LEXZINE D. BRYANT

*** ********* **. ***** *****, NC 27801 252-***-****

adx0xh@r.postjobfree.com

Education

MS/P. Master of Science in Psychology

May 2011- University of Phoenix

BSW. Batchelor in Social Work

May 2002 Barton College, Wilson, NC

Experience

Trillium Health Resources, Greenville, NC

Care Manager June 2012 - present

Assessment and Planning:

• Utilizes person centered planning methods/strategies to gather information, to get to know the members supported and to adequately address specific needs of the individual.

• Provides education and support to members in learning about and exercising rights and responsibilities.

• Consistently completes Discovery activities (information gathering and assessment) as a component of the planning process.

• Ensures that members/legally responsible persons are informed of services available (all types of Medicaid and state-funded services), service options available (e.g. Individual/Family Direction for Innovations participants), processes (e.g. requirements for specific service), Natural and community services, and so forth.

• Assists members/legally responsible persons in choosing service providers, ensuring objectivity in the process.

• Assists the member supported to direct the planning process/plan development, to the extent desired by the member.

• Facilitates timely development of the Comprehensive Care management Assessment, Individual Support Plan, Crisis Plan and other assessments as needed.

• Actively collaborates with members supported and members of the support team to ensure development of a comprehensive plan that is reflects the member’s needs and desired life goals as well as, the physical, behavioral health and social determinant needs, service delivery and health and safety of the member.

• Collaborates with integrated care team members, including but not limited to Specialty Care team and Neighborhood Connections Department to provide integrated care.

• Assists members in navigating the healthcare and social support systems to ensure overall health and wellbeing.

• Promotes use of natural/community resources through the assessment, planning, and linkage process. Facilitates referral if needed

• Ensures that assessments and plans are updated, as needed, whenever the member’s life circumstances change.

• Monitors the quality and effectiveness of interventions.

• Perform peer monitoring/reviews on three charts per month as a compliance and quality strategy to ensure information is accurate, relevant, and/or reflects process expectations. Peer Monitoring/review includes completion of the designated review tool and communication of the findings to their supervisor and/or others designated entity.

• Evaluates outcome of the plan.

• Provides education on the self-direction model in the Innovations Waiver. (e.g. Agency with Choice and Employer of Record models).

• Assist members in understanding and choosing Community Navigator under the Innovations Waiver, when appropriate.

• Linkage to needed psychological, behavioral, educational, Allied Therapy evaluations, medical supports, the Supports Intensity Scale, and so forth, as appropriate for the individual’s needs.

Support Monitoring/Coordination:

• Monitors per established timeframes to ensure quality care, health/safety of the individual, as well as the continued appropriateness of services as needed.

• Ensures that services are monitored as needed (including direct observation of service delivery, telephonic contact, emails, etc.) in all settings.

• Makes announced/unannounced monitoring visits, including nights/weekends as applicable.

• Monitors services for compliance with state standards, waiver requirements, and Medicaid regulations, as applicable (including review of service documentation, review of claims, etc.).

• Promotes problem-solving and goal-oriented partnership with members/legally responsible persons, providers, etc.

Recognizes and reports critical incidents.

• Promotes satisfaction with services through ongoing communication and timely follow-up on any concerns/issues.

• Determines appropriate services for members with I/DD, TBI and co-occurring mental health and / or substance use disorders.

• Coordinates and monitors hospital and institutional admissions and discharges and follow-up.

• Manages transitions of care e.g. members discharging from residential or inpatient settings, transitioning out of school-related services, members experiencing a change in employment or change in primary caregiver

• Ensures the coordination of care with each member’s physician/health home (as needed).

• Ensures member engagement as needed to promote optimal health care and desired outcomes are achieved.

• Ensure members are linked to a primary care physician (PCP) and/or specialist(s) (as appropriate); if a member is not linked with a PCP and/or other identified physicians, responsible for assisting with linking the member with needed supports.

• Provides follow-up to any current or new individual who receives crisis services.

• Recognizes and reports critical incidents.

• Promotes satisfaction with services through ongoing communication and timely follow-up on any concerns/issues.

