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Online Resumes with "Managed Care Organization"
Case Manager
SUMMARY Kathleen Johnson combines the knowledge and experience gained from extensive clinical practice with administrative experience such as utilization review and case management, and working extensively with managed care organizations. Her strengths and skills are the positive relationships with coworkers, clients, members, providers and customers.
Tags for this Online Resume: Computer Aided Software Engineering, Management, VITAL SIGNS, Coding, Documentation, Quality, Quality Assurance, Patient Care, Utilization Management, Nursing
Biotechnical Equipment Sales Representative - 10 Years of Experience - Near 12866
Career Summary: Healthcare Sales Executive with 10+ years of pharmaceutical and medical sales-healthcare business development experience (inclusive of Diabetes, Gastrointestinal, Cardiovascular, and Pulmonary medication). Also skilled with sales territory management with expertise in presenting and selling to diverse Clinical Healthcare Professionals and non-clinical C-Level Suite Healthcare Executives.
Tags for this Online Resume: sales representative, account executive, account manager, technical sales, Medical, Pharmaceutical Industry, Consulting, Managed Care, Pharmaceutical, IDN, GPO, Managed Care Organization, Hospital, Healthcare Sales Strategy, Healthcare Business Development, Healthcare Policy
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
Manged Care Network Management - 20 Years of Experience - Near 29036
Summary of Experience More than 16 years of leadership experience in the Managed Care industry including 10 years in healthcare facilities. Extensive experience in developing, expanding, and maintaining provider networks as well as in: Health Care Delivery Systems Network Development Provider Relations Budget Administration Problem Resolution Team Development Trend Analysis/Valued-Based Purchasing Salesforce Data Regulation...
Tags for this Online Resume: Leadership, Management, Program Manager, Services, Shared Services, Managed Care, healthcare, care, quality improvement, provider relations, network management, medicare, Medicaid, motivation, quality
Registered Nurse
PROFESSIONAL SUMMARY Registered Nurse * I am a healthcare professional with eighteen years practical experience in hospital and primary care. In the past six years I have become more involved with clients health management and have performed admissions for home care with OASIS documentation, High Risk Medical Case Management activities for a Medicaid Managed Care Organization, and managed a client base for a Medicaid Long T...
Tags for this Online Resume: Surgical, Telemetry, Assessments, First Aid, Health Care Industry, Phlebotomy, registered nurse, healthcare, case manager, Correctional, BLS, Medicaid, Medicare
mainframe developer
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, software
Computer Programmer
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: Management, Management Information Systems, CICS, Cobol Programming Language, Cobol II, IBM DB2 Database, Structured Query Language, Team Lead, Test, Acceptance Testing
Computer Programmer
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
Registered Nurse
Highly skilled career professional with clinical and management experience in hospital, clinic and managed care settings seeking a management or clinical position in an ambulatory clinical setting or managed care organization.
Tags for this Online Resume: Gastroenterology, Labor & Delivery, Medical, PEDIATRIC
Billing/Coding Specialist - 8 Years of Experience - Near 60473
SUMMARY Skilled professional with 10+ years of managerial experience in the healthcare sector, managing claims processing systems, data analysis, auditing, financial reporting and contracts. Experienced in managing government programs including Illinois Medicaid and Managed Care Organizations (MCOs) processes. Executed and managed in-network contracts with various MCOs expanding consumer base to increase billing opportuniti...
Tags for this Online Resume: Benefits, Billing, Financial, Government, Managed Care, Project Management, Project Manager, Payroll, Management, Audit
Quality Manager - 25 Years of Experience
Accomplishments * Published "A New Quality Approach to Reducing Vascular Access Infections" in the Nephrology Nurses Journal (2011) as a national Continuing Education Unit (CEU) for Nursing. * Published Four Pinnacle Award performance improvement projects through Health Care Association of New York (HANYS) (2007) Profiles in Quality and Patient Safety. * End Stage Renal Disease (ESRD) Network Quality Champion Award received...
Tags for this Online Resume: Managed Care, Consulting, Manufacturing, Process Improvement, Cms, Management, Root Cause Analysis, Medicare, Quality, Quality Assurance
Quality Coordinator - 20 Years of Experience - Near 30121
Summary Extensive experience in managed care and acute healthcare with emphasis on Quality Management, NCQA and JCAHO, NCQA, and CARF accreditation management, Risk Management, Medical Staff Credentialing, Peer Review, and clinical data management and analysis with demonstrated success. Many years of experience with the statewide cancer registry, hospital based registries, and the American College of Surgeons Commission on ...
Tags for this Online Resume: Audit, Data Management, Documentation, Management, Patient Care, Quality, Quality Assurance, Quality Management, Cancer, Pathway
