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Online Resumes with "Interqual Criteria "
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
Case Manager - 19 Years of Experience - Near 07110
SUMMARY OF QUALIFICATIONS: Nursing professional with diversified clinical and leadership background in case management, utilization review and discharge planning independent consultant as a Health and Wellness Advisor. * Experience with acute / critical care settings, insurance companies, skilled nursing and assisted living facilities. * Proven record in obtaining high quality outcomes, reduction in length of stay and cost-...
Tags for this Online Resume: Management, Referrals, CCU, registered nurse, healthcare
Case Manager - 6 Years of Experience - Near 10031
Accomplishments are: - Ongoing training in Inpatient Utilization Procedures to audit and review medical records - Conduct on-site/off site review of medical records for quality of care and utilization. - Review process including DRG validation and Interqual criteria approval. - Utilized review criteria with the use of InterQual, 3M coding book and grouper, SIMS Plus. - Increased knowledge base on medical comorbidities in ad...
Tags for this Online Resume: Infrastructure, Support, Technical Support, Services, Public Health, Reviews, Quality, Acquired Immune Deficiency Syndrome (AIDS), physical therapist
Case Manager
Summary Director of Nursing in Long-Term Care I have been a Director of Nursing for nursing homes in the state of Texas for over15 years. During that time I have opened up # 1 nursing facility, directed that facility to a 4 Star rated facility, and maintained a good reputation with the Texas Department of Health and Human Services in Arlington, Texas. Medical-Surgical Nursing During my nursing practice I have worked the Acu...
Tags for this Online Resume: Patient Care, Cancer, Computer Aided Software Engineering, Insurance, Psychiatry, Rehabilitation, Nursing, Quality Assurance, Test, Acute Care
Case Manager - 21 Years of Experience - Near 19406
Baccalaureate-prepared Registered Nurse with extensive experience in case management and utilization review. Combining acute care experience, interpersonal communication skills and documentation expertise to optimize the care provided to patients. Skills/Areas of Expertise Case Management * Utilization Review * ICD-10 * InterQual Criteria * CMS Regulations * Electronic Medical Records
Tags for this Online Resume: Management, Computer Aided Software Engineering, Critical Care, Medical, Pulmonary, Surgical, Therapy, Acute Care, Nursing, Medical Records