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Online Resumes with "utilization review "



Director

PROFESSIONAL SUMMARY Six Sigma lean certified Black Belt Operations Manager with over 10+years of operations managerial experience combined with healthcare management experience. Management experience is inclusive of managing internal customer service department and external service providers. Experience making recommendations, great judgment, negotiating, and managing COGS, (cost of goods sold), that positively impact busi...

Tags for this Online Resume: Payroll, Services, CFO, Transportation, Medical, Policies and Procedures, Health Care Industry, Management, Accounts Receivable, Black belt

Case Management Manager - 17 Years of Experience - Nationwide

Co-visits with developing Policy and Procedure Manual to promote the company's Case Management Certification. Assisting in developing the company's Training Manual. Transferred to Utilization Review as per company need at that time: Evaluating physician requested treatment and documentation of outcome per medical guidelines. Fast paced work environment requiring quick thought process and diplomatic communication with all pa...

Tags for this Online Resume: Nursing, Documentation, Quality Assurance, Test, Management, Applications, Critical Care, Evaluate, Insurance, rn

Respiratory Therapist - 20 Years of Experience - Near 33306

My objective is to utilize my extensive real estate knowledge, active communication skills in practicum with goal setting and team building skills to buy residential and/or commercial properties while improving neighborhoods one transaction at a time. Ethical strategies, transparent contractual agreements equaling satisfactory outcomes for all parties involved. Current Experience Sept. 2009 - Current Fundamental Concepts, L...

Tags for this Online Resume: Respiratory Therapy, Therapy, Critical Care - Respiratory, Financial Industry, Packaging, Real Estate, Underwriting, Wholesale, Intensive Care, PEDIATRIC

Registered Nurse - 18 Years of Experience - Near 33309

PROFILE: Multilingual professional (Spanish, Portuguese, Italian) with over twenty five years of experience in healthcare including administration, case management, education, and clinical practice. Doctor of Medicine specialized in Clinical-Surgical Oncology, Radiobiology, and Pathology, Licensed Registered Nurse with a Master in Nursing and Healthcare Education degree with extensive experience in Psych Care, Disability is...

Tags for this Online Resume: Management, Radiology, Documentation, Policies and Procedures, Cms, Computer Aided Software Engineering, Phlebotomy, Security, Nursing, Quality

Registered Nurse - 20 Years of Experience

Professional Summary: Donna Lowe, RN CCM brings 20+ years of clinical experience with 11 years in direct Case Management in an acute care setting. She has 10 years experience with Discharge Planning and Complex Care Management with a successful record of decreasing the overall acute care length of stay. Donna has substantial experience in coordination of resources across the hospital from the ICU, ER, Neuro, Cardiac, Ortho,...

Tags for this Online Resume: Case Manager, Certified RN Case Manager, Detailed Medical Record Review, registered nurse, CCM, Workers Compensation, Local travel, Legal, Medicare, Patient Care

Utilization review

Part time utilization medical review or immunization clinic

Tags for this Online Resume: Medical, Medical/Surgical, nurse, healthcare, rn, Compensation, Computer Aided Software Engineering

Mental Health Care Manager

To work in the mental health/substance abuse field as a care manager, counselor or utilization review.

Registered Nurse - 9 Years of Experience - Near 54940

Professional Summary Director of Nursing Administration with valid Wisconsin RN License. Extensive experience with geriatric population and all levels of acuity. Patient centered approach to care. Solid clinical, utilization review and case management experience within a managed care environment.

Tags for this Online Resume: Infection control, Management, Medical, Medical Records, Scheduling, Patient Care, Wound Care, Nursing, Acute Care, Computer Aided Software Engineering

Registered Nurse - 20 Years of Experience - Near 37040

SUMMARY OF QUALIFICATIONS Nurse with 40+ years' experience in training and coaching employees, peers, and superiors and quality assurance and medical record reviews experience resulting in outstanding results. * Active RN licensure in all compact and non-compact states * Experienced in medical record review, clinical data/chart review and quality improvement Experience with utilization review, review criteria development an...

Tags for this Online Resume: Reviews, Nursing, Managed Care, Phone Triage, Planning, Support, Long Term Care, LPN, Medicare, Ophthalmology

Pharmacist - 0 Years of Experience

SUMMARY * Licensed Pharmacist (Colorado) since July 2017 but not a typical entry-level candidate! * Well-rounded intern pharmacist experience and education: * Experience in retail, clinical, MTM and compound pharmacy settings ADDITIONAL QUALIFICATIONS * Retail experience (12 years) * IM/SC parenteral vaccinations IV admixture preparation Manual BP checks * MTM services Drug Utilization Reviews Medication reconciliation * Ph...

Tags for this Online Resume: BLS, Cardiopulmonary resuscitation (CPR), Drug Information, Drug Utilization, Electrical Engineering, Engineering, Health Care Industry, IEEE, Immunization, Instant Messaging

Mental Health Therapist - 15 Years of Experience - Near 10573

Qualifications Profile Highly committed and compassionate healthcare professional with comprehensive years of experience in clinical management, encompassing implementation all healthcare support services and treatment plans across inpatient and outpatient settings. Recognized for proven expertise in facilitating counseling sessions with specialization in suicide prevention and substance abuse co-occurring conditions. Equip...

Tags for this Online Resume: Support, Trauma, Assessments, Management, Discharge Planning, Patient Assessment, Planning, Services, Therapy, Audit

Featured Profile

Healthcare Operations| Regulatory, Compliance and Quality Subject Matter Expert| Healthcare Risk Mitigation|Policy Strategy Leader

Accomplished and articulate professional with over 15 years of experience, driving sustainable healthcare regulatory and compliance outcomes for varied providers. A proactive quality devotee and legislative clinical practice leader, regulation understanding enable healthcare providers to establish valued national measures for Best Practice productivity. Financial stewardship experience has proven essential to shareholders,...

Ideal Companies: American Hospital Association, Healthcare Association of New York State, American Nurses Association, Western New York Healthcare Association, Johnson and Johnson, Roswell Park Cancer Institute, Bayer, Johns Hopkins Health Care System, New York State Nurses Association, Molina, Vanderbilt University Medical Center, Cleveland Eye Clinic, Cleveland Clinic, St. Jude, Shriners Children's Hospitals

Tags for this Online Resume: Risk Mitigation, Regulatory Affairs, Public Health Policy, Subject Matter Expert: Hospital, Ambulatory Surgical Center, ESRD, Hospice, Competency Coach, EMR Super User Multiple Software, Compliance