SUMMARY More than 20 combined years of primary nursing care, team leadership and case management experience within government and commercial managed care plans. Outstanding utilization review, analytical, research, case investigation and quality assessment skills. Talented educator, supervisor and manager. Strong knowledge of URAC guidelines, NCQA standards and government programs. * Case Management - Liaison between patients, families, attending physicians and care providers. * Nursing - Hands-on clinical nursing, supervisory and managed care experience. * Quality Assurance - Optimizing quality, implementation and delivery of patient care. Registered Nurse License (RN) - Illinois Department of Professional Regulation Nursing Case Manager Certification (CCM) - Case Management Society of America CPR/AED Healthcare Provider & PALS Certifications - American Heart Association

Highlights:

• Computer Aided Software Engineering
• Management
• Managed Care
• Home Health
• Leadership
• Statistics
• Utilization Management
• Insurance