Open to opportunities

Elizabeth Nickerson

@elizabethnickerson

Licensed Occupational Therapist with 17 years driving evidence-based medical necessity reviews and utilization management.

United States

Message

What I'm looking for

I’m seeking a remote clinical quality role focused on Occupational Therapy medical necessity review and utilization management—where I can apply evidence-based OT guidelines, audit clinical documentation, and deliver clear rationales that improve patient safety and appropriate care.

I’m a Licensed Occupational Therapist (MOT, OTR/L) with 17 years of clinical experience evaluating medical necessity, functional capacity, and evidence-based treatment appropriateness for both adult and pediatric populations.

Across home health, skilled nursing, acute care, inpatient rehabilitation, and school-based settings, I critically analyze clinical documentation and progress notes to confirm alignment with Medicare and payer requirements—then clearly communicate my clinical rationale to interdisciplinary stakeholders.

I strengthen care quality by supervising COTAs, educating practitioners on documentation standards and compliance requirements, and partnering with teams to support quality improvement and patient safety initiatives.

I’m currently seeking a remote clinical quality role focused on Occupational Therapy medical necessity review and utilization management, where I can use my documentation, guideline, and utilization-review expertise to reduce care gaps and support appropriate service decisions.

Experience

Work history, roles, and key accomplishments

Current

Occupational Therapist - Geriatrics

Current

CareBridge Home Health Care

Nov 2011 - Present (14 years 5 months)

Performed occupational therapy medical necessity evaluations for geriatric patients across home health, skilled nursing, and inpatient rehabilitation settings. Reviewed documentation for Medicare and payer alignment, communicated clinical rationale to interdisciplinary stakeholders, supervised COTAs, and supported quality improvement and patient safety initiatives.

HIPAA compliance Interdisciplinary Clinical Rationale Communication Supervision (COTA Quality Improvement EHR Documentation (Optima Kinnser NesMed AI)

Occupational Therapist - Pediatrics

Dearborn Speech and Sensory

Jan 2009 - Jan 2015 (6 years)

Assessed pediatric students with complex physical, cognitive, and behavioral impairments to support medical and educational necessity. Developed measurable OT goals and service plans aligned with IDEA requirements, contributed to IEP and multidisciplinary meetings, and educated school staff and families on therapeutic strategies.

Occupational Therapy IDEA 2004 Compliance IEP Development Clinical Documentation For Educational Necessity Family & Staff Education

Occupational Therapist - SNF/Acut

Therapy Staff, L.L.C.

Dec 2009 - Oct 2011 (1 year 10 months)

Conducted standardized OT assessments and functional evaluations to determine medical necessity in skilled nursing, acute care, and inpatient rehabilitation settings. Coordinated with interdisciplinary teams to support appropriate continued services and discharge planning aligned with payer criteria and clinical guidelines.

Medical Necessity Criteria Discharge Planning And Interdisciplinary Teams

Occupational Therapist - Neuro Rehab

Rainbow Rehabilitation

Feb 2009 - Sep 2009 (7 months)

Evaluated functional outcomes for individuals with traumatic brain injury across the lifespan to inform OT care planning and medical necessity. Coordinated with case management, neuropsychology, and therapy teams to support community re-entry, functional independence, and appropriate care transitions.

Occupational Therapy Traumatic Brain Injury Medical Necessity Review Community Re Entry Support Care Coordination