CV, Curriculum Vitae and Online Resumes Search

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Online Resumes with "MEDICAID"

Tester - 15 Years of Experience - Near 80016

PROFESSIONAL SUMMARY * 19+ years of software testing and management experience. Managing and performing different types of testing in AGILE process for web-base (Health care) FACETS applications, HealthCare (MEDICARE & MEDICAID), CBMS/PEAK applications, Mobile App testing, EDI, Financials, and Enterprise Resource Planning (ERP) Suite applications. * Telecommunication & mobile applications, including Oracle Supply Chain Mana...

Tags for this Online Resume: IBM DB2 Database, Oracle, Regression Testing, Test, Test Director, Transportation, Transportation Management, Automation, Billing, Claim Processing, sql, agile, software

Case Manager/ Utilization Coordinator - 20 Years of Experience - Near 08872

COVER LETTER: To Whom It May Concern, I am a 34+ yr experienced RN with diversified hospital experience. My experience includes medical surgery, dialysis (peritoneal), immunology, infectious disease, and IV therapy team experiences including PICC and chemotherapy administration. I have spent 16 years of my career focused on hospital utilization review, case management (Medicaid/Medicare, Managed Care), hospital bill audit, ...

Tags for this Online Resume: Insurance, Medicare, Microsoft SMS, nurse, healthcare, care, rn

Business Analyst - 7 Years of Experience - Near 37209

Professional Summary * Over 8+ years of diverse experience as a Business System Analyst in developing and implementing innovative business processes. * In-depth knowledge and experience in full SDLC with RUP, agile and waterfall methodologies. * Functional experience in health Care Industry with vast knowledge on Medicare and Medicaid. * Expertise in creating the companion guides on various EDI transactions. * Specialize in...

Tags for this Online Resume: Management, Structured Query Language, Business Requirements, Microsoft Visio, Oracle, Use Cases, VISIO, Business Analysis, Business Analyst, Health Insurance Portability And Accountability Act, agile, software, html, c++, sql, medicaid, CMS, HIPPA, Testing

Medical Office Manager - 20 Years of Experience - Near 55369

KEY QUALIFICATIONS AP/AR * Audits * Budgeting * Business Development * Change Management * Client Relations * Consulting CAREER HIGHLIGHTS UnitedHealthcare - Minnetonka, MN 2010 - present Medicare and Retirement - Sales Policy and Oversight Sales Policy Consultant Acted as Interim Department of Insurance consultant researching and addressing inquiries/complaints on agents that come from state insurance departments. Wrote th...

Tags for this Online Resume: Medicare, Management, Policies and Procedures, Assessments, Coding, Documentation, FACETS, Health Insurance Portability And Accountability Act, HIPAA compliance, Insurance

Business Analyst - 5 Years of Experience - Near 20104

PROFESSIONAL SUMMARY: * Over 7+ years extensive Experience as Facets Configuration Consultant in Healthcare Industry with specialization in FACETS implementation and in-depth understanding of Trizetto FACETS data model. * Health Insurance Portability and Accountability Act (HIPAA), Data Warehouse and working on Requirement gathering, Business Process flow, Business Process Modelling, Data Analysis, Data Mapping. * Strong kn...

Tags for this Online Resume: Management, Microsoft Access, Microsoft Office, Microsoft Visio, Test, Unified Modelling Language, VISIO, Microsoft Project, MS Project, Electronic Data Interchange

Registered Nurse - 18 Years of Experience - Near 85022

SUMMARY OF QUALIFICATIONS * Knowledge of Medicare/Medicaid, managed long term care regulations and guidelines, CPT codes, ICD-9/10 codes. * Engages well with patients, medical staff, peers, and internal company staff at all levels takes the time to understand, and ask appropriate questions to determine members appropriate level of care. * Excellent written and verbal communication skills * Identifies strengths and weaknesse...

Tags for this Online Resume: Home Health, Injections, Medical, Medical Records, Assessments, Nursing, Management, Computer Aided Software Engineering, Geriatrics, Long Term Care, registered nurse, nurse

Team Leader / IT Architect - 20+ Years of Experience - Sacramento, CA area

Professional Summary I have over 33 years experience in the IT industry as a Software Engineer, Performance Architect, Infrastructure Architect, Technical Team Lead and Project Manager in both distributed systems and mainframe environments: 21 years of software development and team management experience, 10 years of hands-on experience developing applications in an object oriented environment, 15 years of architect/team lea...

Tags for this Online Resume: Oracle, Management, Infrastructure, Jad, Java Server Pages, Legacy, Team Leadership, Performance Architecture, J2EE, Iterative Design, Sacramento, Java, Integration Architecture, java, sql, linux, agile, software

Licensed Nurse - 17 Years of Experience - Near 02176

Summary of Qualifications Clinical skills to include: * Assess, provide and document nursing care for designated patients in accordance with the physician's plan of care, agency policies and procedures. * Medication administration and management, wound assessment and treatment. * Treatment coordination, mental assessment, nutrition assessment and education. Implement and coordinate services provided in addition to utilizing...

Tags for this Online Resume: Accenture FOUNDATION, Behavioral Health, Computer Aided Software Engineering, Dialysis, Long Term Care, Management, McKesson, Medical, Medicare, nurse

VP Quality and Clinical Performance 15 years

PROFESSIONAL SUMMARY Visionary, Adaptive & Talented Senior Healthcare Executive Record of Transforming Healthcare Organizations: Maximizing reimbursement in Massachusetts 1115 MassHealth Waiver and multiple risk contracts. Proven executive with a discerning knowledge of Integrated Healthcare Delivery systems.Passion for meeting needs of complex patients with goal of improving access and health outcomes. More than 15 years d...

Tags for this Online Resume: Quality & Safety, Coding, Documentation, Management, Patient Care, Quality Assurance, Risk Management, Managed Care, registered nurse, Physician Alignment, Contract Performance

Physician - 20 Years of Experience - Near 85086

Utilize my experience and knowledge of medical practice and insurance industry ( health insurance, managed Medicaid/Medicare, workers compensation, disability). Develop cost containment programs to promote medically efficient health care with quality.

Tags for this Online Resume: medical director, Office only orthopedic practice, alternate payment, Bundled Payment, Risk arrangement contracting, Fraud and Abuse, claims review, Medical Management, Health Insurance, Managed Medicaid and Medicare, Occupational Medicine, Workers compensation, outpatient rehabilitation, disability

Marketing - 20 Years of Experience - Near 55345

Areas of Expertise Campaign Management * Managed complex data driven Medicare direct mail campaign with zero errors - monthly mailings of over 1,000,000 of 35 various data driven formats/packages. * Leading projects from concept through completion * Budget Management - Successfully managed budgets from $2,000 to $17,000,000 with zero cost overruns * Suggested and implemented format changes to the multiple touch points for a...

Tags for this Online Resume: Ariba, Budgeting, Cms, Health Care Industry, Inventory, Legal, Management, Medicare, Microsoft, Microsoft Office, project manager, budget management, vendor management