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Online Resumes with "MANAGED CARE "



Admissions Registration Clerk - 2 Years of Experience - Near 23602

Tags for this Online Resume: Medical Coder, Insurance Industr, Mental Health, Managed Care, Patient Access, Medical Receptionist

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

Medical & Health Services Manager - 18 Years of Experience - Near 34601

My reputation is as a multifaceted, resourceful, and decisive senior level professional with comprehensive experience in development of strategic business solutions to streamline operational effectiveness, cut costs, enhance quality, compliance, productivity, and in-crease profitability. Goal-driven, adaptable and critical-thinking project manager with demonstrated success in implementation of process improvements and chang...

Tags for this Online Resume: government managed care, telecommute, complance, HealthCare Management, provider contracting, vendor oversight, account management

Quality Coordinator - 5 Years of Experience - Near 60431

Tags for this Online Resume: Analysis , healthcare, quality , compliance, managed care, SQL, BIQuery, SPSS

RN Case Manager - 20 Years of Experience - Near 45458

REGISTERED NURSE CERTIFIED CASE MANAGER Patient & Family Advocacy |Utilization Review |Pre-Certification |Liaison, Workersâ?? Comp & Acute Care Multifaceted and resourceful healthcare professional with comprehensive experience in leadership of complex case management, managed care, telephonic nursing and telecommuting. Patient-focused and detail-oriented RN Case Manager with demonstrated success in ability to identify, ...

Tags for this Online Resume: RN Case Manager, detail oriented, , patient focused, collaborative team player, telephonic nursing, Excellent communication and interpersonal , strives for excellance, exceeds expectations

Featured Profile

Innovative and Responsive Program Manager

I want to secure a position as a Program Manager bringing six years of experience in managing strategic and cost-effective projects in alignment with company initiatives and objectives. Demonstrates strong expertise in needs assessment, development, implementation, and routine evaluation processes, as well as budgeting, staffing, and training. Leverages a nine-year business development and marketing background to transform ...

Ideal Companies: Anthem, Telecare, CIGNA, Mattel, Nestle, Nabisco, UnitedHealth, Planned Parenthood, CDK, ADP, Provident, Smart and Final, Vons.

Tags for this Online Resume: Budgeting, negotiating, community outreach, process improvement, Training, Reporting, Supervising, quality assurance, compliance, succession, documentation, conducting surveys, external and internal audits, grievance, administrative, Team Building

Featured Profile

Business Development Manager

Leader in business development with expertise in all facets of pharmaceutical sales and marketing with a proven track record of driving market expansion in multiple territories. Identifies and tracks trends through industry and market research. Locates and explores new business partnerships and opportunities. Closes new business deals and negotiates contracts. Forges strong relationships, ensuring customer loyalty. Highly c...

Ideal Companies: Novartis, Eli Lilly, 3M, Concordia, Ashfield, ZS Pharma

Tags for this Online Resume: Sales Representative, Pharmaceutical Sales, Medical Sales, Specialty Sales, Territory Business Manager, Specialty Pharmaceutical Sales

Mental Health Therapist - 20 Years of Experience - Near 01020

A professional with behavioral healthcare experience directing care benefits through insurance, managed care, employee assistance and psychiatric disability short term and long term plans to compliance within contractual parameters.

Tags for this Online Resume: Behavioral Health, Managed Care, Disabilities, Alcohol & Substance Abuse, Employee Assistance, Insurance Claims

Registered Nurse - 20 Years of Experience - Near 48047

Kim has extensive managed care operational background in HEDIS, MA Stars, NCQA and related quality improvement efforts. Kim is recognized as a problem solver with strengths in strategic and tactical planning as well as the completion of projects within an established timeframes. Kim has proven leadership skills in motivating and integrating a diverse team from multiple business areas that consistently meet goals and objecti...

Tags for this Online Resume: NCQA, Quality Management, Disease Management, Program development, HEDIS, Managed Care, Clinical Integration, Performance Measurement/Management/Improvment, Patient Care, ROI, Services, Management, Data Analysis, Process Improvement, Computer Aided Software Engineering

Featured Profile

Pharmaceutical/Health Care Sales Representative - 15 Years of Experience - Near 33327

A respected sales executive with extensive experience in sales leadership working with key thought leaders or high influence Distributors, customers in large group practices, hospitals and manage care organizations. Consistently achieving top performance in sales by increasing revenue and market share by driving revenue growth while providing visionary sales leadership in highly competitive markets. Expert in consultive sal...

Ideal Companies: Pharmaceuticals and Medical device companies

Tags for this Online Resume: Fort Lauderdale, Miami, MBA, Responsable, Comunicator, WOO, Proactive, Team Playe

Case Management Manager - 20 Years of Experience - Near 11520

Tags for this Online Resume: Educator, Trainer, Care management , Case management , Managed care, Virtual work environment , End of life care, Disease management

Case Manager - 7 Years of Experience - Near 07676

Tags for this Online Resume: casemanager, social services , healthcare, managed care, coordinator, social work, crisis intervention