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Online Resumes with "utilization review"



Case Manager - 19 Years of Experience - Near 07110

SUMMARY OF QUALIFICATIONS: Nursing professional with diversified clinical and leadership background in case management, utilization review and discharge planning independent consultant as a Health and Wellness Advisor. * Experience with acute / critical care settings, insurance companies, skilled nursing and assisted living facilities. * Proven record in obtaining high quality outcomes, reduction in length of stay and cost-...

Tags for this Online Resume: Management, Referrals, CCU, registered nurse, healthcare

Physician - 19 Years of Experience - Near 12953

Hi, I'm an orthopedic surgeon disabled from surgery. I'm looking for a telemedicine position, peer reviewer or utilization reviewer, NY licensed.

Tags for this Online Resume: C Programming Language, Medical, Medical License, telemedicine physician peer reviewer, Telemedicine Physician peer reviewer orthopedic sports medicine, Telemedicine physician peer reviewer Office orthopedics, Telemedicine physician, Peer reviewer, Utilization reviewer, Office Orthopedics, Telemedicine MD, Utilization reviewer MD, Peer reviewer MD

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

A position as a Registered Nurse in a Health Care facility where I can make the most of my Nursing education, training, and leadership abilities, in addition to my interpersonal skills to provide the highest level of patient care and satisfaction. Orchard Gardens: Wichita, KS. 04-2017 - Current Skilled/Long Term Care Director of Nursing Oversee entire operations of the nursing department daily, including addressing issues r...

Tags for this Online Resume: Telemetry, registered nurse, nurse, healthcare

Registered Nurse - 7 Years of Experience - Near 01845

Utilization Review Nurse/Case Manager

Tags for this Online Resume: Assessments, Management, Pain Management, DRESSING CHANGES, Medication Administration, Scheduling, Triage, Home Care, Microsoft Windows NT, Referrals

Case Manager - 20 Years of Experience - Near 30189

To Utilize My Knowledge and Experience to provide for safe hospital discharges that maximize proper continued care designed to minimize hospital return admissions.

Tags for this Online Resume: Telemetry, Automotive, Medication Administration, Computer Aided Software Engineering, physical therapist, physical therapy, registered nurse, nurse, case manager, discharge planner, utilization review, healthcare

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 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

Case Manager - 12 Years of Experience - Near 30040

SUMMARY EXPERIENCE Significant experience in nursing: Critical Care, Nursing management Case Management, ongoing Utilization Review with Medicare and Medicaid experience. Strong administrative and communication skills. Team Lead DME/Radiology prior authorization. Responsible for PA reviews and appropriate Turn around Times for the following areas: DME, Radiology, HOTS, Meds, Office visits, Emergency and non-Emergency transp...

Tags for this Online Resume: Radiology, Computer Aided Software Engineering, Medical, Obstetrics, registered nurse

Registered Nurse - 20 Years of Experience - Near 81212

Professional Summary Experienced Registered Nurse licensed in Colorado with strong clinical and people skills. Professionally trained with experience ensuring high standards of culturally competent care for wide variety of patients with diverse needs. Registered Nurse with 27 years experience in clinical settings providing nursing care to diverse populations. Responsible Registered Nurse with excellent communication skills ...

Tags for this Online Resume: Management, Assessments, Documentation, Medical, Patient Care, IV Therapy, Long Term Care, Nursing, registered nurse

Quality Assurance Director

SUMMARY OF QUALIFICATIONS Over 39 years' experience in broad range of clinical, administrative, and quality and risk management experience . Longtime health care professional with in-depth, versatile experience establishing and managing programs such as risk management, performance improvement, education, infection control, utilization review and case management. Contract work with Indian health of Oklahoma 2014-2016 CLNC O...

Tags for this Online Resume: Infection control, Management, Quality, Quality Assurance, Risk Management, Complaints, Customer Service, Quality Management, Surgical, Surveys

Registered Nurse - 20 Years of Experience - Near 34654

Qualifications: Strong work ethic, reliable, trustworthy, good communicator, caring, conscientious, thorough, high accountability, Licensed in Florida & Louisiana

Ideal Companies: Blue Cross Blu Shield, United Healthcare, Humana

Tags for this Online Resume: Benefits, Insurance, Medicare, Orthopedics, Rehabilitation, Home Health, Acute Rehabilitation, registered nurse, healthcare, outpatient rehabilitation, Care management, utilization review, New Port Richey, FL