Resolute professional with over 10 years within behavioral health utilization management and clinical program consulting. Proven strategic leadership skills with experience in people management.
Overview
16
16
years of professional experience
Work History
Clinical Program Manager
Optum
10.2024 - Current
Lead and managed a team of 18 - 23 clinicians on Utilization Management Triage and Concurrent Review workflows for IFP/Exchange Accounts.
Applied account performance data to diagnose issues, coordinate improvement efforts across clinical and operational teams, and deliver insights to senior leaders.
Ensured timely implementation of regulatory, compliance, and internal deadlines during execution of new processes and guidelines.
Conduct monthly call and chart audits to ensure clinical, compliance, and regulatory guidelines are being met.
Analyzed monthly individual performance metrics and provided targeted coaching to improve clinician outcomes.
Developed new staffing model for Care Advocates that promoted time management and efficiency.
Facilitated weekly leadership meetings to align strategy and enhance communication and process improvements.
Clinical Program Consultant/Solution and Design Architect
Supported Care Advocates with clinical and procedural guidance while leading new-process training to enhance team capabilities.
Conducted call audits and staffed clinical cases, while facilitating provider audit appeals to ensure compliance and quality.
Identified fraudulent billing practices at two facilities by actively participating in provider audit appeal hearings, contributing to integrity in billing processes.
Facility Based Care Advocate
Optum
12.2014 - 04.2018
Managed caseload of 20+ patients and assessed medical necessity using clinical guidelines.
Enhanced case formulation and collaboration during clinical rounds to improve patient care.
Contributed to UM pilots and time-study initiatives to optimize care processes.
Utilization Review Specialist
Anchor Hospital
10.2013 - 07.2014
Handled a caseload of 20–30 patients and collaborated with payers for continued authorization.
Conducted comprehensive reviews of patient treatment plans for medical necessity.
Collaborated with healthcare providers to ensure compliance with regulations.
Analyzed clinical documentation to assess appropriateness of care services.
Social Services Inpatient Counselor
Anchor Hospital
05.2010 - 10.2013
Managed caseload of 12–18 patients while facilitating therapy groups to promote patient progress.
Supported discharge planning through collaboration with psychiatrists to ensure comprehensive patient care.
Led inpatient internship program for graduate students, enhancing their practical experience in a clinical setting.
Education
Masters of Science - Professional Counseling
Mercer University
Bachelor of Arts - Psychology and minor in Sociology
University of West Georgia
Skills
Behavioral Health Clinical Acumen
Regulatory Compliance
Data and Trend Analysis
Process Optimization & Operational Efficiency
Time Management & Project Prioritization
Strong Analytical and Problem-solving skills
Microsoft Office Proficiency
Facilitation, Communication and Presentation skills
Accomplishments
Sages Clinical Award Nominee – 2025
Superhero Award Nominee – 2019
Education And Licensure
Licensed Professional Counselor, GA, 09/30/26
Masters of Science in Professional Counseling, Mercer University
Bachelor of Arts in Psychology, Sociology, University of West Georgia
Timeline
Clinical Program Manager
Optum
10.2024 - Current
Clinical Program Consultant/Solution and Design Architect
Optum
08.2022 - 10.2024
Clinical Program Manager
Optum
11.2020 - 08.2022
Senior Care Advocate/Team Lead
Optum
04.2018 - 11.2020
Facility Based Care Advocate
Optum
12.2014 - 04.2018
Utilization Review Specialist
Anchor Hospital
10.2013 - 07.2014
Social Services Inpatient Counselor
Anchor Hospital
05.2010 - 10.2013
Masters of Science - Professional Counseling
Mercer University
Bachelor of Arts - Psychology and minor in Sociology