Melanie Decker
1350 S. Greenfield Rd. #1194
Mesa, AZ 85206
480) 643-9812
Experience 
Long Term Care Case Manager
United Health Group/Evercare Phoenix, AZ
10/05-10/08
Case Managed Long Term Care members belonging to a managed health care
organization, working in conjunction with members/their families, nursing
facility staff,
Evercare Nurse Practitioners, Physicians and responsible parties to provide
coordination across all facets of the service delivery system in order to
maximize the efficient use of resources and minimize any negative impact to the
member. Required Service planning and coordination of identified medically
necessary and cost-effective services, brokering of services to obtain and
integrate all ALTCS services to be provided in accordance with the service plan;
facilitation/advocacy to resolve issues which impede the member's
progress and access to needed services; monitoring and reassessment of services
provided to ALTCs members, modifying/reviewing member service plans and goals as
necessary based on changes in condition; gatekeeping to assess and determine need
for,and cost effectiveness of ALTCs services for assigned members. Maintained
case files in
accordance with organization's Case File Documentation Standards (documentation
must be complete and comprehensive). Placed primary emphasis on the overall
clinical and social needs of the member, taking steps to ensure that members'
needs are being met. Required ability to directly and effectively deal with a
wide variety of conflicts. Working understanding of local, regional and federal
regulations that relate to long-term care industry and managed care programs.

Long Term Care Case Manager
Phoenix, AZ
Mercy Care Plan
11/00- 4/05
Worked with Managed Care Health Plan to ensure that appropriate,
cost-effective,medically related social and behavioral services were identified,
planned and obtained for ALTC members. Provided adequate information to assist
members and their responsible parties in making informed decisions and choices
regarding long-term care
services. Acted as a liaison for hospital discharge planning staff, Mercy Care
Concurrent Review and Prior Auth Nurses, Skilled Nursing Facility Social Workers,
Directors of Nursing and Administrators to provide continuum of service options
that supported the
members’ medical, social and psychological needs. Maintained case documentation
in adherence to organizational documentation guidelines.

Clinical Care Coordinator and Case Manager Phoenix, AZ
ABS of Arizona
4/98- 2/00
Provided clinical and program consultation services to Clinical Teams of SMI
adult members. Monitored treatment and crisis plans for priority and high risk
populations.Provided leadership, clinical oversight and support to team members
in the development of Individual Service Plans and in the management of
complaints and appeals process. Provided system intervention when obstacles
impeded service delivery. Used skills in crisis intervention, worked with
families, interfaced with human services systems, was involved in community
outreach and client assessment and referral.

Skills 
Human behavior knowledge, change management, written communication, managing
processes, coordination, conflict resolution, teamwork, analyzing information.

Education 
University of South Alabama
March, 1995
Masters of Science in Rehabilitation Counseling
University of South Alabama
March, 1993
Bachelor of Arts in Psychology