Utilization Review Registered Nurse

Eleri Nelson, RN

305-***-**** ***********@*****.***

Summary: Dedicated and detail-oriented Compact Stage Florida Registered Nurse with a demonstrated clinical background, attention to detail and recently obtained Utilization Review training and experience with Remote Learning Services. I pride myself on having a solid knowledge base, high- level critical thinking skills, and ability to apply evidence-based guidelines during the determination process. My clinical background in Acute Rehabilitation, LTC and Geriatrics nursing has given me the foundation that is needed in Risk Management and Care Management by using my knowledge through experiences in post-acute and chronic care environments.

Skills:

● Utilization Review

● Acute Rehabilitation

● Skilled LTC/Geriatrics

● MDS Coordinator

● Admissions Reviews

● Appeals/Denials

● Managed Care

● Medicare/Medicaid

● Knowledge of ICD-10

Employment:

● Concurrent Reviews

● Retrospective Reviews

● Care Plan Development

● Discharge Planning/DME

● Team Collaboration

● Time Management

● Nursing Leadership

● Critical Thinking

● Microsoft Office/Excel

RN/Staff, Acute-Rehabilitation/ Geriatrics/LTC, 10/2020 - 9/2024 Glades West Rehab and Nursing Center, Miramar Florida

● Displayed effective communication skills by building therapeutic relationships with patients.

● Maintains excellent customer service standards while providing compassionate care.

● Responsible for admissions and discharge planning duties with DME ordering as needed.

● Evaluate workflow, establish priorities for time sensitive assignments to ensure quality of work.

● Managed and treated health problems, ranging from common to serious, chronic, and complex for adults and the elderly by continuously fostering improvement. RN/Staff, Interim MDS Coordinator, 10/2019 - 10/2020 Unity Nursing and Rehabilitation, Miami Florida

● Nursing care of post-acute and chronically ill patients on Rehabilitation/Geriatrics units.

● Assured quality of care by building good rapport with residents' family, and facility team.

● Maintained all company systems and data, (including sensitive patient data), secure and safe, according to company’s security policies and HIPAA guidelines LPN/Staff, Wound Care Nurse, 1/2011 - 2/2014

Coral Reef Nursing and Rehabilitation, Perrine Florida

● Daily assessment of new admissions and wound care as per facility policy.

● Coordinated with teams to ensure consistent patient care and improve health outcomes.

● Identified high risk patients for targeted disease management to prevent complications.

● Responsible for admissions and discharge planning duties. LPN/Staff, Restorative Rehabilitation Program, 9/2008 - 12/2010 Azalea Trace Nursing and Rehabilitation, Columbus GA

● Administration and management of restorative nursing programs for the facility.

● Worked collaboratively with an interdisciplinary team to provide patient-centered care. Staff/LPN, MDS Coordinator, 7/1997 - 7/2008

Coral Reef Nursing and Rehabilitation, Perrine, Florida

● Daily nursing care of 20-30 post acute and rehabilitation patients.

● Management of MDS assessments per CMS guidelines.

● Instructed patients and family on disease management, treatment options, and care plans. Professional Education:

Utilization Review-101, Certificate of Completion - 5/2025

● Remote Learning Services, LLC, taught by Marie Peppers LPN and Judy Clarke, RN Southeastern College - Associates Degree Nursing, Miami Lakes, Florida Hillcrest High School Licensed Practical Nursing, Jamaica, New York License: Registered Nurse, Florida - Compact - License # RN9518207

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