Bethany Sayre-Penix
Jackson,OH
Summary
Experienced healthcare professional with expertise in patient care, utilization management, and supervision and mentorship of team members and students. Skilled in fostering positive patient experiences, supporting care transitions, and collaborating with multidisciplinary teams. Adept at providing culturally competent care, navigating community resources, and building lasting relationships with patients. Recognized for excellent communication skills, documentation accuracy, and independent problem-solving. Experienced in direct patient care with all age groups in various settings.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Clinical Reviewer
NaviHealth
04.2022 - Current
- Evaluate medical necessity for skilled services (OT, PT, Speech, MSW) in home health patient charts, ensuring compliance with CMS guidelines
- Approve authorizations for home health services and create accessible content explaining clinical reasoning and determinations for coordinators and providers
- Collaborate with the nursing/therapy team and medical directors to determine appropriate care plans and assess the quality of services provided
- Consistently achieve high KPIs, maintaining productivity 10% above the team average and documentation quality audit scores at 99.0% (highest on the team for 2024)
- Served as Subject Matter Expert (SME) for Alabama state-specific nuances in the Gulf Coast region, focusing on agencies and provider relations
- Completed the Emerging Leader Program, enhancing leadership skills and process improvement knowledge
- Provided training support and mentoring for new hires entering the role, sharing best practices and technical tools gleaned from extensive clinical review experience.
- Served as a reliable resource for team members seeking guidance or clarification on complex cases, fostering a supportive and collaborative work environment.
Occupational Therapist (School-Based)
PresenceLearning
10.2021 - 04.2022
- Delivered teletherapy services to preschool and elementary school students using a proprietary platform
- Developed patient education materials for caregivers and school staff
- Coordinated with parents and educators to implement functional strategies for improving student performance
- Represented occupational therapy in Individualized Education Program meetings, contributing expertise to develop tailored strategies and support plans for student success.
Occupational Therapist (Home Health)
EncompassCare
02.2021 - 04.2022
- Provided evaluation and treatment services to geriatric patients in home health settings, emphasizing fall prevention, equipment recommendations, and home modifications
- Collaborated with the therapy team and caregivers to ensure effective patient education and safe transitions of care
- Supervised occupational therapy assistants and ensured documentation compliance with evidence-based practices
- Provided education to empower patients and families to understand conditions, treatments and treatment options for managing symptoms.
- Promoted independence in activities of daily living through task analysis, environmental adaptations, and compensatory techniques.
Occupational Therapist (SNF)
Edgewood Manor
01.2020 - 04.2022
- Delivered evaluation and treatment services to geriatric patients in skilled nursing facilities, enhancing safety and functional independence in activities of daily living
- Worked with the rehabilitation department to optimize patient outcomes through evidence-based interventions
- Provided oversite and mentorship to occupational therapy assistances, ensuring adherence to treatment plans, regulatory standards, and evidence-based practicies
- Provided education to patients and families on coping strategies, adaptive equipment, and safety modifications
Occupational Therapist
Holzer Medical Center
01.2015 - 04.2022
- Acted as a primary resource in acute/rehab setting for multidisciplinary teams, including physicians and case managers, to ensure effective discharge planning and patient education
- Provided culturally competent education to patients and families, simplifying complex medical information to enhance understanding
- Conducted preoperative education sessions for patients scheduled for joint replacement surgery, providing critical information to enhance preparedness and postoperative outcomes
- Partnered with community resources to address social determinants of health and support member adherence to care plans
- Collaborated with providers to proactively identify and address barriers to care, reducing readmissions and promoting positive health outcomes
- Delivered pediatric occupational therapy services in outpatient settings, addressing developmental, orthopedic, emotional, behavioral, and sensory integration needs
- Served as a clinical instructor to graduate students, providing mentorship, guidance, and hands-on training to develop their clinical competencies and professional skills
- Provided education to empower patients and families to understand conditions, treatments and treatment options for managing symptoms
- Meticulously reviewed records and referrals to determine and implement best treatment methods
- Enhanced team performance by implementing peer review system, fostering culture of continuous improvement
- Led team of occupational therapy assistants, overseeing their work with focus on implementing best practices to achieve therapy goals and facilitating professional development through mentoring
- Streamlined documentation processes, ensuring accurate and timely records while maintaining patient confidentiality.
Education
Master of Occupational Therapy -
Shawnee State University
Portsmouth, OH01.2014
Bachelor of Science - Education
University of Rio Grande
Rio Grande, OH01.2005
Skills
- Health Literacy & Patient Education
- Community Health Expertise
- Care Coordination
- Technology Proficiency
- Clinical Expertise
- Medical Writing
- Regulatory Compliance
- Critical Thinking & Problem Solving
- Chart Audits & Reviews
- Project Management
Personal Information
Title: OTR/L Clinical Review Coordinator | Occupational Therapist
Certification
- National Board for Certification in Occupational Therapy (NBCOT) - Certification #338252.
- Licensed Occupational Therapist - Ohio Board of Occupational Therapy - License OT008905
Timeline
Clinical Reviewer
NaviHealth
04.2022 - Current
Occupational Therapist (School-Based)
PresenceLearning
10.2021 - 04.2022
Occupational Therapist (Home Health)
EncompassCare
02.2021 - 04.2022
Occupational Therapist (SNF)
Edgewood Manor
01.2020 - 04.2022
Occupational Therapist
Holzer Medical Center
01.2015 - 04.2022
Bachelor of Science - Education
University of Rio Grande
- National Board for Certification in Occupational Therapy (NBCOT) - Certification #338252.
- Licensed Occupational Therapist - Ohio Board of Occupational Therapy - License OT008905
Master of Occupational Therapy -
Shawnee State University
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