Shirlianne Stirewalt
Starkville,MS
Summary
Dedicated Registered Nurse with expertise in case management, utilization review, behavioral health, and care coordination. Focused on enhancing patient outcomes by navigating healthcare systems, coordinating resources, and facilitating discharge planning. Proficient in medical necessity review and insurance authorizations, fostering strong relationships with patients, families, and interdisciplinary teams to deliver quality care.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Pediatric Acute Behavioral Health (Contract)
Pine Rest Behavioral Health
Daphne, Michigan
03.2026 - Current
- • Provided acute inpatient psychiatric nursing care for pediatric patients.
• Performed assessments, care planning, medication administration, admission/discharge planning, and family education
Surgical Case Manager
Oktibbeha County Hospital
Starkville , MS
01.2024 - 03.2026
- • Hired as Surgical Case Manager; assumed Utilization Review Nurse responsibilities following departmental staffing changes.
• Performed admission and concurrent utilization reviews using InterQual® criteria to determine medical necessity, level of care, and length of stay.
• Collaborated with Emergency Department physicians to ensure appropriate admission status prior to hospitalization.
• Communicated pre-certifications and concurrent review updates to payors using ICD-10 and CPT coding.
• Prepared and submitted written insurance appeals supporting medical necessity.
Telephone Triage & Case Management RN
Optum
Remote
10.2023 - 01.2024
- • Conducted telephonic clinical assessments to determine appropriate level of care.
• Performed care coordination and case management activities to support patient access to services and continuity of care.
• Managed high-acuity and high-stress calls using established clinical guidelines.
• Demonstrated strong clinical judgment in identifying need for urgent intervention or escalation.
• Facilitated referrals and connected members with appropriate healthcare resources based on assessed needs.
Travel Behavioral Health Registered Nurse
New Leaf Senior Behavior Health
Elizabethton, Tennessee
10.2021 - 04.2023
- • Delivered acute inpatient behavioral health nursing care, including crisis intervention and de-escalation.
• Conducted admissions, discharges, and ongoing clinical assessments.
• Administered and monitored medications in compliance with safety standards.
• Collaborated with interdisciplinary teams to implement individualized treatment plans.
Health Science Instructor
Choctaw County School District
Ackerman, MS
08.2008 - 08.2021
- • Taught health sciences curriculum, integrating real-world clinical applications.
• Educated students pursuing healthcare careers through classroom and laboratory instruction.
• Developed assessments and provided academic support to promote student success.
Registered School Nurse
Choctaw County High School
Ackerman, MS
01.2013 - 01.2019
- • Managed student health clinics, triage, and emergency response.
• Developed and implemented individualized care plans and case management for students with chronic conditions.
• Educated students, families, and staff on health conditions, safety, and wellness initiatives.
Education
Master of Science - Nursing
Mississippi University For Women
Columbus, MS01-2005
Skills
- Case Management
Utilization Review
InterQual® Criteria
Medical Necessity Determinations
Care Coordination
Discharge Planning
Transition of Care Management
Insurance Appeals & Authorizations
Concurrent & Retrospective Review
ICD-10 & CPT Coding - Acute psychiatric nursing
- Utilization review
- Care coordination
Certification
- Registered Nurse (RN)
- Basic Life Support (BLS)
- Advanced Cardiovascular Life Support (ACLS)
- Sigma Thete Tau International Honor Society of Nursing
Timeline
Pediatric Acute Behavioral Health (Contract)
Pine Rest Behavioral Health
03.2026 - Current
Surgical Case Manager
Oktibbeha County Hospital
01.2024 - 03.2026
Telephone Triage & Case Management RN
Optum
10.2023 - 01.2024
Travel Behavioral Health Registered Nurse
New Leaf Senior Behavior Health
10.2021 - 04.2023
Registered School Nurse
Choctaw County High School
01.2013 - 01.2019
Health Science Instructor
Choctaw County School District
08.2008 - 08.2021
Master of Science - Nursing
Mississippi University For Women