Overview
Work History
Education
Skills
Certification
Timeline
Generic

Hilary Nelson

155 Sells Lane Trenton,GA

Overview

10
10
years of professional experience
1
1
Certification

Work History

RN Case Manager

CVS Health/Aetna
Remote
10.2024 - Current
  • RN case manager in the National Medical Excellence unit responsible for UM and CM functions for members undergoing bone marrow transplants and cellular therapy.

RN Clinical Review Manger

BlueCross BlueShield TN
Remote
08.2022 - 09.2024
  • Review medical and pharmacy claims along with clinical received by utilization management
  • Compile and condense information on an Excel spreadsheet to present via Microsoft Teams meeting
  • Collaborate with case management, medical director, pharmacist, account, and leadership team

RN Telephonic/Digital Case Manager

BlueCross BlueShield TN
Remote
11.2019 - 08.2022
  • Telephonic and digital outreach to members for care coordination and chronic condition management
  • Team preceptor

RN/Case Manager

CHI Memorial Hospital
Chattanooga, TN
06.2018 - 11.2019
  • Discharge planning from cardiac floor
  • Collaborated with nursing staff, medical director, providers, utilization management, and social worker

RN/Patient Intake Center

CHI Memorial Hospital
Chattanooga, TN
03.2017 - 11.2019
  • Coordinated bed placement for ER admits, level of care transitions, and outside facility transfers
  • STEMI and Stroke alert coordination

RN/Emergency Room

Erlanger East Chattanooga, TN
12.2016 - 03.2017

RN/Medical Intensive Care Unit

Parkridge Medical Center Chattanooga, TN
05.2016 - 01.2017

RN/Emergency Room

Highlands Medical Center Scottsboro, AL
04.2015 - 11.2016

Education

Associates Applied Science: Nursing -

Northeast Alabama Community College
Rainsville, AL
05.2014

Advanced Diploma/Valedictorian -

Pisgah High School
Pisgah, AL
05.2010

Skills

  • Experience with Microsoft, Excel, and PowerPoint
  • Strong customer service and telephonic skills
  • Computer skills
  • Multitasking
  • Clinical judgment
  • Discharge planning
  • Research
  • Team collaboration
  • Patient education
  • Precepting
  • Licensed RN
  • Case management
  • High level of autonomy
  • Remote work
  • Chronic disease management
  • Emergency care
  • Critical care
  • Managing deadlines
  • Palliative care awareness
  • Coordinating referrals

Certification

  • CCM May 2021
  • Georgia eNLC RN
  • Additional active RN license in the following states: Alaska, California, Connecticut, District of Columbia, Hawaii, Illinois, Michigan, Minnesota, Nevada, New York, & Oregon

Timeline

RN Case Manager

CVS Health/Aetna
10.2024 - Current

RN Clinical Review Manger

BlueCross BlueShield TN
08.2022 - 09.2024

RN Telephonic/Digital Case Manager

BlueCross BlueShield TN
11.2019 - 08.2022

RN/Case Manager

CHI Memorial Hospital
06.2018 - 11.2019

RN/Patient Intake Center

CHI Memorial Hospital
03.2017 - 11.2019

RN/Emergency Room

Erlanger East Chattanooga, TN
12.2016 - 03.2017

RN/Medical Intensive Care Unit

Parkridge Medical Center Chattanooga, TN
05.2016 - 01.2017

RN/Emergency Room

Highlands Medical Center Scottsboro, AL
04.2015 - 11.2016

Associates Applied Science: Nursing -

Northeast Alabama Community College

Advanced Diploma/Valedictorian -

Pisgah High School
Hilary Nelson