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Online Resumes with "utilization management "
Database Administrator - 20 Years of Experience - Near 07721
PROFILE A motivated and results driven department operations professional with eLearning and LMS systems expertise. Extensive experience in the training and development environment. Key contact for developing corporate training materials, learning content, and assessments. Proven ability to understand business requirements with a technology focus. Experienced in contract negotiations, vendor management, employee development...
Tags for this Online Resume: Training, Corporate Training, Data Management, Intranet, Management, Pharmaceutical Industry, Human Resources, Assessments, Sales, Sales Training, LMS Administrator
Pharmacist - 20 Years of Experience - Near 21042
and A Fortune 18 ranking firm with $98B in sales for 2010 with 215k employees in 44 states offering fully integrated pharmacy healthcare services and products. (PBM operations) Virginia
Tags for this Online Resume: Consumer Products, Sales, Management, Account Management, Consulting, Drug Information, Drug Utilization, Therapy, Utilization Management, Long Term Care, pharmacist
Manager - 15 Years of Experience - USA & Saudi Arabia
ACCOMPLISHMENTS Oil & Gas Leadership Saudi Arabia & Middle Eastern Region * Served as Service Coordinator and Lead to roll out Area Resource Manager Project, working cross-functionally with global team to define financial contract service, financial tracking, asset management, and quality standards. * Worked globally to establish new assets, increase jobs and revenue, close service quality gaps, and roll out correction plan...
Ideal Companies: Oil & Gas industry, Construction earth moving, Rock crushing, Industry Ranching cattle registered, breeding, feedlot industry
Tags for this Online Resume: Accounting, Asset Management, Budgeting, Financial, Financial Oversight, Financials, Supervisor, Operation manager, Oil & Gas Manager, Construction Manager, Ranch Manager, Feedlot Manager, Reproduction Manager Angus Registered heard, Owner operator of Ranch & Feedlot, Owner Operator Earth moving & Rock crushing, Quality Assurance Manager, management, assistant manager, manager, Oil & Gas Asset Manager
Medical or Health Services Manager - 17 Years of Experience - Near 60090
and Highlights
Tags for this Online Resume: healthcare compliance, quality management, medical management, utilization review, utilization management, performance improvement, strategy, leadership, management, false claims act, anti-kickback statute, accreditation, licensure, gap analysis, risk assessment, risk management, remediation, project management, public speaking, operations, clinical operations, managed care, Medicare, Medicare Advantage, Medicaid, Managed Medicaid, Payor, Communication
Registered Nurse - 20 Years of Experience - Near 40515
Summary 10 years experience with a Health Insurance Plan in Utilization Management and current role as Clinical Financial Analyst and Appeals Nurse Specialist for a Medicare Advantage Plan.
Tags for this Online Resume: Managed Care, Cms, Medicare, Patient Care, Reinsurance, Utilization Management, registered nurse, utilization review nurs, Claims Review Nurse
Licensed Nurse - 20 Years of Experience - Near 34788
QUALIFICATIONS PROFILE Compassionate, patient-focused, and results-driven professional with extensive experience in offering top-quality care and healthcare services, administering medications, as well as processing client's benefits . Adept at providing pertinent information regarding insurance policies, disease state management, and medication protocol issues. Equipped with time management aptitude to keenly organize work...
Tags for this Online Resume: Management, Utilization Management, HIV, Home Care, LPN, Medicare, PEDIATRIC, Transportation, Benefits, Utilization management
Chief Executive Officer
Globally recognized resourceful and dynamic senior professional with established credibility and demonstrated ability. Possess diverse skill sets and have a multi-segment experience in the energy petrochemical large utility LNG IT and Infocom sectors. Global experience with World Class energy and engineering companies public utilities and IT/Technology companies. Achieved notable success in strategic management & planning r...
Tags for this Online Resume: Total (Db For Lg Comptrs), Applications, Audit, Business Development, Business Plan, Business Process Management, Business Process Re-engineering, Compaq, Contract Negotiations, Dell
Quality Coordinator - 10 Years of Experience - Near 91343
Exceptional Attention to Detail
Tags for this Online Resume: Audit, Cms, Documentation, Management, Support, Technical Support, Utilization Management, Inventory, Medical, Medical Records, Analyst, Regulatory Standards, Analytical, Medical Terminology
Registered Nurse - 20 Years of Experience - Near 65262
SUMMARY: RN with 20 plus years of experience in case, disease and utilization management, medical record review, claims processing, quality, appeals and grievances. Successful contract and care management platform and program implementations. Vast knowledge and experience of complex disease management. Able to manage large member caseloads and prioritize large volume of member activities. Great communicator when presenting ...
Tags for this Online Resume: Business Requirements, Data Analysis, Product Design, Services, Assessments, Billing, Computer Aided Software Engineering, Management, Medical, Medical Records, registered nurse, healthcare, care, rn, nurse, care manager, case manager, quality, utilization management, management, appeals, claims
Case Manager - 11 Years of Experience - Near 37027
Desire a position in the Medical Community, which promotes the well-being of others.
Tags for this Online Resume: Management, Home Health, Inpatient Rehabilitation, Long Term Care, Nursing, Rehabilitation, Surgical, Utilization Management, Assessments, healthcare, outpatient rehabilitation, social work, inpatient, care manager
Licensed Nurse - 20 Years of Experience - Near 37681
Professional Summary: I am a Registered Nurse with extensive supervisory, Case Management and Utilization Review experience within hospital, home health and a senior living facility. I am experienced with preparing for JCAHO accreditations and state surveys, as well as experienced as Director of Case Management. I am accustomed to the integration of new healthcare delivery systems and restructuring of work in an increasingl...
Tags for this Online Resume: Case Management, Health and Wellness Director, Compliance Officer, Compliance, Management, Utilization Management, Assessments, Medical, Medical Records, Scheduling, Home Health
Quality Coordinator
To obtain a position where I can build a career and utilize my skills while providing a benefit to my employer.
Tags for this Online Resume: Riverside, Referrals, Data Entry, Utilization management, Phone's, Dofers, Complaints, Filing, Health Insurance, Insurance
