Rosalyn Baldwin
Zebulon,NC
Summary
Licensed Mental Health Therapist with extensive experience in disability clinical case management, evaluation, risk assessment, and crisis management. Proven ability to deliver exceptional service. Committed to fostering therapeutic relationships that empower others and promote mental well-being.
Overview
19
19
years of professional experience
Work History
Behavioral Health Clinical Case Manager
The Hartford
02.2019 - Current
- Effectively manage behavioral health disability claim referrals utilizing clinical data, functional status, and assessment
- Investigation and resolution of clinical records through assessment, provider clarification, and interview
- Assess and document clinical findings for disability determinations
- Partner with operations staff to ensure timely review of referrals
- Duration management supporting employees in returning to work sooner than estimated by their provider's ensuring optimal claim outcomes
- Provide consultations for clinical and operations staff
- Facilitate trainings on complex behavioral health claims
- Consistently exceeds quality audit and performance standards
- Provide education to the employee and treating provider to increase engagement, identify clinical barriers, and impact to work function
- Clinically manage major client accounts utilizing client specific standards
- Roundtable complex cases with medical director
- Lead team meetings and mentor new clinicians
- Participate in Development Focus and Wellness and Engagement groups
- Handle crisis management
Behavioral Health Clinical Case Manager
Aon Hewitt/ReedGroup
08.2014 - 02.2019
- Managed high-profile accounts- Amazon and Baylor Scott & White Health, providing clinical oversight to behavioral health claims and guidance to case managers throughout the claims process based on medical standards of care and guidelines
- Developed and implemented clinical department standards for potential risk, crisis, and threat management
- Presented complex cases in Clinical Roundtable and Grand Rounds to ensure optimal claim outcomes
- Served as a clinical consultant providing directives, support, and facilitated trainings to clinical and non-clinical staff, and business partners
- Performed comprehensive assessments and evaluation of the claimant’s functionality
- Partnered with treating physicians and therapists to establish appropriate return to work options, successfully facilitating early and safe return to work by reducing maximum duration of disability and minimizing relapse
- Developed and delivered clinical training to ensure staff were adhering to contractual obligations, regulatory requirements and standards
- Provided quality and continuous improvement, identified workflow and process improvements, collaborated with operational leadership team to implement the improvements
- Evaluated claim quality and conducted case analysis to determine accuracy
- Developed corrective action plans to improve overall quality performance by communicating observations, findings, and claim ratings
Disability Behavioral Health Clinical Case Manager
Aetna Insurance
10.2010 - 08.2014
- Managed Bank of America Account
- Provided comprehensive disability behavioral health case management to facilitate healthy return to work outcomes and appropriate claim resolution
- Presented cases during Clinical Roundtable and Grand Rounds to achieve optimum claim outcomes
- Completed functional assessments with evaluation of the disability to assist in making appropriate claim decisions
- Managed crisis calls utilizing threat protocol and clinical department standards
- Partnered with treating providers to assess client’s return to work potential while improving their functional capabilities, identified barriers and established appropriate return to work options
- Engaged in clinical integration making appropriate referrals to disease management and behavioral programs to achieve optimum level of health
- Served as a Behavioral Health Unit Advocate through the Diversity and Inclusion Culture Initiative promoting an environment of integrity and excellence
- Clinical contributor for the Mental Health and Wellness newsletter
Adolescent Clinical Addictions Therapist
Family Service of the Piedmont
08.2008 - 10.2010
- Diagnostic & Assessment planning
- Administered the Global Appraisal of Individual Needs Assessment for the Department of Juvenile Justice and formulated recommendations for appropriate level of care
- Provided written assessment outcomes, made treatment recommendations for families, community services, & Juvenile Court System
- Facilitated individual, group, and family therapy sessions and developed treatment plans
- Trained and supervised therapist in GAIN Administration and Seven Challenges Curriculum & Instruction
Psychotherapist
Carolinas HealthCare System
04.2006 - 08.2008
- Assessed for crisis and facilitated crisis stabilization interventions for high acuity patients seen in the emergency department, mental health crisis clinic, and inpatient psych unit
- Diagnostic & Assessment planning
- Facilitated outpatient individual, group, and family therapy to individuals with chronic and persistent mental illnesses such as mood disorders, adjustment disorders, anxiety related disorders, chemical dependency, self-injury, eating and body image disorders, PTSD, schizoaffective disorders
- Provided education and support fostering optimum mental and emotional well-being by decreasing or eliminating life-threatening behaviors and increasing effective coping and behavioral skills
- Selected as a therapist for the Dialectical Behavioral Therapy Crisis Intervention Team
- Facilitated monthly peer discussions on topics specific to research and treatment of Borderline Personality Disorder and other mental health conditions
- Facilitated educational and training seminars on Co-occurring Disorders for clinical staff
- Triaged cases with multi-disciplinary treatment team on a weekly basis to ensure effective client care and outcome
Education
Master of Science - Counseling
North Carolina Agricultural & Technical State University
Greensboro, NCBachelor of Arts - Psychology
North Carolina Agricultural & Technical State University
Greensboro, NCSkills
- Clear communication
- Problem-solving abilities
- Adaptability
- Effective time management
- Dependable
- Flexible
- Proactive self-starter
- Team-oriented
- Effective collaboration skills
- Empathy
- Strong customer service
- Clear and concise communication
Affiliations
Licensed Clinical Mental Health Counselor North Carolina 5260
Licensed Professional Counselor/MHSP Tennessee 6372
Timeline
Behavioral Health Clinical Case Manager
The Hartford
02.2019 - Current
Behavioral Health Clinical Case Manager
Aon Hewitt/ReedGroup
08.2014 - 02.2019
Disability Behavioral Health Clinical Case Manager
Aetna Insurance
10.2010 - 08.2014
Adolescent Clinical Addictions Therapist
Family Service of the Piedmont
08.2008 - 10.2010
Psychotherapist
Carolinas HealthCare System
04.2006 - 08.2008
Master of Science - Counseling
North Carolina Agricultural & Technical State University
Bachelor of Arts - Psychology
North Carolina Agricultural & Technical State University
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