Holly Seals

• Complete utilization reviews for Detox, Residential Treatment, Partial Hospitalization Program, and Intensive Outpatient Program • Assess and document medical necessity based on clinical presentation, risk factors for relapse, co-occurring psychiatric and medical conditions, and ASAM criteria • Collaborate with treatment teams to ensure appropriate level of care placement and continuity of services • Justify the need for 24/7 monitoring in residential and detox settings and articulate why lower levels of care would not meet client needs • Submit timely initial, concurrent, and appeal reviews in compliance with payer requirements • Monitor clinical documentation to ensure alignment with medical necessity and payer guidelines across all levels of care • Manage time effectively and complete tasks independently without direct supervision • Maintain accurate records while ensuring compliance with HIPAA and all regulatory standards

•Conduct comprehensive assessments and develop individualized treatment plans. •Facilitate group and individual counseling sessions focusing on relapse prevention and life skills. •Engage in case management activities and coordinate with healthcare professionals. •Maintain compliance with HIPAA regulations and ensure accurate documentation. • Provide crisis intervention and support as needed.

• Supervised and mentored recovery advocates in supporting individuals in recovery. •Facilitated educational sessions on relapse prevention, addiction, and coping skills. •Assisted clients with developing structured recovery plans and setting goals. •Provided crisis intervention and connected clients with community resources.