Richard Tatum
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UR Manager
lawreceville, GA 30045

Fast Learner, Dependable, Team Player, Leader

Praises
3 people praised Richard

Praise highlights

The fact that he worked for 28 years in the MH field -- which is almost unheard of in this day and age -- a field that is stressful, with a high employee "burnout" quotient.

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Work experience
Laurel Heights Hospital
Utilization Review Manager

Monitor and analyze admissions, operational resources, and other indicators within the utilization and
quality program. Working with ASD and Behavioral DX clients. Conduct audits to ensure quality patient
care and appropriateness of services within contracts. Oversee day-to-day operational and clinical
activities to ensure quality patient care.

Participates in pre-certifications for admissions with third party payers.

Conduct admission review activities.

Conducts continued stay review activities.

Coordinates third party physician peer-to-peer reviews.

Conducts discharge review activities.

Notifies third party payers of discharge.

Maintains accurate UR information and retrieves date for reports.

Communicates results of third party reviews to appropriate staff for length of stay coordination and
discharge planning.

Establishes and maintains rapport with physicians to ensure adequate, accurate documentation of
patient's care.

Establishes and maintains rapport with clinical staff to ensure adequate, accurate, documentation of
patient's care.

Participate in treatment plan reviews.

Performs concurrent and/or retrospective review/analysis for the appropriateness, effectiveness and
efficiency of services.
Acts as a resource to other staff on UR/third party requirements

Utilization Management Director

MUST Ministries
Veteran LCSW Social Worker

Work with homeless U. S. veterans to attain benefits to which they are entitled.
*Led groups for Veterans focused on anger management, drug addiction, life awareness, and physical fitness
*Ensured basic needs of youth were met daily, including physical and emotional.
*Functioned as member of a multidisciplinary team by communicating and coordinating with all appropriate staff
Help to provide permanent housing, and to make sure that medical and mental health appointments were made and kept.

Treatment Management Company

1.Working with Dual diagnosis clients in the PHP and IOP programs. Manages the utilization of referral
services from a network of seven ambulatory care clinics. Assists in the development and implementation
of procedures to track and trend specialty and ancillary service utilization within the clinics.

2. Responsible for monitoring referral patterns and making recommendations to the Medical Director
on strategies to contain costs, improve access and insure quality care; and ensures implementation of
practice guidelines and referral criteria established by the Medical Director.

3. Responsible for the maintenance of good community relationships with providers who provide services
to Public Health Department patients and ensures a responsive system for authorization of services and
payment of claims; and assisting in negotiating access to care in targeted areas, as requested.

4. Prepares statistical and narrative reports as requested by administrative staff on utilization patterns,
expenditures by area and revenue stream, demographics of service delivery and trending of expenditures
by program.

5. Establishes and amends, as necessary, a reporting system for contract providers; monitors and
analyzes the use of services from outside providers.

6. Trains professional clinic and program staff on current principals and standards of practice of Utilization
Management, medical/surgical diagnosis and treatment coding and reimbursement methodologies.

Magellan Behavioral Health
Senior Care Manager Asses and Triage

Authorizes and reviews utilization of mental health and substance abuse services provided in inpatient
and intermediate care settings; collects and analyzes utilization data. Assists with discharge planning
and ambulatory follow up activity; provides member assistance with mental health and substance abuse
issues, and participates in QI projects. Manages a caseload of ICM members if assigned. May be assigned
additional special responsibilities commensurate with experience and type of licensure. Will be expected
to coach and mentor less experienced Care Managers.

ESSENTIAL FUNCTIONS:

Monitor inpatient and intermediate level of care services related to mental health and substance abuse
treatment to ensure medical necessity and effectiveness.

Perform concurrent reviews for inpatient care and other levels of care as allowed by scope of practice
and experience. In conjunction with providers and facilities, develop discharge plans and oversee their
implementation. Provide telephone triage, crisis intervention and emergency authorizations

Provide information to members and providers regarding mental health and substance abuse benefits,
community treatment resources, mental health managed care programs, and Magellan Health Services
policies and procedures, and criteria.
Interact with Magellan Medical/Associate Director and/or Physician Advisors to discuss Clinical/
authorization questions and concerns regarding specific cases.

