Rebecca Shearon
Murfreesboro,TN
Summary
Clinical Review Coordinator specializing in utilization management and medical necessity evaluation. Demonstrated success in improving patient care planning and quality assurance through effective case management. Focused on optimizing outcomes and delivering results via comprehensive patient support.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Clinical Review Coordinator
Home and Community Care Transitions
Brentwood, TN
01.2020 - Current
- Evaluate pre-authorization requests for skilled nursing and rehabilitative services to assess alignment with medical necessity for requested care level
Registered Nurse, Case Manager
Healogics
Murfreesboro, TN
12.2013 - 11.2019
- Delivered patient care and managed intake and discharge processes for Wound Care Center patients.
- Functioned as Case Manager for assigned Wound Care Center patients, ensuring comprehensive support.
- Coordinated scheduling of patient appointments to optimize clinic efficiency.
Registered Nurse
Select Specialty Hospital
Nashville, TN
07.2013 - 12.2013
- Managed care for chronically and critically ill patients needing extended hospital support
Education
Associate of Applied Science - Nursing
Motlow State Community College
Tullahoma, TN05.2013
Skills
- Utilization management
- Medical necessity evaluation
- Clinical documentation
- Quality assurance
- Patient care planning
- Case management
- Wound care expertise
Certification
Certified Wound Specialist, American Board of Wound Management - 2019
References
References available upon request.
Timeline
Clinical Review Coordinator
Home and Community Care Transitions
01.2020 - Current
Registered Nurse, Case Manager
Healogics
12.2013 - 11.2019
Registered Nurse
Select Specialty Hospital
07.2013 - 12.2013
Associate of Applied Science - Nursing
Motlow State Community College
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