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Online Resumes with "provider contracting"
Executive Assistant - 15 Years of Experience - Near 93065
A consummate, bilingual Executive Assistant/Projects Manager dedicated to making the lives of busy executives easier. Strong general management skills in Medi-Cal/Managed Care, provider contracting, claim submission, member grievances, benefits interpretation, provider office operations and authorizations. Recruited, hired, trained and managed those engaged in managed care. Earned Office Manager/Computerized Accounting Cer...
Tags for this Online Resume: Near 93065, Bilingual, English/Spanish, Results oriented, Customer focused, Training abilties, Project Management, Negotiator
Claims Investigator - 10 Years of Experience - Near 17103
Tags for this Online Resume: Provider relation rep, network management, provider contracting, Provider services, Claims trouble shooting, provider network recruiting
Experienced Utilization Management RN
Results-driven, dedicated, and compassionate healthcare professional with more than 30 years experience delivering high-quality patient care and nursing operations in a variety of areas, including, pediatrics, cardiac critical care, military/emergency nursing, occupational health, commercial health insurance case management, and travel insurance case management. Extensive knowledge of medical illnesses and treatments, hospi...
Ideal Companies: Health Insurance Organizations, Utilization Management, Travel Health insurance
Tags for this Online Resume: Registered Nurse, Utilization Management, Call Centers, Occupational Health, Microsoft Office Suite, Managed Care, Process Improvement, Training and Development
Claims Examiner - 20 Years of Experience - Near 24014
I have been in the Health Insurance business for 31+years. During this time I have been from data entry, customer service, executive inquiry, underwriting, provider contracting,Quality Analyst, Internal Provider Relations Representative, Provider Date Analyst (loading provider and fee schedules), outside Provider Relations Consultant. I am currently working through a temporary agency with Anthem as a Quality Analuyst.
Ideal Companies: Anthem, United Health, Health Insurance
Tags for this Online Resume: Contracting Analyst, Provider Relation Consult, Quality Analyst, , Provider Contractor, Provider Relations Consultant, Fee schedule loads, analyst, health insurance claims, provider relations
Medical & Health Services Manager - 18 Years of Experience - Near 34601
My reputation is as a multifaceted, resourceful, and decisive senior level professional with comprehensive experience in development of strategic business solutions to streamline operational effectiveness, cut costs, enhance quality, compliance, productivity, and in-crease profitability. Goal-driven, adaptable and critical-thinking project manager with demonstrated success in implementation of process improvements and chang...
Tags for this Online Resume: government managed care, telecommute, complance, HealthCare Management, provider contracting, vendor oversight, account management
Certified Senior Project / Program ManagerProgrammer - 20 Years of Experience - Near 75067
PMP® certified professional with an advanced IT technical background in managing diverse global projects for infrastructure support, service management, system design, component integration, transition / transformation, automation & service delivery. Expertise in managing fully integrated, global, cross-functional teams to provide contract service offerings & value-add transformation to clients. Highly motivated, hands-on ...
Tags for this Online Resume: Project / Program / Portfolio management, t | Solution architecture | IT outsourcing | Service Management | Transition / Transformation Management | Automation | Service Delivery | Risk Management | Problem Resolution
Sales Manager - 12 Years of Experience - Near 39047
I have succeeded in sales, sales management, provider contracting and provider contracting management.
Tags for this Online Resume: Jackson, MS, Provider Contracting, Management, Sales Management, Pharmaceutical Sales management, Customer Service Manager, Training and Development, Pricing, Sales, Benefits, Coding, Inventory, Local Area Network, Medical, Medical Terminology
Business Consultant, Benefit/Provider/Claims Configuration, Business Analyst
Twenty plus years in healthcare management and staff support roles in handling medical, claims encounter and dental claims processing, claims auditing, user acceptance testing, EMS billing, AAPC, DRG coding reimbursement, and configuration of various healthcare payers/providers for Medicare, Medicaid, TPA, and Commercial Managed Care products. Strong understanding of healthcare business operations, with a focus on configur...
Tags for this Online Resume: Telecommute, Benefit Configuration, Provider Confguration, SQL queries, User Acceptance Tester, 837p/837I XML/X12, Clearquest
Construction Trade Worker Manager - 18 Years of Experience - Near 95841
Provide clients in property purchase options with professional inspections repair/code violation and cost evaluations. Provide Contract reviews trades management tax liability and post work Final inspections. Manage schedule manpower and supply needed materials for 30+ separate disaster related projects running simultaneously. Adhere to budget/time schedules. Responsible for all trades selection conflict resolutions documen...
Tags for this Online Resume: Accounting, Accounts Payable/Receivable, Applications, Certificate Authority, Communication Skills, Documentation, Financial, Management
VP of Supply Chain/Operations-- Specializing in Transformations -- near Cincinnati, OH
Senior executive with 20+ years of diverse professional experience and ongoing formalized training that culminates in an expansive understanding of tactical and strategic operational and support functions. Especially effective when the business situation requires: -- Challenges to and replacements of existing paradigms and approaches to operational excellence. -- Broad multifunctional alignment up, down and across the organ...
Ideal Companies: Kroger; Coca-Cola; Mercy Health
Tags for this Online Resume: Manufacturing, Supply Chain, Operational Excellence, Procurement, Change Management, Human Resources, Continuous Improvement, Profit/Loss Management
Manager of Cost Control
High energy, self-starting, results-oriented Project Controls Professional with 40 years experience in petrochemical, pharmaceutical, commercial, industrial and R and D projects, from preconstruction through start-up and validation in the US and overseas. It is my goal to use my background and experience as a Manager of Project Controls, Manager of Cost Control, or a Project Controls Manager.
Ideal Companies: Flour, Worley Parsons, Foster Wheeler, KBR, CB&I, ExxonMobil, Shell, Chevron, Bechtel, Bayer
Tags for this Online Resume: Earned Value, Cost Control, PMI, AACE, Primavera
Network Installer - 1 month of Experience - Near 13206
Skill Summary: * 1-month contracted experience in installation/infrastructure, logistics of POS systems, component/ device replacement of POS systems - Debit card readers and bases * Experienced in basic computer hardware assembly * Skilled in Microsoft Word and PowerPoint * Versed in Microsoft Access * Knowledgeable in Point of Sales systems (POS) * Familiar with network configuration, active directory and TCP/IP * Acquain...
Tags for this Online Resume: Transportation, Documentation, Support, Active Directory, Adobe, Adobe Photoshop, Configure, Conversant (At And T)
