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Online Resumes with "Medical necessity"
Pharmacist - 12 Years of Experience - Near 77024
I am very passionate about the goal and purpose of healthcare. It is in my humble opinion using medical and pharmaceutical skills and knowledge to improve patient outcomes in the shortest possible time and in the most efficient way. To this this end I dedicate my skills and energy and thrieve when I see the smiles on the faces of patient as they regain their strength through the collaboration of a myriad of conscientious pr...
Ideal Companies: Houston -(Hospitals, Healix), Harris County Hospital System, San Antonio-Hospitals, Corpus Christi-Hospitals, Victoria - Hospital, Dallas/Ft. Worth - Hospitals, Rio Grande Valley Cities -Hospitals, Retain Chains: HEB, Walgreen Albertsons, Kroger and Independent Chains.
Tags for this Online Resume: Houston TX, San Antonio Tx, Staff , Clinical, Community, Pharmacist, Experienced, Professional, Cerner RX Sys, Siemens, Baxter/Abacus(TPN), Medidose, Pyxis, Scripro, Mckesson, Cardina, QA1
Quality Assurance Director - 20 Years of Experience - Near 33319
Stephen Paul Mirfield, MD , MHA www.linkedin.com/in/drsmirfield January 19, 2016 Dear Sirs or Madam: I am responding to your job listing and, I wish to apply for a position with your institution. Attached is my resume for your consideration. As indicated I have several years’ experience in Healthcare Administration & Management. In my job duties I have directed recruitment and retention of supervisors, office manage...
Tags for this Online Resume: Fort Lauderdeale, Assessments, Management, Planning, Professional Services, Services, Strategic Planning, Billing, Leadership
Physician executive strong CM/UM experience, demonstrated ability to avoid readmission and increase claims efficiance - near 60637/430
Experienced medical professional, expert in adult and geriatric medicine, care coordination that avoids unnecessary readmission,chronic disease management (including home visits,) Medicare, it's managed care partners and dual eligible,managed care administration, medical education, and clinical practice. Committed to empowering providers and utilization/care management nurses to fully partner with payors and health systems ...
Ideal Companies: BlueCross/BlueShield, Medicare, Anthem, Cigna, United Health Care, CMS, Presence, Valence
Tags for this Online Resume: Geriatrics, Chronic disease management, Utilization/Care Management, HIPAA/Clinical Medical Ethics, HealthCare Professional Education, clinical policy development, Physician, Director, Medical Director, Physician Executive, Adult Medicine, Geriatric Medicine, Care Coordination, Population Health, Dual Eligibility Systems, Risk Management, Medical Education, Multidisciplinary Education, Clinical Ethics Training, Medical Ethics, Oral Communication, Written Communication, Social Media, MS Office, MD, FACP, AGSF, Underwriting, Claims, Non Profit, Principle
Claims Investigator
Career Summary MORE THAN 30 YEARS AT ASSURANT HEALTH/FORTIS/TIME INSURANCE COMPANY. EMPLOYMENT ENDED DUE TO COMPANY CLOSING. POSITIONS HELD: CODING REVIEW ASSOCIATE/PHYSICIAN AUDIT EXAMINER, HEALTH CORRESPONDENT/APPEAL RESOLUTION SPECIALIST, MEMBER SERVICE REPRESENTATIVE, PROJECT COORDINATOR, CORPORATE COMMUNICATIONS ASSISTANT, BENEFIT ASSISTANT, DATA ENTRY CLERK, AND CLOSE CLAIMS CLERK. Accomplishments and Career Highlight...
Tags for this Online Resume: Benefit Specialist, Appeals Specialist, Quality Assurance, Claims Representative, Project Coordinator, Customer Resolution Specialist, Telecommute, Customer Service, Clinical/Code Review, Claim Investigations, Data Support Specialist, Adjustment Specialist
Manager - 6 Years of Experience - Near 92101
Tags for this Online Resume: Computer Aided Software Engineering, Management, Cms, Analytical Thinker, Attention to Detail, Complaints, Financial, Financial Management, Documentation, AHLTA, AllScripts, IQCI, EPIC, Cerner, HAIMS, Program Management
Clinical Research Professional
I am looking for a career opportunity in research or any science related field.
