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Online Resumes with "utilization review "



Registered Nurse - 20 Years of Experience - Near 81212

I would like to expand my career into the utilization management for the US military, Tri-care entitlement program.

Tags for this Online Resume: Patient Care, Documentation, PEDIATRIC, Long Term Care, Assessments, ICU, Management, Medication Administration, registered nurse, utilization review specialist

Registered Nurse - 20 Years of Experience - Near 63021/

Summary * Thirty years of nursing experience * Currently a member of the Vascular Access Team at St. Louis Children's Hospital Robyn Masucci, RN 1583 Buckhurst Court Ballwin, MO 63021 September 11, 2017 To whom it may concern, I am submitting my resume in application for the recently advertised Infusion Therapy position at your company. I believe that my training and experience closely match your requirements and my addi...

Tags for this Online Resume: Surgical, Triage, NICU, Nursing, Patient Care, CENTRAL LINES, Consulting, Critical Care - Vascular, DRESSING CHANGES, registered nurse, infusion RN, utilization review

Claims Adjuster - 20 Years of Experience - Near 89144

Summary During my 23 years at State Farm, I have experience in the following areas: company claim policies and procedures, company underwriting standards, medical and anatomical terminology, injury claims investigation, automobile estimates, auto damage claim policy, insurance contracts and endorsements and the law with regards to insurance claims handling. As a bodily injury claim representative, I have the ability to addr...

Tags for this Online Resume: Arbitration, Estimations, Insurance, Insurance Claims, Medical, Policies and Procedures, Underwriting, insurance

Case Manager - 10 Years of Experience - Denver

Nine years experience in patient care, healthcare service, and administration. Four years of experience in utilization review, supervision, employee training, and program management. Knowledgeable in healthcare, employee benefits, and managed care practices.

Tags for this Online Resume: Benefits, Documentation, Managed Care, Management, Assessments, Health Insurance, Insurance, Patient Care, Account Management, Audit, Quality Assurance, Compliance

Case Management Manager - 20 Years of Experience - Near 85383

Outpatient Clinics and Ambulatory Specialist/Quality and Compliance Specialist/Practice Management/Ambulatory Management/Rural Health Clinic Administrator/Director/Nurse Management/Case Management/Quality Assurance/Utilization Review/ Health Educator/Project Management and Pharmaceutical/Medical Sales RN. I am seeking a challenging Director, Administrator, or Managerial position that will allow me to utilize my scholastic b...

Tags for this Online Resume: Assessments, Dialysis, Home Health, Management, Medical, Medical Terminology, Project Management, registered nurse, healthcare, nurse, rn

Registered Nurse - 20 Years of Experience - Near 85298

Communicated Provided direct nursing care on evening shift on 12-bed adolescent and child in-patient psychiatric unit. Offered day shift position. with insurance companies obtaining admission and continued stay authorizations. Collaborated with internal departments regarding payer relations denials and completed quality assurance audits on medical staff. Supervised utilization review RN case managers. (6 months). Assisted i...

Tags for this Online Resume: Infection control, Management, Quality, Quality Assurance, Quality Control, Assessments, Dialysis, Outpatient Rehabilitation, Phlebotomy, Physical Therapy

Admissions Director - 15 Years of Experience - Near 30031

PROFESSIONAL SUMMARY Experienced Registered Nurse in with strong clinical and people skills. A professional advanced practice nurse with experience ensuring high standards of culturally competent care for a wide variety of patients with diverse needs. Over 10 Years of basic screening, diagnostic treatment and rehabilitative and supportive services as a member of a primary health care team. Responsible Registered Nurse with ...

Tags for this Online Resume: Patient Care, Wound Care, Managed Care, Management, People Skills

registered nurse- 27 years experience. Case manager 10 years

PROFESSIONAL SUMMARY: I am a dedicated Registered Nurse with 25 years of experience ranging from Case/Care Management, Utilization Review, Disease Management, Telephonic Nursing and Coronary ICU. I have a strong commitment to providing quality nursing care while maintaining strong organizational skills. I can work closely with multidisciplinary teams which ensure appropriateness of care and medical necessity. Last but not l...

Tags for this Online Resume: Management, Computer Aided Software Engineering, Referrals, ACLS, Automobile Claim Law Specialist, BLS, physical therapist, registered nurse

Registered Nurse - 20 Years of Experience - Near 95670

Career Summary: Over 20 years of experience in Acute Care and Health Service programs including Utilization Review, Provider Dispute Resolution, Quality Management, Inpatient and Ambulatory Case Management, and Grievance and Appeals in a managed care environment for both Health Plan and IPA/MSO settings using evidence based nationally recognized criteria such as ACOG, NCCN, MCG, InterQual and Health Plan Medical guidelines ...

Tags for this Online Resume: Compliance, Management, Quality Management, Assessments, Medical, Medicare, registered nurse, healthcare, Managed Care, Utilization Management

Registered Nurse - 10 Years of Experience - Near 97008

A case management/utilization review position utilizing my nursing and biology degrees, as well as extensive and varied experience in health care, health education and research.

Tags for this Online Resume: Computer Aided Software Engineering, Documentation, Therapy, Home Health, Medical, Medical/Surgical, Nursing, Rehabilitation, Surgical, Surgical Care

Case Management Manager - 15 Years of Experience - Near 48442

PROFESSIONAL SUMMARY Responsible Registered Nurse with excellent communication skills demonstrated by 20+ years of experience in healthcare. Nurse Case Manager with valid State RN License. Solid clinical, utilization review and case management experience within a managed care environment. Professionally trained RN with experience ensuring high standards of culturally competent care for wide variety of patients with diverse ...

Tags for this Online Resume: Assessments, Patient Care, Wound Care, Marketing Management, Network Attach Storage, Computer Aided Software Engineering, Quality, Quality Assurance, Quality Control, Referrals

Registered Nurse - 20 Years of Experience - Near 53070

Case Management Utilization Review Nurse

Tags for this Online Resume: Management, Child Care, Home Health, Referrals, ACLS, Angioplasty, Automobile Claim Law Specialist, Cardiac Cath, Critical Care, Nursing, registered nurse, nurse, case manager, utilization review