• Determines appropriate services for members with I/DD, TBI and co-occurring mental health and / or substance use disorders.

• Coordinates and monitors hospital and institutional admissions and discharges and follow-up.

• Manages transitions of care e.g. members discharging from residential or inpatient settings, transitioning out of school-related services, members experiencing a change in employment or change in primary caregiver

• Ensures the coordination of care with each member’s physician/health home (as needed).

• Ensures member engagement as needed to promote optimal health care and desired outcomes are achieved.

• Ensure members are linked to a primary care physician (PCP) and/or specialist(s) (as appropriate); if a member is not linked with a PCP and/or other identified physicians, responsible for assisting with linking the member with needed supports.

• Provides follow-up to any current or new individual who receives crisis services.

Documentation and Fiscal Accountability:

• Educate members/families on details surrounding the member’s service budget.

• Verifies that services are delivered as outlined in the Individual Support Plan and addresses any deviations in service or follows-up with the provider agency as applicable.

• Ensures that Letters of Medical Necessity/doctor’s orders are obtained, as applicable.

• Verifies members continuing eligibility for Medicaid and “IN” Indicators and promptly follows-up on identified issues, as indicated.

• Proactively responds to a member’s movement outside the Trillium geographic area to ensure changes in their Medicaid County of eligibility are addressed prior to any loss of service.

• Coordinates Medicaid deductibles, as applicable, with the member/legally responsible person and provider(s).

• Proactively monitors documentation/billing to ensure that issues/errors are resolved as quickly as possible.

• Ensures all clinical documentation (e.g. goals, plans, progress notes, etc.) meet state, agency and Medicaid requirements.

• Maintains documentation compliance/quality, as required per the MCO and/or state requirements/standards.

• Documents activities in in the Trillium Connections care management platform.

• Documentation should be timely, accurate, complete and reflective of the member’s needs.

Reviews member information within the care management platform, Updates information as needed and/or informs the appropriate staff when inaccuracies are found.

• Coordination of Medicaid eligibility and benefits.

• Other duties as assigned.

The Arc of NC, Tarboro, NC

Support Broker April 2006 –May 2012

Same Responsibilities

Assessment and Planning

Support Monitoring/Coordination

Support Monitoring/Coordination

Edgecombe Nash Mental Health, Rocky Mount & Tarboro, NC

Case Manager November 2003 – May 2012

Same Responsibilities

Assessment and Planning

Support Monitoring/Coordination

Support Monitoring/Coordination

Additional Information

Knowledge, Skills and Abilities: I have a high level of diplomacy and discretion is required to effectively negotiate and resolve issues with minimal assistance. Problem solving, negotiation, arbitration and conflict resolution skills are essential to balance the needs of both internal and external stakeholders.

I have the detail oriented, able to organize multiple tasks and priorities, and to effectively manage projects from start to finish. Work activities quickly change according to mandated changes, modified priorities within the department, and changes associated with the individual’s needs.

Proficiency in Microsoft products (such as Word, Excel, Outlook, PowerPoint, etc.) is required. The employee will need to build on or adapt computer skills as technology changes to efficiently and effectively perform job duties.

Decision Making/Consequences of Error: Errors in administrative and/or clinical judgment can negatively affect the quality of care and the success of the program. Errors, delays, or failure of adequate record documentation could result in difficulty meeting accreditation standards, failure of continued grant funding (if applicable) and inadequate data to determine outcomes. Failure to coordinate needed services could have a direct impact on the individual. This may result in disciplinary action up to and including dismissal, according to seriousness of errors.

Nature and Purpose of Public Contacts: I have the ability requires to contact on a constant basis with individuals supported and their families, providers, local community partners/resources, colleagues, and community stakeholders from various counties to exchange information and ensure appropriate services for individuals supported.

Mental/Physical Demands: I have the abilities that requires close mental attention. I have the ability to deal and handle stressful situation, meet deadlines and continuous challenges.

Training:

Person Centered Planning

Plan Development

Person Centered Language

Listening Technique

Monitoring Technique

Contact this candidate