines professional knowledge and rendering authorization decisions or seeking peer advisor consultations for non-authorization decisions.

Collaborate with state of Maryland MCO’s for complex medical and mental health consumers to effect appropriate services as needed to maintain mental health.

Act as resource for MCO providers

Educate regarding available mental health services.

Certifications

Board Certified in Advanced Practice Adult Psychiatric Nursing by ANCC

Board Certified in Basic Psychiatric Nursing

Certified HIV Instructor Train the Trainer

Certified to perform HIV counseling and Testing

REFERENCES provided upon request

Professional memberships

American Psychiatric Nurses Association

Awards received

Governor’s Citation for Exemplary State Service

High Smith Rainy Memorial Nursing Scholarship

Served as a Marshal to the Nursing Class of 1983

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