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Online Resumes with "NCQA"
Registered Nurse - 20 Years of Experience - Near 15227
•Case Manager Certified •Facilitated results-oriented, empathetic and professional adult nursing care for over 23 years. •Respect for compliance in all regulated environments while maintaining a clear vision to accomplish the company goals. •Advocated for members to resolve health concerns. •Communicated with all levels of personnel. Skills Include: •Demonstrated computer and internet literacy. ...
Tags for this Online Resume: Case Manager, computer and Internet literate, Utilization review experience, Organized, CPR certified, Motivation interviewing techniques, Chronic condition management, Leader
Registered Nurse, Licensed Health Care Risk Manager
Application of Legal Nurse Consulting and Healthcare Risk Management, URAC and NCQA accreditation experience in fiscally responsible fashion.
Tags for this Online Resume: Director of Nursing, Medical-legal Consultant, Litigation, Risk Manager, Quality Improvement, Policies and Procedures, Healthcare Risk Management, Legal Nurse Consultant, Nursing Faculty
Director -15 years experience-Ft Lauderdale
Increasingly responsible leadership positions in healthcare industry. Management style consists in hiring the right people, establishing goals in concert with those people in a knowledge work environment. Management philosophy based on the belief that having a good system in place is the best way of achieving any objectives.
Ideal Companies: Aetna, Humana BS/BC
Tags for this Online Resume: contracting, quality, risk, revenue cycle, miami
Vice President - 20 Years of Experience - Near 48362
Executive Management position where I can effectively utilize my healthcare experience to lead an organization in the new era of accountable and coordinated healthcare.
Tags for this Online Resume: Provider Networks, Healthcare, Managed Care, Leadership, Healthcare Contracting, Provider Relations, NCQA Experience, Project Management, Management, Network Services, Networking, Quality, Quality Assurance, Quality Management, Services, Complaints, Team Lead, Compliance
Registered Nurse - 20 Years of Experience - Near 48047
Kim has extensive managed care operational background in HEDIS, MA Stars, NCQA and related quality improvement efforts. Kim is recognized as a problem solver with strengths in strategic and tactical planning as well as the completion of projects within an established timeframes. Kim has proven leadership skills in motivating and integrating a diverse team from multiple business areas that consistently meet goals and objecti...
Tags for this Online Resume: NCQA, Quality Management, Disease Management, Program development, HEDIS, Managed Care, Clinical Integration, Performance Measurement/Management/Improvment, Patient Care, ROI, Services, Management, Data Analysis, Process Improvement, Computer Aided Software Engineering
Director - 13 Years of Experience - Near 16066
Tags for this Online Resume: Healthcare , Offshore Managment, Six Sigma, Compliance , NCQA, Leadership, Executive Decsion Maker, P
Quality Improvement Manager - 4 Years of Experience - Near undefined
Tags for this Online Resume: quality, CMS, Epidemiology, Healthcare, Medicare, HEDIS, Star Ratings, NCQA
Medical or Health Services Manager - 20 Years of Experience - Near 30022
I am currently seeking employment opportunity in business operations or healthcare management. More than 25 years of diversified experienced with increasing management responsibilities. Goal-oriented, resourceful team member and skilled leader with strong attention to detail. High relational skills with clients, colleagues and team members. Comprehensive background in healthcare administration which includes but not limited...
Tags for this Online Resume: Healthcare, Practice Manager, Practice Coordinator, Longterm Care, Director, Assistant Director
Medical or Health Services Manager - 20 Years of Experience - Near 75230
Areas of Expertise & Technical Skills * Project Management * Risk Assessment * Regulatory Compliance * Audit Planning * Medical Records Review/Determination * Microsoft Tools & Internet Programs * Stakeholder Communication * Certifications & Accreditations * ICD-9-CM/ICD-10-CM * CPT/HCPCS Codes * InterQual * NCQA & Medicare
Tags for this Online Resume: Assessments, Quality, Documentation, Medical, Management, Medicare, Utilization Management, Compliance
Quality Coordinator - 14 Years of Experience
An accomplished multi-lingual medical program administrator/manager/trainer and auditor whose specialty in quality control, management analysis, risk and fiscal review of health care services/programs and departments, coupled with effective communication and case management expertise, thorough knowledge of QA practices, awareness of local, State and Federal government trends for quality controls and public safety of infecti...
Tags for this Online Resume: Management, Medicare, Coding, Fraud, Home Health, Risk Management, Services, Audit
Health Technologist - 18 Years of Experience - Near 02446
Summary: I have over 16+ yrs. experience in HIT leadership and 9 years in academic research. I am passionate healthcare and biotechnology program delivery. I am a certified PMP practitioner of Waterfall and Agile management methodologies, consistently promoting a standard platform for implementation, upgrade and support of clinical, operational, analytical and administrative software and hardware I have led large teams both...
Tags for this Online Resume: Billing, Project Management, Project Manager, Publishing, Scheduling, Senior Project Manager, Support, ANSI, Ansi (Am Natl Stds Inst), EDI
Medical Office Manager - 4 Years of Experience - Near 92154
QUALIFICATIONS SUMMARY A CPCS certified, highly talented Medical Staff Services Professional with 16+ years of experience working in Credentialing, Provider Enrollment, Medical Staff Services, Regulatory Compliance and Quality Management for both corporate and non-profit organizations. Highly adept at team and project management, organization and managing deadlines and multi-tasking in fast-paced and highly challenging sett...
Tags for this Online Resume: Credentialing, Accreditation, NCQA, Enrollment, Joint Commission, Project Manager, Medical, Medical Staff
