Katrina Jeanette
UofL Health
Mount Washington
15
years of professional experience
Detail-oriented Utilization Review Nurse with expertise in MCG guidelines, clinical assessment, and documentation. Proven ability to enhance care coordination and improve resource utilization.
Work History
Utilization Review Nurse
5 Months- Conducted thorough reviews of patient treatment plans for medical necessity and compliance with guidelines. Proficient in MCG criteria.
- Evaluated clinical documentation to support authorization requests and appeals processes.
- Collaborated with interdisciplinary teams to coordinate care and ensure optimal resource utilization.
- Assisted in identifying opportunities for process improvements within utilization review workflows.
- Submit to 3rd party reviewer PC3 when needed.
RN Case Manager
2 Years- Assessed patient needs and developed comprehensive care plans to ensure optimal health outcomes.
- Monitored patient progress and adjusted care plans based on ongoing evaluations and feedback.
- Coordinated interdisciplinary team meetings to enhance communication and streamline patient care processes.
- Educated patients and families on treatment options, medication management, and resources available for support.
- Implemented quality improvement initiatives that enhanced patient satisfaction and reduced readmission rates.
- Collaborated with healthcare providers to facilitate referrals, ensuring continuity of care across services.
- Advocated for patients' rights and preferences, promoting individualized care approaches within clinical settings.
- Provided emotional support to patients coping with chronic illness or end-of-life decisions, fostering resilience during difficult times.
- Collaborated closely with physicians to develop individualized treatment plans, supporting optimal patient outcomes.
- Educated patients and families on available community resources, facilitating access to necessary support services.
Practice Manager II
2 Years- Oversaw daily operations, ensuring efficient workflow and optimal patient care delivery.
- Analyzed practice performance metrics to drive strategic improvements in operational efficiency.
- Implemented scheduling systems to enhance appointment management and reduce patient wait times.
- Developed training programs for staff, improving team performance and service quality.
- Led cross-functional teams in implementing new healthcare technologies and systems integration.
- Fostered a collaborative environment, mentoring junior staff to enhance professional development.
- Established standard operating procedures, ensuring compliance with healthcare regulations and best practices.
- Addressed patient concerns promptly and professionally, demonstrating empathy and excellent problem-solving skills.
- Managed daily practice operations to optimize appointment scheduling, patient records management and billing functions.
- Ordered all office supplies and kept check on inventory levels.
Case Manager
10 Years 9 Months- Assessed client needs and developed tailored intervention strategies.
- Monitored progress of clients, ensuring adherence to treatment protocols.
- Coordinated care plans for diverse populations to enhance patient outcomes.
- Collaborated with healthcare teams to optimize resource allocation and case management processes.
- Educated patients and families on disease management, treatment options, and preventive care practices.
- Evaluated patient progress and adjusted care plans accordingly, ensuring continuity of care across all healthcare settings.
- Provided education and support to patients and families, empowering them to make informed decisions regarding their healthcare needs.
Education
Associate of Science - Nursing
Skills
MCG criteria
Prior authorization
Clinical assessment
Prior authorization process
Documentation
HIPAA compliance
Discharge coordination
Records analysis
Timeline
Utilization Review Nurse
UofL Health
03.2026 - CurrentRead More
RN Case Manager
UofL Health - University Hospital
03.2024 - 03.2026Read More
Practice Manager II
ULP Physicians
03.2022 - 03.2024Read More
Case Manager
Humana
06.2011 - 03.2022Read More
Galen College of Nursing
Associate of Science from Nursing
Read More