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Online Resumes with "MEDICAID"
Developer - 20 Years of Experience - Near 12065
QUALIFICATIONS SUMMARY Accomplished Medicaid Management Information System (MMIS) Project and Systems Manager with 20+ years Technical, Analytical, and Management Skills. * Proficient at delivering highly critical projects on time, under budget, and in scope as is evidenced by the Louisiana HIPAA project * Overall management for implementing all HIPAA-mandated initiatives for the Louisiana MMIS. Under his management, Louisi...
Tags for this Online Resume: CICS, Management, Management Information Systems, Cobol Programming Language, Cobol II, IBM DB2 Database, Structured Query Language, Acceptance Testing, IBM, IBM Mainframes, sql, software, it jobs
Medical Secretaries - 13 Years of Experience - Near 87114
PROFESSIONAL SUMMARY * 4+ years of healthcare experience providing helpful patient assistance, administrative support, and managing patient inquiries. * Previously worked for EPOCH Industrial Health Services, ABC Staffing, and Palmilla Assisted Living. * Responded to telephone calls and responded to patient inquiries regarding issues and /or concerns. * Provided options and solutions to inquiries while upholding company uni...
Tags for this Online Resume: Billing, Back Office, Front Office, Medical, Scheduling, Ultrasound, Accounting, Accounts Payable, Inventory, Management
Customer Service Supervisor - 2 Years of Experience - Near 10310
Tags for this Online Resume: Medicaid, Manager, Connecticut, New York, Dept of health, Human Resources administration, Landscaping, Microsoft, Microsoft Excel, Complaints
System Engineer
Member of CIO division (Optum technology) Senior Leadership team specialized in implementing Health Care initiatives for Government services handling state programs with budgets of over 15 million USD managed a 100+ team covering Medicare/Medicaid Health Insurance Exchange and Benefit Management handling in-house products like Integrated Eligibility (IE) & Optum Integrated Layer (OIL) and SQA Advisor to the State on impleme...
Tags for this Online Resume: Management, Quality Assurance, Test, Banking Industry, Business Case Development, Compliance, Computer Aided Software Engineering, Consulting, Data General Nova, Program Management
Registered Nurse - 20 Years of Experience - Near 95670
Career Summary: Over 20 years of experience in Acute Care and Health Service programs including Utilization Review, Provider Dispute Resolution, Quality Management, Inpatient and Ambulatory Case Management, and Grievance and Appeals in a managed care environment for both Health Plan and IPA/MSO settings using evidence based nationally recognized criteria such as ACOG, NCCN, MCG, InterQual and Health Plan Medical guidelines ...
Tags for this Online Resume: Compliance, Management, Quality Management, Assessments, Medical, Medicare, registered nurse, healthcare, Managed Care, Utilization Management
Customer Service Supervisor - 8 Years of Experience - Near 94534
Summary Of Qualifications Claims Team Supervisor with strong extensive experience in claims processing. I handled 30-35 examiner in a team. Responsible for Claims Processing, managing Medicare/Medicaid and Commercial insurances, capitation HMO, PPO. Responsible for non-cover claim to support staff for issuance of appropriate denial letters and/or referral to HMO. Responsible for following up on commercial and managed care c...
Tags for this Online Resume: Budgetary, Complaints, Policies and Procedures, ADA, Ada Programming Language, Team Player, Facilitator, HR, Human Resources, Management, call center
Business Analyst - 7 Years of Experience - Near 60661
Summary: * Qualified professional with more than 7 years of experience as a IT Business Analyst in Healthcare and Banking Industry. * Highly motivated team player with excellent communication, presentation and interpersonal skills, always willing to work in challenging and cross-platform environment. * Demonstrated ability to work actively in different phases of Software Development Life Cycle (SDLC) using Waterfall, RUP an...
Tags for this Online Resume: Business Analysis, Business Requirements, Insurance, Microsoft Visio, Structured Query Language, Unified Modelling Language, Use Cases, agile, Risk analysis, Impact analysis, Change management, EDI Claims
Registered Nurse - 15 Years of Experience - Near 07040
Phone: * Prepare program for re-accreditation and ensure that program is in compliance with federal, state and accreditation standards * Manage curriculum design, evaluations and security of curriculum resources * Coordinate instructional technologies, clinical placements and ensure all program operations meet training, certification requirements and regulation standards. * Serve as College Liaison to the New Jersey Board o...
Tags for this Online Resume: Medicare, Public Health, Security, Pharmacology, Quality Assurance, Test, Nursing, Insurance, Leadership, Assessments, Management / Educator
Admissions Registration Clerk - 15 Years of Experience - Near 33174
Qualifications * Evaluated hospital census report to determine eligibility for disability patients. * Interview patients for state Federal & county assistance, disability and Medicaid programs. * Process patient applications and submit to appropriate agencies (Federal, Sates and county). * Designated representative to hospitals in order to clean outstanding cases and Clarify aging receivables. * Generated an average revenue...
Tags for this Online Resume: Bookkeeper, Security, Training, Troubleshooting, Clarify, Computer Aided Software Engineering, Database, English Language, Evaluate, physical therapist, rn, outpatient physical therapy, physical therapy, care, registered nurse, healthcare, nurse, pt, outpatient rehabilitation
Medical & Health Services Manager - 20 Years of Experience - Near 01949
management position locally, with upward mobility and advancement
Tags for this Online Resume: Referrals, Rehabilitation, Payroll, Procurement, Computer Aided Software Engineering, management, nursing/medical, insurance,, reimbursement, medicare/medicaid, customer service, sales/marketing
Case Management Manager
PROFESSIONAL SUMMARY Over twenty years of practical healthcare experience working with seniors in various types of senior living communities, including CCRCs, traditional assisted living and memory care, homecare and skilled nursing. SKILL HIGHLIGHTS Staffing management ability Sound decision making Proven patience and Staff training and development self-discipline Effectively influences others Confident public speaker Cult...
Tags for this Online Resume: Documentation, Payroll, Policies and Procedures, Protocol, Quality, Rehabilitation, Billing, Support, Assessments, Facebook, Case manager
Director - 20 Years of Experience - Near 92708
SUMMARY Seeking a position where I can utilize my accomplished leadership skills in nursing, management and organization to provide projected, qualitative client and business outcomes. To utilize my nursing and leadership background and extensive knowledge of Managed Care, including Commercial, Medicare, and Medicaid experience, in an environment where excellence, professionalism, and vision are valued. Talented interviewer...
Tags for this Online Resume: Management, Cms, Integrate, Medicare, Assessments, Leadership, Planning, Quality, Quality Assurance
