Katie Nelson
Huron
Summary
Dedicated Registered Nurse with over 11 years of experience in ambulatory nursing and long-term care. Expertise includes care management, triage, and utilization review through prior authorizations and preventative care initiatives. Proven ability to enhance patient outcomes through effective education, scheduling, thorough chart reviews, and ensuring payer compliance across Medicare, Medicaid, and commercial plans. Committed to delivering high-quality, patient-centered care while optimizing healthcare processes and resources.
Overview
12
12
years of professional experience
Work History
Sales & Marketing Director / PRN Registered Nurse
Peaceful Pines Senior Living
08.2024 - 05.2025
- Provided nursing support on a PRN basis, ensuring safe and appropriate care delivery.
- Assisted with resident admissions, onboarding, and documentation.
- Partnered with families and providers to align care decisions with patient needs which aided in reaching occupancy goal of 50% capacity in 8 months.
- Represented the organization through outreach, presentations, and community engagement.
Registered Nurse
New Life Clinic
10.2021 - 08.2024
- Supported the launch of general surgeon’s practice by managing referrals, scheduling surgeries, obtaining authorizations, and educating patients.
- Coordinated and completed prior authorization requests with insurance providers for surgical procedures.
- Collected and organized patient medical history in preparation for consultations.
- Evaluated clinical information to triage patient needs, identify urgent cases, and escalate appropriately to provider.
Registered Nurse
Tschetter & Hohm Clinic
11.2013 - 10.2021
- Assisted with in-office surgical procedures and ensured accurate patient documentation.
- Followed up on diagnostic testing and lab results and communicated results to providers for care planning.
- Conducted triage assessments and maintained detailed records of patient encounters.
- Educated patients and families on disease management and preventive care strategies.
- Completed prior authorizations for surgical procedures, medications, and diagnostic imaging.
- Responsible for managing a high volume of phone-based communication (~50 incoming calls per day), including patient triage (averaging 40 appointments per day), care coordination, and follow-ups.
Education
Associate of Science Degree - Nursing
Dakota Wesleyan University
Mitchell, SD05-2013
Skills
- Utilization Review & Management (prospective, concurrent, retrospective)
- Medical Necessity Determinations & Clinical Documentation Reviews
- Knowledge of Payer Guidelines, Insurance Policies, and Coverage Criteria
- Care Coordination & Case Management Across Multiple Settings
- Patient & Provider Communication
- Electronic Medical Records (EMR) & Documentation Accuracy
- Adaptability to Guideline-Based Tools (MCG, InterQual)
- Time Management & Productivity in Remote Environments
- Sales & Marketing Tactics to Support Growth and Patient Retention
Timeline
Sales & Marketing Director / PRN Registered Nurse
Peaceful Pines Senior Living
08.2024 - 05.2025
Registered Nurse
New Life Clinic
10.2021 - 08.2024
Registered Nurse
Tschetter & Hohm Clinic
11.2013 - 10.2021
Associate of Science Degree - Nursing
Dakota Wesleyan University
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