Tiffany Gutierrez
Evolent Health
Tampa,FL
1
Certification
17
years of professional experience
Dedicated Clinical Reviewer with a strong focus on quality, specializing in the assessment of medical documentation, compliance monitoring, and quality assurance. Recognized for exceptional attention to detail and the ability to foster seamless collaboration across cross-functional teams. Proven adaptability ensures consistent delivery of high-quality reviews, even under tight deadlines. Committed to enhancing healthcare outcomes through meticulous evaluation and adherence to regulatory standards.
Work History
Clinical Reviewer - Speech Language Pathology
4 Years- Conduct detailed clinical reviews of speech-language therapy clinical documentation to determine medical necessity, level of care, and adherence to Medicare, Medicaid, and commercial insurance guidelines.
- Apply advanced clinical knowledge in swallowing, cognitive, and speech-language pathology to conduct thorough reviews of medical documentation and authorization requests.
- Draft precise, concise clinical rationales for adverse determinations and support the peer to peer and appeals process for complex therapy authorization requests.
- Conduct comprehensive internal audits to evaluate clinical review documentation accuracy, determination appropriateness, and adherence to quality standards.
- Serve as a member of the Total Knowledge Team by demonstrating comprehensive understanding of everyday workflows, serving as a subject matter expert in clinical processes, and demonstrating detailed knowledge of clinical guidelines.
- Identify trends, address workflow gaps, and implement solutions that support both clinicians and organizational performance.
- Balance high-volume productivity standards with rigorous clinical assessment to deliver accurate, detailed case evaluations.
Speech-Language Pathologist
4 Years 8 Months- Served as Senior therapist to establish departmental policies and procedures for pandemic-related risk reduction, attendance improvement, and facility-wide developmental screening
- Contributed as a committee member to the development and implementation of system-wide dosing guidelines.
- Conducted and interpreted pediatric Modified Barium Swallow Studies
- Provided clinic-based assessment and intervention with the pediatric population
- Evaluated and treated disorders including feeding and swallowing disorders, autism spectrum disorders, receptive/expressive language delays, cleft palate and craniofacial anomalies, aural rehabilitation, childhood apraxia of speech, phonological and articulation disorders, traumatic brain injury, cerebral palsy, muscular dystrophy, and chromosomal abnormalities
- Collaborated with medical professionals, families, and related disciplines to develop comprehensive treatment plans and deliver effective services
Speech-Language Pathologist
4 Years 7 Months- Conducted evaluation and treatment of the following disorders/diagnoses: Feeding and Swallowing Disorders, Autism Spectrum Disorders, Receptive/Expressive Language Delay and Disorder, Cleft Palate and Craniofacial Anomalies, Aural Rehabilitation, Aphasia, Developmental Apraxia of Speech, Phonological and Articulation Disorders, Traumatic Brain Injury
- Provided clinic-based assessment and intervention with the pediatric population
- Conducted evaluation and treatment of the following disorders/diagnoses: Feeding and Swallowing Disorders, Autism Spectrum Disorders, Receptive/Expressive Language Delay and Disorder, Cleft Palate and Craniofacial Anomalies, Aural Rehabilitation, Aphasia, Developmental Apraxia of Speech, Phonological and Articulation Disorders, Traumatic Brain Injury
- Conducted bedside swallow assessments and provided diagnostic evaluations and treatment for patients with speech, language, voice, fluency, cognitive, memory, auditory processing, and swallowing disorders in adult inpatient settings
- Collaborated with medical professionals, families, and interdisciplinary teams to develop and implement comprehensive treatment plans
Speech-Language Pathologist
11 Months- Evaluated and treated diverse speech/language and swallowing disorders in patients with stroke, Parkinson's, Alzheimer's disease, traumatic brain injury, and Multiple Sclerosis in skilled nursing facility, enhancing patient recovery and quality of life
- Collaborated with medical professionals, families, and interdisciplinary teams for comprehensive treatment planning and service provision, ensuring holistic care for patients
- Developed individualized therapy plans to enhance communication skills in diverse pediatric populations.
- Conducted assessments to identify speech and language disorders, ensuring accurate diagnosis and intervention strategies.
- Collaborated with multidisciplinary teams to create comprehensive treatment programs for children with special needs.
Speech-Language Pathologist
1 Year 7 Months- Conducted Bedside Swallow Assessment, and provided diagnostic evaluation and treatment services to patients with speech, language, voice, fluency, cognitive, memory, auditory processing, and/or swallowing disorders in an inpatient health care center and nursing home setting
- Collaborated with medical professionals and families to develop treatment plans and coordinate service provision
- Developed individualized treatment plans for children with speech and language disorders.
- Implemented evidence-based interventions to improve communication skills in diverse populations.
- Collaborated with multidisciplinary teams to support holistic development of clients.
Speech-Language Pathologist
1 Year 10 Months- Provided clinic and home-based assessment and intervention with the pediatric and adult population
- Conducted comprehensive assessments to evaluate communication and swallowing abilities and needs of children.
- Implemented evidence-based interventions to enhance speech, language, and cognitive-communication skills.
- Established strong relationships with patients and families, fostering trust and collaboration towards shared treatment goals.
Education
Master of Science - Speech-Language Pathology
Bachelor of Arts - Sociology/Health Science Education
Skills
Clinical Judgment
Analytical thinking
Problem-solving
Attention to detail
Clinical documentation
Task prioritization
Verbal and written communication
Teamwork and collaboration
Certification
- American Speech-Language-Hearing Association - Certificate of Clinical Competence #12136436
- Licensed Speech Language Pathologist - State of Florida #SA 10478
Timeline
Clinical Reviewer - Speech Language Pathology
Evolent Health
08.2022 - CurrentRead More
Speech-Language Pathologist
Shriners Hospitals for Children
08.2017 - 04.2022Read More
Speech-Language Pathologist
BayCare Health System, South Florida Baptist Hospital
01.2013 - 08.2017Read More
Speech-Language Pathologist
Accentia Health and Rehabilitation Center
10.2012 - 09.2013Read More
Speech-Language Pathologist
The Health Center of Plant City
03.2011 - 10.2012Read More
Speech-Language Pathologist
Independent Living, Inc
05.2009 - 03.2011Read More
University of Florida
Bachelor of Arts from Sociology/Health Science Education
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University of South Florida
Master of Science from Speech-Language Pathology
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