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Online Resumes with "Medicare Medicaid "



Compliance Manager

To use my skills, training, education and experience to secure a position in the field of healthcare leadership as a program manager to increase revenue, patient satisfaction, reduce rejected and denied claims while managing increased claim volume with a reputable company.

Ideal Companies: center of medicare and medicaid, amazon

Tags for this Online Resume: Compliance, Benefits, Benefits Administration, Billing, Computer Aided Software Engineering, Management, Pediatrics, Audit, Cms, Coding

Registered Nurse - 3 Years of Experience - Near 60004

Qualifications Profile Highly organized, analytical, and multifaceted registered nurse, offering extensive experience in the healthcare industry complemented with hands-on experience in utilization management and staff supervision. Performance-focused leader, skilled at directing and overseeing a wide array of tasks and services while ensuring compliance with operational and organizational standards. Knowledgeable of Nation...

Ideal Companies: Aetna

Tags for this Online Resume: Audit, Cms, Compliance, Discharge Planning, Distribution, LPN, Management, Medicare, Planning, Policies and Procedures

Billing/Coding Specialist - 20 Years of Experience - Near 75218

Tags for this Online Resume: Medicare, Benefits, EDI, Electronic Data Interchange, Intrepid, Billing, Health Care Industry, Services, Insurance, Receivables

Claims Investigator

SUMMARY OF QUALIFICATIONS Experienced insurance management professional with expertise in provider relations, contract development, compliance, operations, call center management, reinsurance, and account/program management. Organized, self-starter with in-depth knowledge of employee benefits, group and individual health, life, Medicare and Medicaid products. Extensive experience in managing professional staff, developing e...

Tags for this Online Resume: Compliance, Insurance, Managed Care, Policies and Procedures, Process Improvement, Process Improvements, Management, Networking, Pricing, Project Management

Featured Profile

Experienced consultant, expertise in business development and lead generation, Oregon

My career is dedicated to best practices. I have found success by utilizing coalition building in parallel with marketing, communication and public relations by designing cost-effective research to create program of strategic planning to generate new leads and business development. I offer successful and fiscally responsible expertise and possess the skill and spirit necessary to assist the any organization develop and expa...

Ideal Companies: Agencies, Health Care, Social Service

Tags for this Online Resume: Social Media, Data General Eclipse, Distribution, Eclipse, Home Health, Legacy, Rehabilitation, Research

Featured Profile

Senior Vice President Payment Transformation, Vice President Managed Care, Network Development, Contracting and Provider Relations - 20+ years Experience, Kansas

I am searching for a progressive organization that is moving from pay for volume to paying for value. I have built a prospective bundled payment program for the ambulatory setting. I've also partnered with Oracle to co-develop a technology platform to automate the payment of prospective and retrospective bundles. I have negotiated bundled payments, shared savings arrangements, bundled payments, FFS, case rates and PCMH ...

Ideal Companies: UHG, Humana, Blue Cross Blue Shield, Lumeris, Adventist Health System

Tags for this Online Resume: contract negotiations, network development, value based contracting, managed care, ACO, clinical integration, Compensation, Prospective Bundles Program, Commercial, MA and Medicaid

Health and Wellness consultant - 0 Years of Experience

AREAS OF EXPERTISE -Regulatory Compliance -Training and Team Building -Operational Support -Strategic Planning -Clinical Administration -Project Coordination -LTC Facility Management -Business Development -Budget and Cost Control -Data Analysis and Reporting - Marketing and Promotions -Health and Safety Standards Summary of Qualifications and Achievements * Increased Payer Sources from just Medicare, Medicaid and Private Pa...

Tags for this Online Resume: Nursing, Health Care Industry, Budgeting, Compliance, Cost Control, Data Analysis, Evaluate, Financial, Health Insurance Portability And Accountability Act, Home Health, Detroit

Project Manager - 10 Years of Experience

EXECUTIVE PROFILE Both PMP - and ITIL-certified a highly accomplished, Program/Project Management (PMO) professional with over 20 years progressively responsible client-facing service delivery, consulting experience, the past 10 on Medicare projects supporting the 1-800 Medicare enterprise SDLC and IT Service Delivery for the Centers for Medicare and Medicaid Services (CMS). A proven, motivated self-starter, with demonstrat...

Tags for this Online Resume: Management, Coding, Medicare, Scheduling, Support, Call Center, Health Insurance, Insurance, Insurance Claims, Monitoring, Program/Project Manager, Program Manager, Operations Manager

Licensed Nurse - 20 Years of Experience

SUMMARY OF QUALIFICATIONS: * Diversely experienced LVN with over 30 years of experience * Proficient working with multiple computer applications including Microsoft Office * Experienced and familiar providing patient and family education * Assisting with the development and implementation of care plans * Well versed in Medicare, Medicaid, and private insurance * Initiating, processing, and reviewing referrals and authorizat...

Tags for this Online Resume: Management, Patient Care, Data Entry, Infection control, Injections, Inventory, Laptop Computer, Medical, Medical Records, Referrals

Help Desk Specialist

Tags for this Online Resume: Software, Management, Microsoft Windows XP, Pc, Personal Computer, Windows XP, Email, Microsoft Windows, System Administration, Microsoft Windows 8

State Government - 4 Years of Experience - Near 30308

Tags for this Online Resume: Cms, Management, CMOS, Documentation, Financial, Financial Management, Policies and Procedures, Program Manager

Featured Profile

Pharmacist - 20 Years of Experience - Near 76116

My goals and aspirations are to always have the best attitude, be open minded, to always be learning and to learn from my mistakes, and do the best job to the best of my ability to improve the lives of others and the Company I work for.

Ideal Companies: Long Term Care, Hospital, Government Hospital, JPS, Indepent Pharmacy, Managed Care, PBM Mail Order, Costco, Sam’s, Target, Walgreens, Walmart

Tags for this Online Resume: Inventory, Pharmaceutical, Management, Medical, Immunization, Distribution, Managed Care, Team Lead, Inventory management, Medicare