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Online Resumes with "utilization review "



Case Manager - 20 Years of Experience - Near 80208

looking to relocate to Denver, Co. Wish to find dynamic and rewarding position in case management or other track. Would like to work a maximum 4 day/week while finishing up MSN.

Tags for this Online Resume: nurse director, critical care, continuing care, utilization review, admission nurse, orthopedic/spine

Case Manager

PROFILE: RN with experience in adult, geriatric and pediatric populations within emergency, acute, chronic and managed care Settings. Proficient in Telephonic Triage skilled Disease Management Coach. Seeking part time clinic or facility opportunity. * Telephone Triage * Utilization Review * Case Management * Medical Surgical * Emergency & Urgent Care * Family Practice * Long Term Care * Scheduling * Electronic Medical Recor...

Tags for this Online Resume: CLINIC, Phone Triage, Management, PEDIATRIC, CASE MANAGEMENT, Disease Management, Family Practice, UTILIZATION REVIEW, Intensive Care, URGENT CARE, SMALL ER, PATIENT EDUCATION

Licensed Nurse - 20 Years of Experience - Near 32409

Summary of Qualifications and skills * Participatory Management Style * Experienced in Due Diligence Investigations * Experienced in CQI Processes/OBQI * Program, Policy and Procedure Development * Automated Clinical System Implementation * Medical Record Documentation Review * Preparation/Presentation of Education Programs * Medicare and Medicaid Regulations * Utilization Review, Billing and Compliance Audit * JCAHO/CHAP R...

Tags for this Online Resume: Medical, Services, Clinical Management, Clinical Programs, Compliance, Home Health, Management, Data Analysis, Medicare, Patient Care

Pharmacist - 13 Years of Experience - Near 33785

SUMMARY: * Active Florida Pharmacist License #53616 * Highly knowledgeable with experience in prior authorization, hospital, retail and long-term care pharmacy. * Adept at all aspects of daily management and inventory * Strong decision-making ability * Efficient and accurate * Skilled in clinical interventions * Strong clinical background * Drug utilization review * Inventory management * Expert understanding of Medicare an...

Tags for this Online Resume: Management, Triage, Nephrology, Cardiovascular, Data Management, Research, Sales, Sales Training, Training, Clinical Research

Case Manager - 20 Years of Experience - Near 60457

To obtain position in Utilization Review /Case Management which will incorporate my interest and education and will also utilize my extensive experience in healthcare.

Tags for this Online Resume: Assessments, Bookkeeper, Management, Nursing, Payroll, Phone Triage, Quick Books, Quickbooks, Triage

Registered Nurse

Professional Summary Nurse Case Manager with valid State RN License. Solid clinical, utilization review and case management experience within a managed care environment.I am a dedicated registered nurse (RN) with specialty experience in varied skills since November, 1969. In these forty-seven years, I have held staff, supervisory and management positions for inpatient and home health duties. My focus has always been the qua...

Tags for this Online Resume: Compliance, Health Insurance Portability And Accountability Act, HIPAA compliance, Medical, Cancer, Infection control, Management, Cardiopulmonary resuscitation (CPR), Data Entry, Evaluate, self starter

Mental Health Therapist - 19 Years of Experience - Near 92804

Career Summary: * Licensed Marriage Family Therapist and Certified Addiction Specialist/ EMDR trained * 18 years of experience and training holding positions in all levels of Co-occurring Disorder's Treatment. * Lead Therapist, Director, Admissions Coordinator, Counselor/ Case Manager, Support Staff, Outreach. * Supervising and training staff for over 16 years. Long history working with women's issues/ domestic violence tra...

Tags for this Online Resume: Training, Discharge Planning, Documentation

Licensed Nurse - 17 Years of Experience - Near 33705

Summary of Qualifications: Over 17 years' of working experiences in a wide variety of clinical and administrative settings providing nursing care in Case Management, Utilization Review, Gerontological nursing, Cardiac care, Medical & Surgical units, Chronic & Infectious diseases, Public Health, Psychiatric nursing, Hospitals, Hiv clinics, LTC, Assisted living, Home health care, Biologic infusions & Marketing. * Excellent Le...

Tags for this Online Resume: Amazon Elastic MapReduce, EMR/, HIV Clinics, Home Health/ Public Health, Immunization, Wound Care/Wound Vac, Behavioral Health, Cardiopulmonary resuscitation (CPR), Chronic Diseases, CENTRAL LINES, Case Management, Utilization Review

Case Management Manager

Tags for this Online Resume: New Jersey, Case manager, utilization review, Milliman, Interqual

Registered Nurse - 14 Years of Experience - Near 40065

PROFESSIONAL SUMMARY I am a Registered Nurse with 15+ years experience in disease management, medication management and caring for patients as well as their families or caregivers. I am extremely passionate about taking care of patients and their needs.

Tags for this Online Resume: Case Management, Disease Management, Medication Management, Utilization Review, Utilization Management, RN, Management, Patient Care, Microsoft Word, Microsoft Excel, Microsoft Outlook

Case Management Manager - 3 Years of Experience - Near 33321

AREAS OF EXPERTISE Mental and Substance Abuse Utilization Review Specialist * Over 2 years' experience as an Utilization Review Specialist knowledge in counseling clients in individual or group sessions to assist them in dealing with substance abuse, mental or physical illness, poverty, unemployment, or physical abuse. * Interviewed clients, review records, conduct assessments, or confer with other professionals to evaluate...

Tags for this Online Resume: Behavioral Health, Patient Care, SAFE (Slab Analysis by the Finite Element Method), Assessments, Attention to Detail, Compliance, Computer Aided Software Engineering, Evaluate, Inventory, Lotus Notes

Case Management Manager - 15 Years of Experience - Near 20603

PROFESSIONAL SUMMARY A successful, highly effective healthcare leader with over 20 years of clinical, and administrative hospital leadership experience. Innovative, and progressive facilitator of successful change through interpersonal, analytical, and team problem solving. Highly skilled, professional, multi-medium communicator. AREAS OF EXPERTISE * Able to successfully lead, train, and organize multiple specialties/discip...

Tags for this Online Resume: Cardiovascular, Nursing, Computer Aided Software Engineering, Management, Emergency Room, ER, Integrate, Medical, ACLS, Automobile Claim Law Specialist, Washington DC,MD, VA