Ideal Companies: Any research company, FBI, CIA
Tags for this Online Resume: clinical, research, project management, biology, medical , science, monitoring, clinical trials, regulatory, quality assurance, laboratory
Family or General Practitioner - 11 Years of Experience - Near 40243
Duties:, and implement medical treatment for predominantly neuro/ orthopedic pts. Collaborated with neurosurgeon, medical advisor. Consult with doctors and other health-care providers about the circumstances that surrounded a medical situation gathering documentation in preparation for an approval denial or appeal for services based on policy provisions and medical necessity.
Tags for this Online Resume: Insurance, Compensation, Workers Compensation, Computer Aided Software Engineering, Consulting, Management, nurse practitioner, APRN
Case Manager - 20 Years of Experience - Near 92630
I am looking for a full time permanent opportunity with a growing Case Management Company with excellent comprehensive benefits including Health Insurance, dental, vision and 401k option. I am a dedicated, highly skilled, self-motivated, registered nurses that that has significant experience with workers compensation & commercial case management as well as Utilization Management. I am also highly skilled in using Microsoft...
Ideal Companies: Strong and Stable, Kaiser, Hoag, St Joseph.
Tags for this Online Resume: healthcare, rn, case manager, utilization review, Registered Nurse, Milliman Care Guidelines, care coordination
Licensed Nurse - 20 Years of Experience - Near 21229
PROFILE: NURSE MANAGER ~ CASE MANAGER ~ UTILIZATION REVIEW Highly efficient and dedicated Nurse Case Manager and Clinician with 20+ years of success and contributions in clinical and educational settings. Significant Skills and Abilities Include: * Deep and rich knowledge of nursing field with a solid clinical, administrative, and medical acumen engage and collaborate with a host of healthcare professionals and specialists ...
Tags for this Online Resume: Nursing, Services, Patient Care, Quality, nurse, registered nurse, home health, long term care, home health field nurse, case manager home health, nurse supervisor weekend, nursing supervisor part time, nursing supervisor per diem
Registered Nurse - 20 Years of Experience - Near 78599
I have worked as a pediatric nurse both in the acute care setting and the home care setting. In the acue care setting I functioned as a charge nurse in the pediatric intensive care unit at McAllen Medical Center. Areas I rotated within the hospital included NICU PEDIATRICS ADULT ICU and ER. I have had certification for PICC line insertion thru MMC and MCH Services. I also had NALS and PALS certifications. In the home care s...
Tags for this Online Resume: Computer Aided Software Engineering, Home Health, PICU, PEDIATRIC, ICU, NICU, Nursing, Pediatrics, Coding, Documentation, nurse
Administrative Services Manager - 10 Years of Experience - Near 80104
Summary of Experience * Management/HR: Solid background in project management, client relationship management and high-level support leadership. Advanced communication skills. Successful in the areas of recruiting, staff development, training and process development/execution. 10+ years' management experience with teams of up to 400 people. Versed in multiple disciplines of scheduling and logistics. * Administrative/Executi...
Tags for this Online Resume: Training, Audit, Accounting, Analytics, Data, Healthcare, Medical Coding, AR/AP, Reconciliation/Daily/Month End, Staff Management, Human Resources, Recruiting, Retention and Development, Project Management, Office/Practice Management, Records Management, CRM, EMR/EHR, Electronic Filing, Legal Support, Documentation Specialist, Logistics, Executive Support, Medical Claims Specialist
registered nurse- 27 years experience. Case manager 10 years
PROFESSIONAL SUMMARY: I am a dedicated Registered Nurse with 25 years of experience ranging from Case/Care Management, Utilization Review, Disease Management, Telephonic Nursing and Coronary ICU. I have a strong commitment to providing quality nursing care while maintaining strong organizational skills. I can work closely with multidisciplinary teams which ensure appropriateness of care and medical necessity. Last but not l...
Tags for this Online Resume: Management, Computer Aided Software Engineering, Referrals, ACLS, Automobile Claim Law Specialist, BLS, physical therapist, registered nurse
