Alyssa Tejas
@alyssatejas
Behavioral health utilization management specialist driving compliance, revenue recovery, and improved clinical workflows.
United StatesWhat I'm looking for
I am a behavioral health utilization management professional (RMHCI) with progressive experience applying MCG and InterQual medical necessity criteria across inpatient and outpatient settings, managing denials and appeals, and supporting operations in a pseudo-assistant manager role.
I have demonstrated success recovering $100,000+ through appeals, overseeing prior authorizations and continued stay reviews, and advancing regulatory and parity compliance while mentoring staff and improving UM workflows.
Experience
Work history, roles, and key accomplishments
Utilization Review Specialist
North Tampa Behavioral Health
Jul 2024 - Present (1 year 8 months)
Conduct behavioral health utilization reviews using MCG and InterQual criteria, managed denials and appeals resulting in $100,000+ recovered revenue, and supported operations in a pseudo-assistant manager capacity to improve workflows and compliance.
Utilization Review Coordinator
Windmoor Healthcare
Dec 2023 - Jul 2024 (7 months)
Performed utilization reviews and prior authorizations for inpatient and outpatient behavioral health, managed denials and appeals to meet payer timelines, and monitored trends for quality and policy improvements.
Forensic Outreach Therapist
Suncoast Center
Nov 2022 - Dec 2023 (1 year 1 month)
Provided community-based behavioral health services to justice-involved individuals, completed assessments and Medicaid-compliant documentation, and coordinated interdisciplinary case staffings and community outreach.
Education
Degrees, certifications, and relevant coursework
Capella University
Master of Science, Forensic Psychology
Master of Science in Clinical Psychology with a specialization in Forensic Psychology.
University of North Florida
Bachelor of Arts, Psychology
Bachelor of Arts in Psychology focused on foundational psychological principles and assessment.
Availability
Location
United StatesAuthorized to work in
Job categories
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