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Online Resumes with "Medicaid "
registered nurse with BSN over 10 years of utilization review that includes management
to work full time with a company that values experienced indivuals
Tags for this Online Resume: utilization review, management, insurance, medicare/medicaid, computer literate
Healthcare Manager 13 years experience- EMR-OASIS-ACA-Marketing Stategies-Recruitment
I am a Healthcare Manager with an MSA in Public and Community Healthcare Management. I have over 10 years of healthcare management, training, education, recruitment, staffing, conflict resolution and settlement in both government and cilvilian sector. I am looking forward to working with a new organizational family which will encourage continuing education in the healthcare and business management industry as well as, promo...
Tags for this Online Resume: Maryland , Washington, DC, Recruitment, Medicaid , Medicare, Customer Service
Risk Manager
Highly Skilled and Decorated retired Police Officer and Detective with over 25 years of high-profile Law Enforcement experience in Uniform Policing, Police Officer Training and Development, and Narcotics Investigations with strong knowledge in Federal regulations, State Law, including Criminal Law, FEMA, HAZMAT & HAZCOM. Proven investigative expertise as an undercover detective and a police patrol officer. Strong law enfor...
Ideal Companies: Homeland Security, FBI, Secret Service, CIA, State Farm Insurance, Farmer's Insurance, Government Contractors, Medicare/Medicaid), FEMA, OSHA,
Tags for this Online Resume: investigations, leadership, management, team building, analyst
Senior Investigator - 10 years Experience- Washington, DC
An experienced criminal and medical investigator with a strong background in court processes and Medicaid investigation. Works tenaciously to uncover cases of fraud, abuse and neglect through surveillance, background checks, interviews and the utilization of modern technologies. Collaborates effectively with the FBI, the Inspector General and other law enforcement agencies. Exercising independent judgment and initiative wi...
Tags for this Online Resume: Health care Fraud, Investigator, Claims, Medicaid
Program Specialist - 23 years government experience
Over 23 years of diverse experience in the human services arena. This experience includes interviewing and auditing public assistance benefits cases for eligibility and correctness of benefits received as both a Caseworker and a Quality Control Analyst. I also worked as a Training Officer/Team Leader for the Medicaid program. In this position I worked with state and federal officials to interpret state and federal laws, pol...
Sr. Medical Billing Representative
Highly Skilled Accounts Receivable Representative with over 15 years’ of medical and business billing experience. Proven expertise working with patients to resolve Medicare / Medicaid denials and submit appeals. Skilled at medical coding, medical billing, processing medical claims, and performing insurance research.
Ideal Companies: Hospital
Tags for this Online Resume: Billing Coding, Medical Terminology, Collections, Office Administration, Data Entry, Medical Coding, HIPPA Standards
Human Service field- 10 years-New York
I'm a Human Services Professional who has a diverse background in Human Resources, Case Management, Quality Assurance and Medicaid Service Coordinator in the non-profit sector.
Tags for this Online Resume: Recruiting, Compliance, Case Manager, Benefit Management, Quality Assurance Coordinator, Individual Service Plans, Indivudual Service Plans, Behav
Administrator for Home Health Agency for 14 years. Have been Director of Quality improvement
I am a Registered Nurse with Administrative and Management skills over the past 24 years. I have extensive knowledge regarding Medicare/Medicaid and Medicare Advantage Plans. Have negotiated with Insurance Agencies for contracts and reimbursement. Have hired, oriented, and have been responsible for staff development and education. Was responsible for supervision of all disciplines in health care including RNs, LPN, Cert...
Ideal Companies: Blue Cross Blue Shield, United Health, Molina Health, Humana, Aetna, Home Health and Hospice Agencies, Case Manager Companies
Network Relations Consultant/Provider Relations Representative
Dedicated professional with years as a successful employee in the Healthcare Industry for the State of Texas with experiences in supervision, project management, provider relations, provider recruitment, contract negotiations, complaint and problem resolution, staff training, and territory management/networking for Medicaid/Medicare and Managed Care areas. Business focused and seeking to provide exceptional work in the are...
Tags for this Online Resume: network consultant, provider relations
Director of Nursing/Case Manager 7 years experience -- Folsom, CA
I'm a Registered Nurse who has worked in a Director of Nursing position for the past 5 years, with experience in Case Management as a travel nurse. Completed Admission and concurrent reviews for authorization for payment through the InterQual guidelines. Worked with HMO’s, Medicare and Medicaid, and hospital based Medicaid systems (developed to meet the affordable care act criteria) Hospice’s the Clinical team as well as Wo...
Registered Nurse: 3 years management experience with 2+ years in Case Management
I'm a Registered Nurse with 7 years experience working in diverse areas and levels within nursing. Extensive knowledge of Medicare and Medicaid guidelines as well as Utilization Management.
Tags for this Online Resume: Utilization Management, MDS, Supervisor, Manager, Case Management, Utilization Review, Customer Satisfaction, Interdisciplinary Team, Teamwork, Acute Rehabilitation, Skilled Rehabilitation, Medicare, Medicaid, Concurrent Review, Managed Care, Insurance, Cost Control, Scheduling, Staffing, Communication, Discharge Planning
Health Care Surveyor Investigator
Extensively experienced and dedicated OTR/L offering more than twenty years of management experience; history of work experience in geriatrics, adults, pediatrics, mental health, acute care, out-patient, traumatic brain injury, and home health. Substantial knowledge of Medicare and Medicaid regulations, as well as a working knowledge of third party payers.
Tags for this Online Resume: healthcare, manager, Medicare, skilled nursing, acute care, director
