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Online Resumes with "interqual"



I am an widely experienced RN, believing I can coordinate individualized patient care; making clinical judgements that will enhance the patient's clinical course and the payor's financial bottom line.

I am looking for a stimulating and challenging job where I work with RN and MD professionals making healthcare decisions. Those employers could be the Federal, State or local governments. I would like to work for an organization that is instrumental in directing our fee for service healthcare system to univeral healthcare should that day ever come.

Ideal Companies: I would like to work in the case management field with the decision makers, the insurance companies or the providers of care who need assistance with patient care coordination and commplex planning for their health care needs.

Tags for this Online Resume: Interqual-severity of illness and intensity of service, Electronic medical record review, Care coordination/complex discharge planning, Educating the public regarding Medicare's important message, Proactively assisting physicians with difficult discharge planning and alternative levels of care., Active professonal participation on committees

Featured Profile

Healthcare Management Professional

I am looking for a position within the healthcare field where I can continue to expand my skills while making solid contributions. I offer over 15 years of progressive healthcare experience beginning with nursing and direct patient care continuing into roles including Hospice Team Manager and Admission Nurse, Branch Director for a proprietary home care agency, marketing/nurse liaison for a rehabilitation hospital. to each...

Ideal Companies: Humana, Blue Cross Florida, United Health Care, Daiichi Sankyo Inc., Metronics

Tags for this Online Resume: Registered Nurse, Hospice, Rehabilitation, Healthcare Sales and Marketing, Physician and Community Relations, Discharge Planning, Program Management, Business Development, Volume Expansion, Medicare and Medicaid CoPs, Recruitment, Training, Personnel Management, Admissions, Insurance Verifications, Scheduling, Forcasting, Staff Development, Customer Service, Nursing Assessments, Problem Solving, Quality and Compliance, Educator, Pediatrics, Teacher of Exceptional Student Education, Branch Director, Front Office Administrator, Account Managment, Case Management, Patient Advocate

Registered Nurse Case Manager

To continue to enhance my nursing career in various settings

Tags for this Online Resume: CCM, BCLS, WinUCS, Excel, Interqual, Milliman, Certified Trainer

RN Care Coordinator--UtilizationReview/Case Management/Insurance--Interqual-Midas-EMR

I have worked at a variety of roles in the health care field for over 25 years. My education includes a Master's Degree in Public Health. Some of the positions I have held during that time include: RN Case Manager/Care Coordinator (hospital, insurance and private sector), adjunct nursing faculty, start-up positions through grant-funded initiatives, home care and skilled rehabilitation. I would like to find a position once a...

Tags for this Online Resume: Public Health, Homeland Security, Infectious Disease, Referrral & Outreach, Accountable Care Organization (ACO), Education/Teaching, All Hazards Emergency Preparedness

Veterinary Technician

Tags for this Online Resume: case manager, able to identify state reportable incidents, use interqual, bilingual english - spanish, chart review, emergency room experience

Professional Health Insurance & Claims Adjuster

My ideal job in Health insurance is to achieve solid sales growth, and acquire new clients while maintaining current clients. As a claims adjuster I'm seeking opportunity to utilize my current experience with a company that is growing to provide me the opportunity to advance my skills.

Ideal Companies: I would like to work with any company that I can utilize my professional skills whether it's health insurance or claims adjuster that will offer stability and growth.

Tags for this Online Resume: claims adjuster, health insurance sales, worker comp, Property, Casualty, Interqual Criteria, IC-9, Xactimate, citizen certification

11 yrs of nursing management various acute care unit., admittingdepartmetn,business development and marketing. able to negotiate contracts w/ various payors. assist in the the hospital reviews of medicare chart reviews. undertanding and application of drg

case maangement . supervisory or icu,er case management position

Ideal Companies: sort term acute hospital

Tags for this Online Resume: critical care registered nurse, case management training, drg, interqual, goal oriented

Case Manager and Utilization review RN-12 years in this and a total of 24 years as a RN.

I would like to continue my education by getting my Bachelor degree and continue to keep updated in the new medications and procedures that are new each year. I love to continue to learn new information.

Tags for this Online Resume: Interqual, Milliam, Chart Audit, Case Manager , Utilization Review, Management, Mecdicaid & commercial understanding

Admissions Director

Tags for this Online Resume: Interqual certified

casemanagement/ discharge planner/ utilization review/ 10 yrs. experience in hospital/ telephonic case manager for harvard pilgrim/ exp. in using Midas Interqual

Interested in working at home;sandwich, ma. telephonic case manager. Utilization review, case reviews updates, etc.

Tags for this Online Resume: casemanagement, utilization review, telephonic case manager

29 tears experience as a LVN with strong clinical skills and expertise in managed care.

Knowledge of ICD9 & CPT codes; InterQual; DRGs. Past nursing experience as clinic supervisor.

Utilization Review Nurse- 7 years experience

Continue working within the area of utilization review while using my nursing experience and clinical skills that I have already honed.

Tags for this Online Resume: medical review, clinical documentation, Medical policy & procedure, use of Interqual criteria, use of Milliman criteria, Medicaid and private insurance