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Online Resumes with "Utilation Review"



Customer Service Representative - 16 Years of Experience - Near 80917

I would like to work in insurance underwriting support.

Tags for this Online Resume: Corporate Accounts, Utilization Review, Colorado Springs, Zurich North America, Workers' Compensation, Underwriting, Strong Work Ethic, Services, Team Lead, Training

Business Analyst - 6 Years of Experience

Experience Summary * 7.9 years of experience in IT industry and immense knowledge about US healthcare domain and 5 years of experience in closely working with Business by Managing Various Client Projects. * 10 months of experience in the USA, California in CRM leads management using Salesforce. * Project Manager Expertise includes Planning and Defining Scope in Documentation of client requirements and translates them into d...

Tags for this Online Resume: Management, System design, Test, Test Plan, Coding, Monitoring, Project Management, Scheduler, Stored Procedures, Structured Query Language

Medical or Health Services Manager - 20 Years of Experience - Near 33534

SUMMARY * 15+ years' experience as a clinical professional with a broad range of healthcare experience, talent and expertise also in Medicaid claims reviews programs * Extensive nursing experience in multiple areas (Utilization Review/Managed Care including Inpatient/Outpatient service for Pre-Cert, Concurrent Review, Case Management, Medical Claim/Bill Review, ICD-9/ICD-10 Coding, Hedis Reviews, Home Health Care, School Nu...

Tags for this Online Resume: Medicare, Computer Aided Software Engineering, Management, Injections, Insurance, VITAL SIGNS, Medication Administration, Nursing, Wound Care, D.O.D., Case Manager, Billing, Coding, Auditing, Utilization Review, Manager, Supervisor, Health Services, Nurse, LPN, Trainer

Quality Coordinator

To apply for a position in appeals, medical record review, or concurrent review

Tags for this Online Resume: Internal Auditor, Medical, Medical Records, Medicare, Medical appeals, utilization review, concurrent review

Registered Nurse - 20 Years of Experience - Near 23450

QUALIFICATIONS: My nursing experience includes: Utilization Review, ICD-9 Code Auditing, HEDIS Chart Reviews, Surgical Pre-Op Assessment, Chronic Hemodialysis, ICU/CCU, Radiology Nursing, Cardiac Cath Lab, Telemetry, Acute Care, ER Triage, Cardiac Rehab, and Telephone Advice Nursing. I have Charge Nurse/Supervisory Experience in many of these areas.

Tags for this Online Resume: Reviews, Medicare, Assessments, Audit, CCU, ICU, Medical, Medical Records, Cms, Dialysis, UR/UM

Case Manager - 7 Years of Experience - Near 90018

Currently seeking an opportunity that would allow me to successfully transition into Case Management/Utilization Review, where my skills, education and valuable experience can be effectively utilized in a clinical setting conducive to professional development.

Tags for this Online Resume: LVN CASE MANAGER, Home Health, Computer Aided Software Engineering, Direct Patient Care, Injections, IV Therapy, Management, Medicare, MediTech, Microsoft Excel

Licensed Nurse - 20 Years of Experience - Near 33610

Healthintegrated - April 18 2016 to May 19 2017 Utilization Review Coordinator Telephonic pre-authorization of procedures over the phone for inpatient and outpatient utilizes clinical skills to support the coordination documentation and communication of medical services and/or benefit administration determinations. Critical competencies include flexibility professionalism as well as clinical knowledge with claims. InterQual...

Tags for this Online Resume: Back Office, LPN, Drug Screen, Home Health, Injections, Management, Nursing, Patient Care, Patient Education, Policies and Procedures

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

Licensed Nurse - 15 Years of Experience - Near 79924

PROFESSIONAL SUMMARY MDS Coordinator with Medicare, Medicaid and Managed Care experience, Solid Clinical, Utilization Review and Case Management experience within Skilled Nursing Facility environment.

Tags for this Online Resume: Medicare, Coding, Documentation, ICD 10, Managed Care, Management, LVN, CASE MANAGER

Case Manager/ Utilization Coordinator - 20 Years of Experience - Near 08872

COVER LETTER: To Whom It May Concern, I am a 34+ yr experienced RN with diversified hospital experience. My experience includes medical surgery, dialysis (peritoneal), immunology, infectious disease, and IV therapy team experiences including PICC and chemotherapy administration. I have spent 16 years of my career focused on hospital utilization review, case management (Medicaid/Medicare, Managed Care), hospital bill audit, ...

Tags for this Online Resume: Insurance, Medicare, Microsoft SMS, nurse, healthcare, care, rn

Registered Nurse - 20 Years of Experience - Near 21076

an opportunity to utilize my knowledge & skills as a Utilization Review Specialist remotely. EMPOLYMENT HISTORY Utilization Review Manager VA Hospital Baltimore, MD 2013 to present My current position as a Utilization Review Management is a fulltime position and I work as an autonomist nurse from home. I am a member of an interdisciplinary team for the Critical Care Service Line. The team consists of a Case Manager, Social ...

Tags for this Online Resume: Cardiovascular, Medical, Medical/Surgical, Neurological, Nursing, Surgical, Telemetry, physical therapist, outpatient physical therapy, outpatient rehabilitation, physical therapy, pt, medical

Case Manager - 20 Years of Experience - Near 01752

Tags for this Online Resume: Orthopedics, Medicare, CCU, ICU, Insurance, Management, Nursing, Transitions, Acute Rehabilitation, Assessments, registered nurse, Utilization Review, Case Management, Risk Adjustment