Benita Watson
Columbus,OH
Summary
Passionate and dedicated Registered Nurse with 20+ years of experience providing quality care to patients in a variety of healthcare settings, including utilization review, care management, rehabilitation admissions, telehealth program development, and executive clinic operations. Known for providing superb customer service in a busy environment to foster conversions and improve the customer journey. Demonstrated success leading interdisciplinary teams, ensuring regulatory compliance, managing budgets, and delivering evidence-based clinical oversight in both in-person and fully remote environments.
Overview
20
20
years of professional experience
Work History
Utilization Review Nurse (Remote)
Quantum Health
01.2021 - 12.2025
- Requested clinical, researched, extrapolated pertinent clinical, applied appropriate Summary Plan Description Guidelines, and navigated through multiple computer system applications.
- Reviewed documentation and interpreted data obtained from clinical records to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for provider issues.
- Collaborated with the Appeals department to resolve clinical appeals.
- Led inpatient utilization review activities using evidence-based criteria.
- Conducted initial, concurrent, and retrospective reviews, followed by approval or escalation to the Medical Director for approval based on medical necessity.
- Coordinated complex discharge planning across post-acute services, including discharge planning to Hospice per Medicare guidelines.
- Served as clinical advisor to Medical Directors and interdisciplinary teams.
- Ensured compliance with regulatory and organizational standards.
Clinical Nurse Liaison
Cleveland Clinic Rehabilitation Hospital (Select Medical)
10.2019 - 11.2020
- Directed pre-admission clinical assessments and level-of-care determinations.
- Built physician and hospital relationships to support strategic growth.
- Educated patients and families on rehabilitation services, fostering understanding and compliance.
- Facilitated effective communication between patients, families, and multidisciplinary teams, increasing patient satisfaction scores.
- Conducted comprehensive assessments and developed strategic interventions to reduce post-discharge complications for high-risk patients.
- Collaborated with interdisciplinary teams to coordinate patient care plans and enhance recovery processes.
RN Care Coordinator
LakeHealth
06.2019 - 10.2019
- Worked in collaboration with physicians and mid-level providers to determine the appropriate level of care assignment of patients while monitoring the appropriateness of hospital admissions and patients placed in observation status.
- Entered clinical reviews into the UM workflow management system to ensure necessary concurrent clinical information was transmitted to third-party payors utilizing InterQual and MCG guidelines.
- Reviewed medical records for accurate application of medical necessity criteria to determine the appropriateness of admission using industry-accepted level of care criteria through clinical expertise.
- Collaborated with other members of the healthcare team to ensure continuity of care.
- Developed effective transitional care plans to ensure patients received timely, quality care, as well as safe, appropriate discharge from the acute care setting to the next level of care.
Clinical Coordinator
Menorah Park, Home Care
03.2018 - 05.2019
- Implemented and monitored quality assurance processes to ensure clinical accuracy.
- Developed and updated clinical policies and procedures to ensure patient safety.
- Monitored clinical staff performance to ensure compliance with safety regulations.
- Managed daily operations of the clinical department, overseeing a team of [number] staff and maintaining compliance with state regulations to ensure high-quality care delivery.
Clinical Nurse Liaison
Cleveland Clinic Rehabilitation Hospital (Select Medical)
07.2015 - 03.2018
- Worked collaboratively with admission personnel, administrators, and physicians in the admission process.
- Collaborated with the Vice President and Director of Business Development to identify opportunities for expansion of strategic business initiatives.
- Supported Sales and Marketing through educational programs, tours, and meetings in assigned hospitals.
- Documented pre-admission assessments on patient referrals that justified admission into a rehabilitation hospital and appropriately recommended candidates for admission. Responsible for determining the financial status as well as the discharge disposition of patients.
- Educated hospitals and communities on acute rehabilitation while establishing and maintaining relationships with hospital personnel, physicians, and other potential referral sources to develop and manage key accounts within a specific geographical territory.
- Served as an advocate for patients and their families while helping them facilitate the admission process to the rehabilitation hospital.
Telehealth Program Manager
FirstHealth Home Care
12.2012 - 07.2015
- Maintained the daily operations and multisite program development of telehealth services to a diverse population of home care patients and the patients of network partners, while ensuring healthcare practices met the professional quality assurance standards of FirstHealth and applicable regulatory bodies.
- Developed and implemented telehealth policies and procedures across affiliate agencies in accordance with current trends.