Participate in QI activities, including data collection, tracking, and analysis.

Creative Community Services
Family Consultant

Meet with clients on a regular, consistent basis, not less than one time monthly. The frequency of
visits is determined by level of care needed on a case by case basis and/or by the referral source.
Engage and assist the client's participation in the treatment planning process. Coordinate and
case manage appropriate educational, vocational, recreational, and other services, as needed.
Provide ongoing support for clients, including emergency and crisis consultation on a 24-hour basis.
Completion of clear, accurate documentation of 1) all contacts with clients, 2) monthly reports, 3)
court reports, and 4) treatment plans. Demonstrate respect and cultural sensitivity to all clients and
to all referral sources. Maintain strict confidentiality at all times to protect clients' privacy. Comply
with required in-service / continuing education hours as outlined in policy manual. Attain / maintain
CPR and First Aid certifications. Sevices will be provided Effectively, Efficiently, and with Evidence
provided for each case. (See "Performance Benchmarks" attached).

Behaioral Health Well Care Health Care Service
LCSW Social Worker

Participates in and supports developed care plans for members with high level acuity needs utilizing
social service expertise to evaluate the members need for alternative services and third party needs.
* Outreaches to members telephonically and/or in-person and coordinates member's case
management services.
* Interacts continuously with members, family, physician(s), and other resources to determine
appropriate behavioral action needed to address/support medical needs. Reviews benefits options,
researches community resources, coordinates services, trains/creates behavioral routines and enables
members to be active participants in their own healthcare.
* Provides telephone follow-up to ensure members have seen their PCP and are completing their
treatment plan or preventive care services a defined by the PCP or guidelines.
* Coordinates community resources with emphasis on the development of natural support system.
Coordinates benefits, regulations, laws and public entitlement programs.
* Acts as a liaison and member advocate between the member/family, physician and facilities/
agencies.
* Assists in obtaining benefits for members through community resources when benefits are exhausted
or not available.
* Manage members with severe mental illness who have high rates of behavioral health utilization and/
or severe psychosocial vulnerability. Acts as team SME in order to archive optimal clinical and resource
outcomes.

Care Manager for Veterans

MUST Ministries

Work with homeless U. S. veterans to attain benefits to which they are entitled.
Led groups for Veterans focused on anger management, drug addiction, life awareness, and physical
fitness

Ensured basic needs of youth were met daily, including physical and emotional.

Functioned as member of a multidisciplinary team by communicating and coordinating with all
appropriate staff

Help to provide permanent housing, and to make sure that medical and mental health appointments
were made and kept.

Well Care Health Care Service
BH LCSW Social Worker

Participates in and supports developed care plans for members with high level acuity needs utilizing social service expertise to evaluate the members need for alternative services and third party needs.
* Outreaches to members telephonically and/or in-person and coordinates member's case management services.
* Interacts continuously with members, family, physician(s), and other resources to determine appropriate behavioral action needed to address/support medical needs. Reviews benefits options, researches community resources, coordinates services, trains/creates behavioral routines and enables members to be active participants in their own healthcare.
* Provides telephone follow-up to ensure members have seen their PCP and are completing their treatment plan or preventive care services a defined by the PCP or guidelines.
* Coordinates community resources with emphasis on the development of natural support system. Coordinates benefits, regulations, laws and public entitlement programs.
* Acts as a liaison and member advocate between the member/family, physician and facilities/agencies.
* Assists in obtaining benefits for members through community resources when benefits are exhausted or not available.
* Manage members with severe mental illness who have high rates of behavioral health utilization and/or severe psychosocial vulnerability. Acts as team SME in order to archive optimal clinical and resource outcomes.

