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Online Resumes with "Hedis "
Registered Nurse - 20 Years of Experience - Near 24201
I have over 29 years in management in various aspects of nursing. I have a strong background in education / staff development and believe this is a major aspect in all avenues of nursing. I strive for perfection and excellence in every task that I undertake. I believe that all patients deserve the most excellent care that our organization can provide. I have extensive background in case management and HEDIS Field Review S...
Tags for this Online Resume: case management, work at home, managment, nurse manager, director, telecommute, Intensive Care, Training, Insurance, Medicare, Order Entry
Registered Nurse Manager - 20 Years of Experience - Near 44143
Summary of Qualifications Results-oriented nursing professional, with 22+ years' experience in corporate and medical facility environments. Possess an entrepreneurial spirit, high energy, strategic thinking skills and the ability to motivate others toward achieving company goals in patient care, nurse and physician communication.
Tags for this Online Resume: Epic EMR, quality improvement, Joint Commisson, Manager, Hospice, Ambultory Care, Diversity, Nursing, Patient Care, Data Analysis, dialysis, Diabetes Management, Dementia Care, gerontology, patient safety, Joint commission, Hedis Measurse, Hypertension care
Business Analyst
Professional Summary: * Proven leader with over 25 years of experience directing cross-functional teams in the successful delivery of complex healthcare projects. * Product Manager of leading clinical mobile solution resulting in over $500K in new sales and increased client retention. * Reviewed, interpreted and led teams in implementing complex regulatory requirements for post-acute, acute and ambulatory healthcare segment...
Tags for this Online Resume: Business Analyst, Product Owner, Clinical Decision Support, Agile, User Stories, Quality, Quality Assurance, Support, Healthcare
Quality Coordinator - 5 Years of Experience - Near 77584
As the Senior Clinical Analyst for over 5 plus years, I have trained other business analysts, and quality managers. I know it is time to stop training others for management position and step-up to a management position myself.
Tags for this Online Resume: HEDIS, Project Management, Clinical Data Analysis, focus studies, Clinical Coding, Compliance, Reporting Analysis, ICD-9, Cost Control, Fraud
Quality Assurance Director - 20 Years of Experience - Near 87113
Goal: To find a challenging position utilizing my abilities developed through my experiences and education with the opportunity for professional growth based on my performance. I am a high-performing Manager with 20 years of health care experience in hospital home and medical office environments. HEDIS Reviewer an experienced Social Worker/LVN/LPN licensed in New Mexico (Compact State License) and in California with strong ...
Tags for this Online Resume: Quality/HEDIS, NCQA, Health Care Industry, STARS, Therapy, Computer Aided Software Engineering, Surgical, Advanced Cardiac Life Support, Cardiopulmonary resuscitation (CPR), Support
Medical or Health Services Manager - 11 Years of Experience - Near 53090
Summary The diverse jobs skills I have obtained, has effectively prepared me to become a successful Team Leader. Major strengths include excellent multitasking, computer literacy, and financial/medical administration. A dependable, thorough, well-organized individual with very effective communication skills.
Tags for this Online Resume: Audit, Client Relations, CSS, EDI, Accounting, Financial, Management, Quality Assurance, Reimbursement, Billing, Claims Processing, CMS, Medicaid, Medicare, HEDIS, Training, Hiring, SQL, Contracting, Sales, Customer Service
Executive Vice President - 15 Years of Experience - Near 92708
Energetically outperforming healthcare executive with various roles as VP/ CFO/ COO who helps started two MAPD SNP Health Plans, a MSO, 2 IPA's, a Multi-Specialty Medical Facility successfully from scratch. Ability to roll up sleeve and dive in any challenge incurred in healthcare management and increase shareholder ROI.
Tags for this Online Resume: Management, Accounting, Consulting, Medicare, Infrastructure, Billing, CMS, EDI, Electronic Data Interchange, Insurance, Medicaid, CMS, Program Management, Project Management, Operations, HEDIS, Risk Adjustment, Revenue Cycle, Provider Contracting, Network Expansion, Healthcare Software Development, Claim Operations, Finance
Registered Nurse - 20 Years of Experience - Near 08232
across age spectrum from neonates through geriatric population with respect also to culturally diverse populations Leveraging technology to identify and close gaps in care and quality improvement and use of Milliman Guideline and HEDIS criteria Evaluation and Data collection of HEDIS compliance and AHRQ standards of care Contract procurement for commercial and non- profit organizations Ability to leverage technology and ana...
Tags for this Online Resume: Rehabilitation, Computer Aided Software Engineering, Imaging, Mammogram, Management, PEDIATRIC, Home Health, Medical, Pulmonary, Surgical
Medical or Health Services Manager - 20 Years of Experience - Near 33534
SUMMARY * 15+ years' experience as a clinical professional with a broad range of healthcare experience, talent and expertise also in Medicaid claims reviews programs * Extensive nursing experience in multiple areas (Utilization Review/Managed Care including Inpatient/Outpatient service for Pre-Cert, Concurrent Review, Case Management, Medical Claim/Bill Review, ICD-9/ICD-10 Coding, Hedis Reviews, Home Health Care, School Nu...
Tags for this Online Resume: Medicare, Computer Aided Software Engineering, Management, Injections, Insurance, VITAL SIGNS, Medication Administration, Nursing, Wound Care, D.O.D., Case Manager, Billing, Coding, Auditing, Utilization Review, Manager, Supervisor, Health Services, Nurse, LPN, Trainer
Registered Nurse - 20 Years of Experience - Near 23450
QUALIFICATIONS: My nursing experience includes: Utilization Review, ICD-9 Code Auditing, HEDIS Chart Reviews, Surgical Pre-Op Assessment, Chronic Hemodialysis, ICU/CCU, Radiology Nursing, Cardiac Cath Lab, Telemetry, Acute Care, ER Triage, Cardiac Rehab, and Telephone Advice Nursing. I have Charge Nurse/Supervisory Experience in many of these areas.
Tags for this Online Resume: Reviews, Medicare, Assessments, Audit, CCU, ICU, Medical, Medical Records, Cms, Dialysis, UR/UM
Registered Nurse - 22 Years of Experience - Near 65202
Tags for this Online Resume: Medicare, Nursing, Insurance, Managed Care, Assessments, HEDIS, Health Coach, Disease Management, Preauthorization, Utilization Review, Quality Improvement, Quality Review, Medical Record Review, URAC, Case Management, Drug Adherence
Medical Office Manager - 20 Years of Experience - Near 34476
Areas of Expertise * Quality Improvement * Medical Billing & Coding * Account Receivables * Medicare & Medicaid Billing * MCR/MCD Dual Plans * MCR/MCD HMO Plans * ICD-9 CM & ICD-10 CM * Account Reconciliation * EHR/Practice Management Systems * Customer Service * Innovative Goal Setting * Compliance Plans & Programs * Policy & Procedure Writing * CMS-1500 & UB - 04 * Project Management * Team Leadership * Setting Fees * CDI...
Tags for this Online Resume: Audit, Training, Coding, Customer Service, Policies and Procedures, Necessary Adjustments, Medicare, Reviews, Evaluate, Leadership, Billing Manager, Revenue Integrity Manager, Revenue Cycle Manager, Reimbursement Manager, Medical Billing Manager, Accounts Receivables Manager
