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Social Worker Utilization Review

Location:
Rutherfordton, NC
Salary:
70,000
Posted:
April 02, 2023

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Resume:

Belinda Ann Greene Sprouse

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

Forest City, NC 28043

804-***-****

adwap7@r.postjobfree.com

CAREER OBJECTIVE Seeking a challenging career in the field of mental health/substance abuse, and/or case management.

EDUCATION

Associates of Art in Bereavement Counseling. John Tyler Community College. May 2016. GPA 4.0

Masters of Social Work Norfolk State University. May 2004, GPA 3.5

Bachelors of Art in Sociology Elizabeth City State University. Dec ‘99, GPA 3.4.

Associate of Science in Agribusiness Management NC State Univ. May ‘97, GPA 3.9.

LICENSURES

LCSW Eligibility. Approved by Assoc of Social Work Board to take examination.

HIGHLIGHTED SKILLS

20+ years experience with case management, discharge planning including DME and home health referrals, dialysis coordination, SNF/LTC coordination, Uniformed Assessment Instruments required for LTC Medicaid and auxiliary grants and thorough knowledge of community resources to ensure safe discharge. Knowledge of medical terminology, ICD9 coding and some familiarity with DRG reimbursements and utilization review. Knowledge of third party insurances, medicare, medicaid and/or authorizations and eligibility requirements. Knowledge of psychosocial theories and DSM IV diagnosis as applied to implementation and treatment of diverse mental illnesses and MR diagnosis. Experience with substance abuse assessments and counseling, crisis intervention, clinical assessments/mental status exams, and group/individual therapy. Experience working with varying milieus including geriatrics, mental illness/substance abuse, developmental and intellectually disabled as well as “at-risk” youth. Proficiency using Microsoft Word, Excel, Access, Outlook, PowerPoint, Internet Explorer and other marketing and communications tools including Facebook/Twitter. MS-DOS, and SPSS statistical programming and research. CPR/First Aid Certifications. Leadership and Management Certifications. Business Writing Certifications.

PROFESSIONAL EXPERIENCE

Hospice Social Worker/Bereavement Counselor, Gentiva Hospice, 12 19 2013-Present. 8000 Richmond,VA23229, 804-***-****. Supervisor: Crystal Barbour.

Duties: Knowledge of health and welfare resources and facilities; knowledge of insurance benefits, including Medicare and Medicaid reimbursement for hospice patients; knowledge of medical, legal and financial implications for patients and their families, particularly those relating to end-of-life decisions (eg, medical advance directives, Do Not Resuscitate orders, guardianship, power of attorney), and age-specific service needs. provide psychosocial and emotional counseling support to terminal patients and their family members who present with bereavement risk factors, inadequate coping skills and are at risk of complicated grief.

Social Worker, PRN Paradise Home Heatlh, 08/2014-03/2015, 8900 Three Chopt Road, Richmond, VA 23229, 804-***-****.

Palliative/Hospice Social Worker Bon Secours Hospice, 03/08-01/09, 8550 Magellan Pkwy Richmond,VA23227, 804-***-****.

Duties: Knowledge of health and welfare resources and facilities; knowledge of insurance benefits, including Medicare and Medicaid reimbursement for hospice patients; knowledge of medical, legal and financial implications for patients and their families, particularly those relating to end-of-life decisions (eg, medical advance directives, Do Not Resuscitate orders, guardianship, power of attorney), and age-specific service needs.

Social Worker II Inova Health Systems-Fairfax Hospital, 05/06-03/08, 3300 Gallows RD, Falls Church, VA 22042, 703-***-****.

Duties: Assess, diagnose and plan for interventions related to patient and family needs and behaviors. Integrate assessments using information related to cultural, clinical, ethnic, age and other factors into plan of care in order to implement transition plans and treatments. Act as active team member in the discharge planning process and primary responsibility for identifying complicating social and financial factors and barriers to appropriate discharge. Assure that patient is referred to appropriate social and financial resources post discharge in order to transition patient efficiently and achieve the desired outcome. Refer patients/families and care givers to appropriate resources regarding abuse/ neglect/ domestic violence, alcohol and substance abuse. Perform appropriate clinical interventions related to grief counseling, bereavement, adjustment, crisis intervention in order to support the process of transition planning. Participate and develop inpatient and community programs that benefit patient, families and staff. Implement support groups for specified disease processes to assist community outreach and development. Perform follow up service as needed to measure clinical outcomes. Currently work on Telemetry and Medical/Surgical Unit and have experience in discharge planning, social work consulting in relation to discharge planning, mental health, substance abuse, homelessness, HIV, terminal illness, medication assistance, hospice/palliative care, DME, infusion therapy, outpatient dialysis, SNF/NF placement, Medicaid guidelines and application processes for SNF/NF placement, Medicare knowledge, third party insurances, and utilization review.