- Collaborated with IT specialists to enhance telehealth platform usability, achieving a [number]% satisfaction rate among healthcare providers and patients.
- Analyzed patient data to identify trends, improve service delivery, and increase overall health outcomes for program participants.
- Spearheaded training programs for staff, enhancing telehealth service proficiency and leading to a decrease in technical issues reported by users.
Registered Nurse (RN)
FirstHealth of the Carolinas Inc.
01.2012 - 12.2012
- Utilized critical thinking skills to quickly assess and address patients' needs, resulting in a [percentage]% reduction in wait times.
- Utilized critical thinking skills to quickly assess and address patients' needs, resulting in a reduction in wait times.
Executive Director
Montgomery County Free Clinic
04.2011 - 01.2012
- Responsible for the successful implementation, management, marketing, and overall success of the free clinic, including operations, personnel, budget, quality management, and marketing.
- Collected and analyzed data for the development of monthly operations reports to the Board of Directors.
- Responsible for maintaining compliance with all applicable regulatory and governmental agencies.
- Recruited, interviewed, screened and hired new employees in collaboration with the Board of Directors.
Chronic Care Coordinator
Community Care of the Sandhills
11.2009 - 04.2011
- Managed a team of nine CHF case managers and off-site community-based case managers located throughout several counties.
- Provided leadership and direction in the areas of care management, quality improvement, and program development and implementation.
- Responsible for the coordination of transitional care to a culturally diverse patient population with chronic diseases.
- Served as liaison to case managers and the North Carolina Division of Medical Assistance Medicare Program.
Program Director
National Healing Corporation (FirstHealth Richmond Memorial Hospital)
01.2007 - 07.2009
- Responsible for the successful implementation, management, and overall success of the FirstHealth Richmond Memorial Hospital Wound Care & Hyperbaric Center in Rockingham, NC, including operations, personnel, budget, quality management, marketing, and sales.
- Worked in collaboration with the Medical Director, FirstHealth Marketing/PR Department and National Healing Corporate Marketing to coordinate services in providing quality care to patients with chronic healing wounds.
- Responsible for maintaining compliance with all applicable regulatory and governmental agencies.
- Provided hands-on wound care and hyperbaric oxygen therapy to patients in an ambulatory clinic.
Registered Nurse (RN)
FirstHealth of the Carolinas Inc.
02.2006 - 01.2007
- Served as charge nurse, primary nurse, and preceptor to new department hires in the surgical department.
Education
Master of Business Administration - Healthcare Administration & Policy
University of Miami
Coral Gables, FL01.2006
Associate of Science - Nursing
Miami Dade Community College
Miami, FL01.2003
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Cleveland Marshall College of Law
Cleveland, OH01.1991
Bachelor of Arts - Psychology
Case Western Reserve University
Cleveland, OH01.1991
Skills
- Clinical utilization review
- Knowledge of InterQual and MCG standards
- Proficient in Microsoft Word
- Data analysis
- Skilled in remote collaboration
- Independent and collaborative work
- High-quality client service
- Care coordination expertise
- Exceptional communication skills
- Time efficient, highly organized, and able to multitask
- Proficiency with computer skills including navigating multiple systems
Timeline
Utilization Review Nurse (Remote)
Quantum Health
01.2021 - 12.2025
Clinical Nurse Liaison
Cleveland Clinic Rehabilitation Hospital (Select Medical)
10.2019 - 11.2020
RN Care Coordinator
LakeHealth
06.2019 - 10.2019
Clinical Coordinator
Menorah Park, Home Care
03.2018 - 05.2019
Clinical Nurse Liaison
Cleveland Clinic Rehabilitation Hospital (Select Medical)
07.2015 - 03.2018
Telehealth Program Manager
FirstHealth Home Care
12.2012 - 07.2015
Registered Nurse (RN)
FirstHealth of the Carolinas Inc.
01.2012 - 12.2012
Executive Director
Montgomery County Free Clinic
04.2011 - 01.2012
Chronic Care Coordinator
Community Care of the Sandhills
11.2009 - 04.2011
Program Director
National Healing Corporation (FirstHealth Richmond Memorial Hospital)
01.2007 - 07.2009
Registered Nurse (RN)
FirstHealth of the Carolinas Inc.
02.2006 - 01.2007
Associate of Science - Nursing
Miami Dade Community College
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Cleveland Marshall College of Law
Bachelor of Arts - Psychology
Case Western Reserve University
Master of Business Administration - Healthcare Administration & Policy
University of Miami