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Online Resumes with "utilization review "



Case Manager - 6 Years of Experience - Near 10031

Accomplishments are: - Ongoing training in Inpatient Utilization Procedures to audit and review medical records - Conduct on-site/off site review of medical records for quality of care and utilization. - Review process including DRG validation and Interqual criteria approval. - Utilized review criteria with the use of InterQual, 3M coding book and grouper, SIMS Plus. - Increased knowledge base on medical comorbidities in ad...

Tags for this Online Resume: Infrastructure, Support, Technical Support, Services, Public Health, Reviews, Quality, Acquired Immune Deficiency Syndrome (AIDS), physical therapist

Registered Nurse - 20 Years of Experience - Near 11735

QUALIFICATIONS HIGHLIGHTS: * Motivated, responsible professional committed to the highest standard of care to all patients. * The ability to handle many tasks at once in a fast-paced environment. * Strong commitment in coordinating patient care with members of a Multi-Interdisciplinary Treatment Team. * Utilizes the nursing process of assessment, diagnosis, implementation and evaluation for optimum patient outcomes. * Exper...

Tags for this Online Resume: First Aid, Assessments, Behavioral Health, Documentation, HIV, HYGIENE, Insurance, Medical, Medical Records

Registered Nurse - 20 Years of Experience - Near 92405

Profile: Currently 29+ years work experience as a Registered Nurse in many specialties to include: In-patient Case Management Insurance Care Coordinator State Compensation Concurrent Review Nurse, Utilization Review Nurse, Air Force Urgent Care Flight Nurse Officer, Staff Nurse/ Rehabilitation Charge Nurse, Medical Surgical Nursing, Step down ICU, and Psychiatric RN.

Tags for this Online Resume: Nursing, Imaging, Management, Pain Management, Rehabilitation, Patient Care, Compensation, Insurance, Transportation, Workers Compensation, rn case manager

Registered Nurse Case Manager

Work in the health care fied, insurance, managed care, hospital setting, home health care, etc.

Tags for this Online Resume: Case Manager, Staff Nurse, Utilization Review, Discharge Planner, Insurance Nurse

Case Manager - 4 Years of Experience - Near 92395

Qualifications My prior experience has provided me with skills such as time management, excellent public relations, problem solving, organizational and written and oral communication skills which have enabled me to handle multiple tasks simultaneously. I am able to handle complex situations effectively and efficiently.

Tags for this Online Resume: Medical, nurse, LVN, Case Manager, Utilization Review, Assistant Director of Nurses, Time Management, Integrity, Outgoing, Friendly, Resource for nurses and cna's

Insurance Sales Representative

Utilization Review Specialist

Tags for this Online Resume: Insurance, Leadership, Negotiation Skills, Support, Teamwork, Training

Licensed Nurse - 16 Years of Experience - Near 06076

PROFESSIONAL SUMMARY Nurse Case Manager with valid State LPN Licenses. Solid clinical, utilization review and case management experience within a managed care environment. Looking to secure a position within an organization that will challenge my diverse clinical experience as well as proven leadership, business, communication, and nursing skills. CORE QUALIFICATIONS Case Management

Tags for this Online Resume: Nursing, Computer Aided Software Engineering, Patient Care, Assessments, Medical, Quality, Rehabilitation, Business Plan, Compensation, Compliance

Case Manager - 10 Years of Experience - Near 89122

I have been a nurse since 1993. I love the variety of healthcare settings and the levels of patient care I have experienced. It is my goal at this time to engage in a career move that allows me to utilize my vast nursing experience and education and offer room for advancement and continued intellectual enhancement. My varied nursing experiences and formal education advancement allow me to bring a wealth of knowledge to any ...

Tags for this Online Resume: Microsoft, Microsoft Office, Nursing, Cardiovascular, Cms, Registered nurse, Utilization review, Case management, Life insurance, Public speaker, Educator, Writer, Nurse educator

Medical & Health Services Manager - 20 Years of Experience - Near 33437

Profile Sales Team Development Quality Control New Venture Start-Ups Process Systems/Controls Utilization Review Executive Management HMO & ACHA Compliance Provider Relations Account Management Operations Management Business Expansion Centers of Excellence

Tags for this Online Resume: Dos, ICD-9, Microsoft DOS, Statistics, Management, Assessments, Microsoft, Microsoft Office, Microsoft Outlook, Microsoft PowerPoint, management, PRACTICE MEDICAL MANAGEMENT AND CONSULTANT

Registered Nurse

Qualifications I have worked with a variety of stakeholders to bring patient safety, quality, nursing leadership and person-centered care concepts to hospitals, nursing facilities, home health agencies and hospice providers. I am a strong advocate for patients and clinical excellence. I have experience in a variety of care settings, including Long Term Care, Home Health, and Acute Care settings, consisting of Medical/Surgic...

Tags for this Online Resume: Consulting, Medical, Medicare, Services, Acute Care, Data Analysis, Home Health, Integrate, Leadership, Networking, rn, nurse, registered nurse, healthcare

Case Manager -10 Years of Experience - Near 92563

PROFESSIONAL SUMMARY Authorized to work in the US for any employer . Nurse Case Manager with over 10+ years solid, clinical, utilization review, and case management experience within a healthcare environment. Effective LVN who adapts easily to changing environments and demands. High-performing LVN with over 20 years of healthcare experience in hospital and other environments. Experienced with various medical conditions incl...

Tags for this Online Resume: LVN Case Manager, Utilization Review, Billing, Computer Aided Software Engineering, Medical, Urgent Care, VITAL SIGNS, Management, Nursing, Services

Pharmacy Manager with great communication and sales experience

Strong healthcare services professional with a Bachelor's degree in Pharmacy from University of Louisiana at Monroe. Skilled in data entry and verification, MTM, patient counseling, drug utilization review, side effect management, and proper dosing from prescribers. Experienced Store Manager with a demonstrated history of working in the pharmaceuticals industry. Skilled in Pharmacy Benefit Management, Team Building, Reta...

Tags for this Online Resume: Management, Order Entry, Travel, pharmacist, Long Term Care, Services, Communication Skills, Health Care Industry, Microsoft Excel, Microsoft PowerPoint