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Online Resumes with "Inter Qual"

Featured Profile

Healthcare Management Professional

I am looking for a position within the healthcare field where I can continue to expand my skills while making solid contributions. I offer over 15 years of progressive healthcare experience beginning with nursing and direct patient care continuing into roles including Hospice Team Manager and Admission Nurse, Branch Director for a proprietary home care agency, marketing/nurse liaison for a rehabilitation hospital. to each...

Ideal Companies: Humana, Blue Cross Florida, United Health Care, Daiichi Sankyo Inc., Metronics

Tags for this Online Resume: Registered Nurse, Hospice, Rehabilitation, Healthcare Sales and Marketing, Physician and Community Relations, Discharge Planning, Program Management, Business Development, Volume Expansion, Medicare and Medicaid CoPs, Recruitment, Training, Personnel Management, Admissions, Insurance Verifications, Scheduling, Forcasting, Staff Development, Customer Service, Nursing Assessments, Problem Solving, Quality and Compliance, Educator, Pediatrics, Teacher of Exceptional Student Education, Branch Director, Front Office Administrator, Account Managment, Case Management, Patient Advocate

29 tears experience as a LVN with strong clinical skills and expertise in managed care.

Knowledge of ICD9 & CPT codes; InterQual; DRGs. Past nursing experience as clinic supervisor.

Training Manager, Registered Nurse, Certified InterQual Instructor

Continued professional growth and achievement within an organization where InterQual Criteria training, medical claims training, CPT Coding training, SIU medical training, and medical consulting can be utilized to enhance fraud identification, improve medical claims handling and ensure the appropriate level of patient care is being delivered

RN Case Manager-6 years experience UR/CM, InterQual trained.

RN Case Manager with 6 years acute inpatient psych experience, 5 years home health and 2 years Alzheimer's care/ Adult Day health experience. Current use of McKessen InterQual program. Knowledge of CADD Care program. My Career Objective is to get a position which uses the Case Management skills to benefit patients through education and resources.

Tags for this Online Resume: Inland Empire, RN, UR, Mental Health, Prior Auth, CM

Featured Profile

Care and Quality Coordinator- 4 years including training, mentoring, implemetation and Go-live experience.

Obtain a position where my current knowledge and skill set may be applied, along with learning, growth, and leadership opportunities. To gain additional experience in implementation, training and project management. To work with various clinical and billing applications/software.

Tags for this Online Resume: Implementation, Training, Clinical, Go-live, InterQual, Utilization Management

Director of Nursing/Case Manager 7 years experience -- Folsom, CA

I'm a Registered Nurse who has worked in a Director of Nursing position for the past 5 years, with experience in Case Management as a travel nurse. Completed Admission and concurrent reviews for authorization for payment through the InterQual guidelines. Worked with HMO’s, Medicare and Medicaid, and hospital based Medicaid systems (developed to meet the affordable care act criteria) Hospice’s the Clinical team as well as Wo...

RN UM Case Manager , medical , and mental Health Clinical Reviews

I Have 15 years experience working in managed care in insurance companies , inpatient mental health and medical inpatient. I have computer experience using InterQual ,Word ,Power Point, & Outlook MediTech

Featured Profile

Registered Nurse & Consultant-over 40 years experience-Seattle

Dynamic, versatile Registered Nurse and Consultant with 40+ years of experience in the healthcare industry. A registered nurse with exceptional communication and consulting skills combined with a proven ability to provide counseling, patient care, and leadership to promote wellness, organization, and effective service to clients, companies, and patients. Outstanding entrepreneur and public speaker distinguished for proven l...

Tags for this Online Resume: Seattle, Nursng, Utilization Review, Clinical Appeals, Medicare & Medicaid, Education, Case Management, Regstered Nurse

RN Case Manager/Utilization-14 years experience

I am Registered Nurse with over 30 years experience and 19 years experience in case management in the hospital area as well as the managed care insurance area, utilization review, precertification, concurrent and retrospective reviews, knowledge of Medicaid and Medicare guidelines, InterQual and Millman's criteria, discharge planning.

Featured Profile

Medical or Health Services Manager - 5 Years of Experience - Near 78108

A dedicated, resourceful, and self-directed professional who is a proactive problem solver exceptional at motivating teams to optimum performance, generating solutions, and implementing effective strategies.

Ideal Companies: Proctor and Gable, Mayo Clinic, The Center of Disease

Tags for this Online Resume: Performance Maximization, Change Agent, Executive Liaison, Budget Administration, Needs Assessment, Conflict Resolution, Process Improvement, Program/Project Management, Manager, Nurse

Case Manager - 15 Years of Experience - Near 98501- Olympia WA

Tags for this Online Resume: RN, Case Manager, Olympia, Utilization Review, Milliman, InterQual, CCM