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Online Resumes with "Milliman"
My career uniquely combines a solid understanding of medical health care practice and business management and my goal is to continue as a hospital provider advocate within the medical auditing and clinical documentation career path.
Tags for this Online Resume: Registered Nurse, Medical/Surgical, Home Health, Infusion Therapy, Director of Nurses, CCU/ICU/Telemetry, Documentation Review EHR, Quality Assurance, Telecommute, Medicare Recovery Auditor, IternQual, ICD--9 ICDCCU/ICU/Telemetry, Integrated Case Manager, Quality Assurance/HIM; Healthcare Information & Documentation Manager, Medicare Denials appeal and Managed Care Risk/ medical necessity auditor, InterQual/ICD-9/MCG;Millliman/DRGs/Lean/CMS Guidelines MS Office, telephonic/remote, CCU/ICU/Telemetry/evidence based best practice provider and physican advocate, HEDIS abstractor, internal risk auditor, EHR quality assurance, ICD-9, Interqual/Milliman, clinical coordinator
I am a Registered Nurse of 32 years with 12 years of DRG Integrity reviewing, 8 years of utilization Reviewing, and 5 years of Case Management. I am proficient in the use of Interqual and Milliman quidelines. My objective is to concentrate all efforts on further developing my skills in the area of information management, specifically as a Clinical Documentation Integrity Specialist, and enter the field of CDS consulting in ...
AREAS OF EXPERTISE * Patient Relations/ Counseling Experienced with Milliman Care Guidelines. CCU and IMC Units at both Providence and Sierra Hospitals.
across age spectrum from neonates through geriatric population with respect also to culturally diverse populations Leveraging technology to identify and close gaps in care and quality improvement and use of Milliman Guideline and HEDIS criteria Evaluation and Data collection of HEDIS compliance and AHRQ standards of care Contract procurement for commercial and non- profit organizations Ability to leverage technology and ana...
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-...
I am looking for a full time permanent opportunity with a growing Case Management Company with excellent comprehensive benefits including Health Insurance, dental, vision and 401k option. I am a dedicated, highly skilled, self-motivated, registered nurses that that has significant experience with workers compensation & commercial case management as well as Utilization Management. I am also highly skilled in using Microsoft...
I am currently looking for a 32 - 40 hour a week job with benefits. I would highly consider related work in my field as well, potentially in home modification, assistive device or adaptive equipment sales, and management. I am open to learning new skills in specialty areas within my field as well, i.e: lymphedema as an example.
Summary: My professional experience has been extremely diversified. My focus has always been "customer service oriented." My professional experience has also included several stints as a Temporary Nursing Staff member, which has allowed me to be able to expand my base knowledge on Milliman Care Guidelines, as well as increase my computer skills. Most recent Professional Experience: SNF- Rehab- Transplant Coordinator- Cigna ...
Tags for this Online Resume: Critical Care - Respiratory, Acute Rehabilitation, Documentation, Rehabilitation, Surgical, Microsoft Outlook, Nursing, Computer Literate, Medical, Medical Technician, physical therapist, physical therapy, rn, registered nurse
QUALIFICATIONS Account executive and business development professional with leadership skills and experience in start-up and large organizations, strategic and operational planning, sales, negotiations, budget development, public speaking, operations, training, program and personnel management. SUMMARY OF RESPONSIBILITIES / KNOWLEDGE Financial: * Consulting sales @$500,000/year targeting clients, business assessments, contr...
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...