Crisis Intervention Clinician Bon Secours-Maryview Medical Center, 03/05-11/05, 3636 High ST Portsmouth, Virginia 23707, 757-***-****.

Screen and assess individuals in crisis including psychosis, suicidal/homicidal ideation, and substance abuse detoxification, for appropriate level inpatient/outpatient level of care. Coordinate with private and community resources for mental wellness and disease prevention/decompensation for individuals identified as high-risk.

Director of Admissions and Social Work Sentara Lifecare, 03/02-03/05, 4201 Greenwood DR Porstmouth, Virginia 23701, 757-***-****, 2230 Executive DR. Hampton, VA 23666, 757-***-****.

Duties: Completed supervisory duties of department including hiring and completion of human resource requirements as well as completion of required evaluations and employment improvement planning. Created and maintained budgets for upcoming fiscal year including monitoring, controlling and minimizing the use of overtime.. Provided social services through interdisciplinary care planning, acting as a liaison between local community agencies, and consulting family/residents regarding Medicaid/Medicare assistance, grievances, bereavement, and referral services. Assessed the needs of prospective residents through evaluation of medical records, social history, cognitive assessment, and discharge plans.

Client Behavioral Specialist Pride in North Carolina, Inc., 02/01-02/02, 905 Halstead BLVD Elizabeth City, NC, 27909, (252) 331-032.

Duties: Worked as a high-risk intervention worker and provided services to “at-risk” youth who demonstrate signs of mental, cognitive, and behavior delay. Worked individually with adolescents in their schools, homes, and community to develop age appropriate social, living, and coping skills. Completed Medicaid documentation.

Social Worker Britthaven Nursing Home, 02/00-08/00, 466 Paradise RD Edenton,

North Carolina 27948, 252-***-****

Duties: Provided social services through interdisciplinary care planning, acting as a liaison between local community agencies, and consulting family/residents regarding Medicaid/Medicare assistance, grievances, bereavement, and referral services. Assessed the needs of prospective residents through evaluation of medical records, social history, cognitive assessment, and discharge plans.

Research Assistant Elizabeth City State University, 12/98-12/99, 7401 Weeksville RD. Elizabeth City, NC, 27909, 252-***-****.

Duties: Provided technical assistance in collecting, editing, analyzing, and reporting data through manipulating spreadsheets and statistical computer programs, including SPSS.

INTERNSHIP/VOLUNTEER EXPERIENCE

Counselor/Intern Community Services Board-HNN, 08/04-06/05, Lassen Program, 1930 Pembroke AVE, Hampton, VA. 757-***-****.

Duties: Successfully completed @ 700 clinical hours at day-treatment program for individuals diagnosed with diverse mental illnesses including schizophrenia, bipolar, PTSD, and depression. Worked one on one with individuals in developing appropriate social and coping skills. Made referrals and appointments to outside agencies as well as psychiatrists/therapists to ensure the wellness of our mental health consumers. Facilitation of group and individual therapy including Anger and Stress Management, Depression, Relaxation therapy groups and the development and implementation of Art Therapy. Completion of clinical assessments and mental status exams. Development and implementation of treatment plans. Monthly/Quarterly documentation.

Counselor/Intern Community Services Board-HNN, 01/03-06/03, 1930 Pembroke AVE, Hampton, VA 23666. 757-***-****

Duties: Successfully completed 336 field hours at a residential treatment program for pregnant women diagnosed with substance abuse. Participated in treatment program through co-facilitation of group and individual therapy sessions, intake coordination including handling referrals and admissions processing, acting as a liaison between community agencies, discharge planning, assisting in completion of Medicaid applications, medical record reviews, and documentation.

ACHIEVEMENTS/MEMBERSHIPS

Kindred/Gentiva Bronze Coin Recognition. National Association of Social Workers. Alpha Delta Mu National Social Work Honorary Society, Delta Tau Alpha Honorary Society, Alpha Chi National Honorary Society, National Dean’s List, Award of Excellence in Sociology, All-American Scholar Honorary Society, Merit Scholarship, Langley Kennel Club Scholarship, Who’s Who Among College Students, Phillip Morris Merit Scholarship.



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