Open to opportunities

Sheena Ford

@sheenaford

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Licensed professional counselor leveraging utilization review expertise for evidence-based care authorization.

United States

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What I'm looking for

I’m seeking a utilization review role where I independently review cases, apply payer criteria and medical necessity, and help authorize appropriate, evidence-based care—supported by strong DSM-5 diagnostic skill, clinical documentation, and quantitative research experience.

I’m a doctoral-level Licensed Professional Counselor with 15+ years of direct clinical practice and a deep command of evidence-based behavioral health treatment. I apply DSM-5 diagnostic criteria, evaluate functional impairment, and ensure decisions align with medical necessity standards.

In my telehealth private practice, I serve across NJ, PA, and SC—completing 500+ biopsychosocial evaluations. I establish diagnoses, determine appropriate levels of care (outpatient, IOP, PHP, inpatient), and build individualized treatment plans that reflect clinical best practices.

I bring strong clinical documentation and payer-readiness to my work, authoring progress notes, treatment plans, and outcome reports that meet HIPAA, state licensing, and insurance standards. I regularly interface with insurance requirements for prior authorizations, using evidence-based protocols to support treatment justification.

I’m also an IRB-approved researcher with SPSS proficiency, using quantitative analysis and clinical data interpretation to identify patterns and inform decision-making. I’m seeking to apply my clinical expertise directly in a utilization review role—independently reviewing cases and applying payer criteria to support appropriate, authorized, evidence-based care.

Experience

Work history, roles, and key accomplishments

Current

Founder & Lead Counselor

Current

Spring Valley Counseling

Jan 2015 - Present (11 years 4 months)

Founded and led a multi-state telehealth practice, completing 500+ biopsychosocial evaluations and applying DSM-5 criteria to establish diagnoses, levels of care, and individualized treatment plans for anxiety, depression, trauma, and ADHD. Conducted medical-necessity and prior-authorization reviews while maintaining HIPAA- and payer-compliant clinical documentation.

DSM 5 Level Of Care Reviews Medical Necessity Review Utilization Review Prior Authorizations

Doctoral Researcher

Grand Canyon University

Jan 2020 - Jan 2024 (4 years)

Conducted IRB-approved quantitative research (N=75) using Amazon MTurk to examine behavioral and psychological predictors of academic performance. Analyzed survey data in SPSS (regression, correlation, ANOVA) and designed ethical data collection instruments and protocols.

SPSS regression ANOVA Survey Design Amazon MTurk Research

Staff Therapist

Silver Springs Martin Luther School

Jan 2018 - Jan 2019 (1 year)

Provided individual and group therapy for students with co-occurring diagnoses, assessing clinical severity and adjusting treatment plans based on documented progress. Collaborated with interdisciplinary teams on treatment reviews and maintained institution- and regulatory-compliant clinical documentation.

Individual Therapy Group Therapy Treatment Plans And Interdisciplinary Teams Clinical Documentation

Mobile Behavior Specialist

Child Guidance Resource Center

Jan 2013 - Jan 2016 (3 years)

Conducted behavioral assessments to determine appropriate intervention strategies and tracked clinical progress using data-driven documentation. Developed individualized behavior modification plans based on functional assessments while maintaining records aligned with regulatory and billing standards.

Behavior Plans Clinical Documentation Regulatory Billing Documentation

Education

Degrees, certifications, and relevant coursework

Grand Canyon University

Doctor of Philosophy, Psychology – Cognition & Instruction

Grade: GPA: 3.66

Earned a Doctor of Philosophy (Ph.D.) in Psychology—Cognition & Instruction from Grand Canyon University (GPA 3.66). Dissertation focused on mindful self-care, social self-efficacy, interaction anxiety, and academic performance of post-pandemic university students.