Open To Work
Katherine Knighten
Marshall,TX
Work Preference
Summary
Skilled healthcare professional with expertise in patient assessment, documentation accuracy, and regulatory compliance. Background in prior authorization processes and clinical operations supports enhanced patient care. Experienced in chart updates, medication monitoring, and collaboration with multidisciplinary teams. Certified Case Manager since Nov. 2023.
Overview
1
1
Certification
36
36
years of professional experience
Work History
RN Case Manager
Christus Good Shepherd Medical Center
Longview, Texas
03.2015 - Current
- Coordinated patient care plans across multidisciplinary teams.
- Assessed patients' physical, mental, and psychosocial health to create tailored care plans that address individual needs.
- Educated patients on treatment options and self-management strategies.
- Actively participated in multidisciplinary rounds discussing complex cases with members of the healthcare team.
- Conducted weekly interdisciplinary team meetings to review case management activities for assigned caseloads.
- Ensured compliance with regulatory standards concerning utilization review, ethical decision making and legal aspects of case management practice.
Prior Authorization Nurse
Good Shepherd Hospital
Longview, Texas
03.2015 - Current
- Reviewed patient medical records to assess medical necessity and compliance with payer criteria.
- Evaluated referrals from primary care physicians to determine service eligibility based on regulatory guidelines.
- Analyzed clinical data to inform decisions on prior authorization requests, streamlining review processes.
- Submitted authorization requests to insurance companies efficiently, minimizing delays.
- Collaborated with healthcare providers to gather essential information for accurate assessments.
- Communicated decisions regarding authorizations to patients and providers promptly.
- Clarified insurance coverage guidelines for patients and families, enhancing understanding of benefits.
- Maintained precise documentation of prior authorization activities, ensuring adherence to policies and facilitating audits.
Branch Manager
Accent Care
Longview, Texas
09.2007 - Current
- Developed strategies to increase customer satisfaction and loyalty.
- Implemented training programs to enhance employee skills and performance.
- Led team meetings to discuss challenges, goals, and updates on operations.
- Assigned duties to employees and examined work for accuracy, neatness and timeliness.
- Complied with company policies and government regulations to prevent and detect rule violations and protect the organization from fines and lawsuits.
Education
Bachelor of Science - Nursing
Pima Medical Institute
Tuscon12-2025
Associate of Applied Science - Nursing
Kilgore College
Kilgore, TX05-1990
Skills
- Case management
- Care coordination
- Patient assessment
- Utilization review
- Regulatory compliance
- Documentation accuracy
- Communication skills
Certification
- Certified Case Manager, since Nov. 2023.
Timeline
RN Case Manager
Christus Good Shepherd Medical Center
03.2015 - Current
Prior Authorization Nurse
Good Shepherd Hospital
03.2015 - Current
Branch Manager
Accent Care
09.2007 - Current
Bachelor of Science - Nursing
Pima Medical Institute
Associate of Applied Science - Nursing
Kilgore College