CV, Curriculum Vitae and Online Resumes Search

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Online Resumes with "Urac"

Clinical Director (Pharmacist), Raleigh NC - 15+ year experience - managed care, health policy, clinical services, URAC, NCQA, regulatory - PBM, GPO, academic and exrce

I am a health care professional looking for challenging opportunities within a dynamic organization. I enjoy leading teams and initiatives and know how to achieve results. I am looking for an organization that will value my diverse background and foster opportunities for professional growth.

Tags for this Online Resume: Pharmacy, managed care, health policy, management, regulatory, clinical services, drug information, formulary, clinical communications, academic programs, PBM, clinical pharmacist

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

Case Manager - 20 Years of Experience - up to 25 miles from 33176

NELLY GAZMEN CONROY, RN, BSN Cellular: (305) 926-0725 npgconroy@gmail.com ------------------------------------------------------------------------------------------------------------------------ CAREER OBJECTIVE: A position in a progressive growing company which affords opportunities and advancement for motivated, hardworking, qualified ...

Tags for this Online Resume: Miami, Broward, Case Management, Director of Nursing, Teaching, Consulting, Computer, Gen Orientation

Quality Coordinator - 20 Years of Experience - Near 85266

Tags for this Online Resume: Medical, Healthcare, Quality, Audit, Data Analysis, Scottsdale, Documentation, Quality Improvement, URAC, Process Improvement, Phoenix, telecommute

Director of Human Resources - 15 Years of Experience - Near 19355

CAREER SUMMARY Senior Human Resources Professional with specific expertise in building and transforming HR operations Human Resources Generalist Benefits Compliance Establishing HR Department Administration URAC Accreditation Hiring/Onboarding/Orientation POP/125 Plans FMLA/EEO/OSHA Employee Relations/Counseling COBRA Administration I-9 Performance Management Workers Compensation Employment Law Job Descriptions ACA Complian...

Tags for this Online Resume: Equity, Home Health, Private Equity, Benefits, HR, Management, Associate of the Conference of Consulting Actuaries, Audit, Cobra

Registered Nurse - 22 Years of Experience - Near 65202

Tags for this Online Resume: Medicare, Nursing, Insurance, Managed Care, Assessments, HEDIS, Health Coach, Disease Management, Preauthorization, Utilization Review, Quality Improvement, Quality Review, Medical Record Review, URAC, Case Management, Drug Adherence

Medical or Health Services Manager - 20 Years of Experience - Near 07087

To obtain a challenging Coordinator position that will utilize my skills such as customer service, scheduling, insurance verification, prior authorization & follow ups. Knowledge on CAHC, JACHO and URAC. February 2017 - Present Empire Specialty Pharmacy West New York, NJ Intake/Prior Auth Coordinator * Obtain referrals from doctors, insurance companies and account representatives * Insurance verification and eligibility * O...

Tags for this Online Resume: Accenture FOUNDATION, Acquired Immune Deficiency Syndrome (AIDS), Coaching, English Language, Sports, healthcare

Quality Assurance Director - 15 Years of Experience - Near 94585

SUMMARY OF QUALIFICATIONS: * 15 years of Operations Management experience in ambulatory, behavioral health, inpatient FQHC and Indian Health * 15 years of Management/Supervision of FTE experience (union/non-union) * 12 years of Quality (CQI)/Performance Improvement experience * 10 years of Compliance, Accreditation and Risk Management experience: (JCAHO, CMS, DHCS, Title 22, URAC, NCQA, AAAHC) * 8 years of Chronic Disease T...

Tags for this Online Resume: Compliance, Management, Medication Administration, Audit, Medical, Medical Records, Microsoft Access, Program Management, DSS, health services system, population based health administration

Quality Manager - 17 Years of Experience - Near 11050

Tags for this Online Resume: Management, Manufacturing, Project Management, Project Manager, Black belt, Home Health, Medical, Medical Records, "Six Sigma", Healthcare, "Operational Excellence", Lean, Quality, Director, URAC, GMP

Managing Director - 12 Years of Experience - Near 76028

Professional Summary I have 20+ years' experience working in Managed Care. The last 17 years of my career have been focused on managing Clinical Quality Management and enhancing organizational performance. I have experience managing HEDIS, NCQA accreditations and URAC accreditations.

Tags for this Online Resume: management, Networking, Complaints, Quality, Quality Assurance, Quality of Service, Utilization Management, Negotiation Skills, Project Management, Quality Management

Director

PROFESSIONAL SUMMARY Six Sigma lean certified Black Belt Operations Manager with over 10+years of operations managerial experience combined with healthcare management experience. Management experience is inclusive of managing internal customer service department and external service providers. Experience making recommendations, great judgment, negotiating, and managing COGS, (cost of goods sold), that positively impact busi...

Tags for this Online Resume: Payroll, Services, CFO, Transportation, Medical, Policies and Procedures, Health Care Industry, Management, Accounts Receivable, Black belt

Quality Assurance Director - 17 Years of Experience - Near 11050

Tags for this Online Resume: Statistical Analysis, Manufacturing, Black belt, Home Health, Medical, Medical Records, Project Management, Project Manager, Six Sigma Quality, Lean, Quality, Performance Improvement, Operational Excellence