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Online Resumes with "InterQual"
Registered NurseMedical Record reviewer - 20 Years of Experience - Near 12035
I am a Registered Nurse, licensed in New York state. I would like to express my interest in a full time permanent position processing appeals. I am detail-oriented, conscientious, thorough and patient-focused; and my reviews are clear, concise and accurate. I would prefer a remote position. I do have a dedicated home office.
Tags for this Online Resume: appeals , RN, insurance, provider, remote, medical record reviewer
Case Manager - 20 Years of Experience - up to 25 miles from 33176
NELLY GAZMEN CONROY, RN, BSN Cellular: (305) 926-0725 npgconroy@gmail.com ------------------------------------------------------------------------------------------------------------------------ CAREER OBJECTIVE: A position in a progressive growing company which affords opportunities and advancement for motivated, hardworking, qualified ...
Tags for this Online Resume: Miami, Broward, Case Management, Director of Nursing, Teaching, Consulting, Computer, Gen Orientation
Experienced Registered Nurse -EHR/ICD-9, HEDIS documentation expert
My career uniquely combines a solid understanding of medical health care practice and business management and my goal is to continue as a hospital provider advocate within the medical auditing and clinical documentation career path.
Tags for this Online Resume: Registered Nurse, Medical/Surgical, Home Health, Infusion Therapy, Director of Nurses, CCU/ICU/Telemetry, Documentation Review EHR, Quality Assurance, Telecommute, Medicare Recovery Auditor, IternQual, ICD--9 ICDCCU/ICU/Telemetry, Integrated Case Manager, Quality Assurance/HIM; Healthcare Information & Documentation Manager, Medicare Denials appeal and Managed Care Risk/ medical necessity auditor, InterQual/ICD-9/MCG;Millliman/DRGs/Lean/CMS Guidelines MS Office, telephonic/remote, CCU/ICU/Telemetry/evidence based best practice provider and physican advocate, HEDIS abstractor, internal risk auditor, EHR quality assurance, ICD-9, Interqual/Milliman, clinical coordinator
Case Manager - 20 Years of Experience - Near 29204
I am a Registered Nurse of 32 years with 12 years of DRG Integrity reviewing, 8 years of utilization Reviewing, and 5 years of Case Management. I am proficient in the use of Interqual and Milliman quidelines. My objective is to concentrate all efforts on further developing my skills in the area of information management, specifically as a Clinical Documentation Integrity Specialist, and enter the field of CDS consulting in ...
Tags for this Online Resume: Clinical Documentation Integrity Specialist, Utilization Reviewer, Case Manager
Licensed Nurse - 16 Years of Experience - Near 53213
to increase my knowledge and professional growth in my profession
Tags for this Online Resume: Florida,, Interqual, Trustworthy, esin, compact state, microsoft, all scripts, Computer Aided Software Engineering, Management, Training, ALLSCRIPTS, CCU, CERNER, ICU, Case management
Registered Nurse - 17 Years of Experience - Near 33172
Ana B. Francisco RN BSN LNC LHRM 510 NW 109th Avenue, #5, Miami, Florida 33172 (786) 286-7160 W O R K E X P E R I E N C E: 2007-2009: DIRECTOR OF NURSING / ALTERNATE ADMINISTRATOR: Advantis Home Care, Inc., 2921 SW 8th St Miami, Florida 33135 Supervision of clinical and non-clinical staff operation; update of agency Policies and Procedures books, case management, utilization review, initiated the Quality Assurance ...
Ideal Companies: health care
Tags for this Online Resume: RISK MANAGER LICENSED, DIRECTOR OF NURSING, QUALITY ASSURANCE NURSE, UTILIZATION REVIEW
Medical or Health Services Manager - 20 Years of Experience - Near 75230
Areas of Expertise & Technical Skills * Project Management * Risk Assessment * Regulatory Compliance * Audit Planning * Medical Records Review/Determination * Microsoft Tools & Internet Programs * Stakeholder Communication * Certifications & Accreditations * ICD-9-CM/ICD-10-CM * CPT/HCPCS Codes * InterQual * NCQA & Medicare
Tags for this Online Resume: Assessments, Quality, Documentation, Medical, Management, Medicare, Utilization Management, Compliance
Case Management Manager - 20 Years of Experience - Near 60409
I am a Nurse Case Management professional with upwards of 16 experience. My experience includes but is not limited to Telephonic Complex Case Management, Occupational Health/Worker’s compensation, and Psychiatric Nursing. Additionally, my proficiency with Utilization Review software, namely InterQual criteria and guidelines as well as Epic allows me the opportunity to make determinations on admissions, prior authorization, ...
Tags for this Online Resume: Utilization Review, ICD-9, Health Care Industry, Interqual, MCG, Communication Skills, Computer Aided Software Engineering, Patient Care, Coding, ICD-9, Health Care Industry, Management, Benefits, Communication Skills, Computer Aided Software Engineering, Patient Care, Utilization Review Nurse, Allscripts, Powerchart, Epic, EMR, CPT Codes
Case Management Manager
Tags for this Online Resume: New Jersey, Case manager, utilization review, Milliman, Interqual
Case Manager - 20 Years of Experience - Near 77354
Tags for this Online Resume: Tomball, Interqual, Curaspan, Utilization, Hospital, Midas, Review, Cypress, Medicare, Compensation, Patient Care, Triage, Insurance, Nursing, Telemetry, Houston
Registered Nurse
Professional Summary ( Diversified, knowledgeable Registered Nurse who thrives on new challenges and takes pride in a job well done. ( Understanding, compassionate patient advocate who goes the extra mile to provide highest quality care. ( Highly accountable team leader who takes ownership of and assumes full responsibility for the position. ( Dedicated, reliable team player who serves as a resource to coworkers, patients, ...
Tags for this Online Resume: Cancer, Trauma, Behavioral Health, Computer Aided Software Engineering, Insurance, Medical, Medical/Surgical, Oncology, Radiation, SD, claims, telephonic
Case Management Manager - 11 Years of Experience - Near 32162
Professional Summary: I have over 17 years experience in Case Management in the provider setting as Director of Case Management, Lead Case Manager and Key account Manager for Managed Care Companies, Physicians, Hospitals and Home Health Care Agencies. Specializing in admissions and concurrent reviews using Inter-Qual Criteria and MCG on a daily basis to determine decisions of appropriateness of admissions and continued stay...
Tags for this Online Resume: Insurance, Benefits, Home Health, Health Care Industry, Referrals, Compensation, Computer Aided Software Engineering, Assessments, Management, Medication Adherence
