Open To Work
Deena Foote
Fergus Falls,MN
Work Preference
Summary
Registered Nurse with over 35 years of expertise in healthcare leadership, regulatory compliance, and Medicare clinical review, currently leveraging this background as a business owner in direct sales and network marketing. Strong skills in team development, education-based marketing, and ownership-driven income strategies. Recognized for a calm, integrity-focused leadership style that prioritizes trust, compliance, and sustainable growth. Committed to empowering others to transition from traditional employment to scalable and sustainable income opportunities.
Work History
Founder & Business Owner
NextGen Opportunities
11.2025 - Current
- Founded and scaled an independent business focused on direct sales, network marketing, and ownership-based income strategies within the health and wellness space
- Educate individuals on long-term, asset-based income models, including residual income and scalable business structures
- Build, mentor, and lead a growing team through structured onboarding, training systems, and leadership development
- Develop and implement education-based marketing strategies to attract aligned prospects and build trust-driven relationships
- Guide individuals through opportunity evaluation and decision-making aligned with personal, financial, and lifestyle goals
- Support team development through sales training, duplication systems, and consistent business-building practices
- Manage business operations, vendor relationships, and workflow systems to ensure efficiency, scalability, and compliance
- Maintain ethical marketing standards and ensure alignment with regulatory and professional guidelines
- Leverage a background in healthcare regulatory compliance and clinical analysis to support accurate, ethical decision-making
Senior Clinical Review Nurse – Medicare Part A Appeals
Noridian Healthcare Solutions
07.2020 - 01.2026
- Conducted advanced clinical review of Medicare Part A appeals to determine medical necessity, coverage, and compliance with CMS policies and guidelines.
- Led workload planning and case distribution to balance volumes while meeting quality and timeliness standards.
- Facilitated internal team meetings and represented the department in external meetings with CMS, providers, and key stakeholders.
- Developed and refined workflows, review processes, and documentation templates to improve consistency, efficiency, and regulatory adherence.
- Performed quality assurance reviews and delivered individualized and group training to clinical review staff.
- Supported departmental initiatives and delegated projects aligned with operational excellence and continuous improvement.
Clinical Review Nurse – Medicare Part A & B (Pre-Pay & Appeals)
Noridian Healthcare Solutions
02.2013 - 07.2020
- Performed comprehensive clinical review of Medicare Part A and B claims, including pre-pay reviews and Redetermination appeals.
- Evaluated medical records for medical necessity, coverage, and compliance with CMS regulations, LCDs, NCDs, and internal procedures.
- Applied InterQual and MCG (Milliman Care Guidelines) to support accurate, defensible claim determinations.
- Communicated with providers and internal stakeholders to clarify documentation and resolve review discrepancies.
- Delivered provider education to improve documentation quality, reduce denials, and support ongoing Medicare compliance.
- Maintained accurate, organized, and compliant case documentation in accordance with HIPAA and organizational standards.
Director of Nursing Services – RN
Park Gardens (Assisted Living & Memory Care)
09.2011 - 12.2012
- Directed nursing services in assisted living and memory care settings, ensuring compliance with state regulations and clinical standards.
- Led hiring, training, and performance management of nursing staff.
- Oversaw care planning, quality initiatives, and regulatory readiness.
Private Duty Nurse – RN
New Dimensions Home Health Care
Fergus Falls, MN
09.2009 - 09.2011
- Provided individualized in-home nursing care including assessment, medication administration, and patient/family education.
- Documented care per regulatory and agency standards while promoting patient safety and independence.
Education
Associate of Science - Nursing (RN)
University of South Dakota
Vermillion, SD01-2009
Diploma - Practical Nursing (LPN)
Minnesota State Community and Technical College
01-2004
Associate of Science - Occupational Therapy Assistant (COTA)
North Dakota State College of Science
Wahpeton, ND01-1996
Skills
- Medicare Part A & Part B of A Clinical Review (Pre- & Post-Payment)
- Redeterminations, Reopenings & Appeals Management
- CMS Guidelines, LCD/NCD Application & Regulatory Compliance
- Medical Necessity Determination & Clinical Documentation Review
- Fraud, Waste & Abuse Identification
- Utilization Review & Coverage Determinations
- Quality Assurance, Audit & Calibration Processes
- Documentation & Coding Validation
- Performance Analysis & Continuous Quality Improvement
- Standards of Care Evaluation
- Workflow Optimization & Process Improvement
Medicare & Regulatory Expertise
Clinical Review & Quality Assurance
Operations & Systems Management
- Policy & Procedure Development and Implementation
- Operational Efficiency & Process Standardization
- Systems: MAS, FISS, OnBase, EHRs, MDS Repository, Microsoft Office, Teams, Zoom
- Team Building, Mentorship & Training
- Collaborative Leadership & Stakeholder Engagement
- Provider Education & Clinical Guidance
- Project Coordination & Cross-Functional Collaboration
- Analytical Problem-Solving & Critical Thinking
- Strong Written & Verbal Communication
- Regulatory Oversight & Ethical Decision-Making
- Adaptability & Responsiveness to Change
- Relationship Building & Mission Alignment
Leadership & Team Development
Strategy & Professional Strengths
Certification
Registered Nurse – Minnesota | License #1931013 (Active)
Timeline
Founder & Business Owner
NextGen Opportunities
11.2025 - Current
Senior Clinical Review Nurse – Medicare Part A Appeals
Noridian Healthcare Solutions
07.2020 - 01.2026
Clinical Review Nurse – Medicare Part A & B (Pre-Pay & Appeals)
Noridian Healthcare Solutions
02.2013 - 07.2020
Director of Nursing Services – RN
Park Gardens (Assisted Living & Memory Care)
09.2011 - 12.2012
Private Duty Nurse – RN
New Dimensions Home Health Care
09.2009 - 09.2011
Diploma - Practical Nursing (LPN)
Minnesota State Community and Technical College
Associate of Science - Occupational Therapy Assistant (COTA)
North Dakota State College of Science
Associate of Science - Nursing (RN)
University of South Dakota
Additional Information
- Healthcare experience since 1991 across CNA, COTA, LPN, and RN roles
- Background includes long-term care, skilled nursing, acute care, home health, and Medicare medical review
- Proven ability to work independently with high accuracy, organization, and attention to detail
- Extensive remote work experience with sustained productivity, collaboration, and quality standards
Overview
35
35
years of professional experience