St. Joseph's Mercy Care
Senior Mental Health Case Manager

Assist homeless individuals with mental illness to obtain housing, mental health and medical services
*Teach individuals on mental health caseload independent living skills such as how to schedule needed services as well as obtain required documents such as driver's license and birth certificate
*Work with homeless U. S. veterans to attain benefits to which they are entitled
*Help clients on mental health caseload obtain transitional housing upon departure from shelter
*Follow up on clients' progress after completion or discharge from program as member of PATH team
*Conduct Crisis Prevention-Intervention training for staff
*Collaborate with other professionals in the mental health field to end homelessness as a member of the Mayor's Initiative Team-Unsheltered No More Program
*Provide medication to homeless individuals in Atlanta by participating in Street Medicine Program
*Supervise mental health unit at Gateway Homeless Shelter 24/7
*Conduct group therapy for adolescent clients dealing with issues related to poverty and neighborhood violence

Devereux Georgia Treatment Network
Program Supervisor

Worked with multidisciplinary treatment team to develop and ensure appropriate implementation of
individualized treatment plans
Maintained a safe and therapeutic milieu environment through utilization of Positive Behavior
Support program and modeling positive behaviors for staff and clients
Responsible for the development, implementation and coordination of assigned shift's operation
including planning, staff scheduling, maintaining staff to client ratios, and overtime prevention for
assigned team on a daily basis

Devereux Georgia Treatment Network
Program Supervisor

Worked with multidisciplinary treatment team to develop and ensure appropriate implementation of individualized treatment plans
*Maintained a safe and therapeutic milieu environment through utilization of Positive Behavior Support program and modeling positive behaviors for staff and clients
*Responsible for the development, implementation and coordination of assigned shift's operation including planning, staff scheduling, maintaining staff to client ratios, and overtime prevention for assigned team on a daily basis

Erie County Medical Center
Program Coordinator

Led groups for youth focused on anger management, drug addiction, gang involvement, life awareness, and physical fitness
*Ensured basic needs of youth were met daily, including physical and emotional
*Functioned as member of a multidisciplinary team by communicating and coordinating with all appropriate staff during shift changes
*Trained new staff in therapeutic interventions, safety measures, and appropriate boundaries
*Intervened in crises utilizing approved crisis intervention strategies

Baker Victory Service
Lead Mental Health Specialist

Assisted at-risk youth with histories of gang involvement and sexual offending behaviors with developing Independent Living Skills
*Demonstrated knowledge and skills necessary to provide appropriate care, treatment, and services for the emotional and behavioral health needs of children and adolescents
*Ensured appropriate documentation of client progress, incident fact sheets, and special treatment procedures

Baker Victory Services/ChildPro
Mental Health Technician Lead
Buffalo Public Schools
Youth Counselor

Actively supervised and interacted with group of youth in daily activities according to structured daily schedule and facilitated activities as needed
*Established clear expectations, set and enforced consequences for disruptive behavior
*Assisted students with their educational needs by providing them with quality tutoring and skills to improve academic achievement
*Assisted teachers with development of educational plans to assist students with their academic growth

Lead Mental Health Specialist

risk youth with histories of gang involvement and sexual offending behaviors with
developing Independent Living Skills

Demonstrated knowledge and skills necessary to provide appropriate care, treatment, and services for
the emotional and behavioral health needs of children and adolescents

Ensured appropriate documentation of client progress, incident fact sheets, and special treatment
procedures

Traits
resume-trait-icon-set
Accountable
I take responsibility for my actions and follow through on my promises.
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Communicator
I am able to effectively and respectfully communicate with superiors, colleagues, and staff.
resume-trait-icon-set
Dependable
I can be counted on to complete whatever task, objective, or job is needed.
Education
S.U.N.Y
Psychology
State University of New York
Masters, Psychology
Kensington Business Institute
Bachelors, Mental HealthBehavioral Science
Kensington Business Institute
Bachelors, Mental Health
Certifications & licenses
LCSW
NY State
Skills
  • Conflict Resolution Skills
  • Active Listener
  • Building Customer Service
  • Customer Service Skills
Staffing and freelance

Richard is affiliated with the following companies:

  • Aerotek
Volunteering
gateway center