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Online Resumes with "Prior Authorizations"
Summary of Qualifications; Multifaceted nurse with proven record of more than 20 years' medical/surgical experience in fast-paced acute care units, medical offices/clinics, and home health/home Infusion care * Dedicated adherence to Institutional/Facility policies and procedures * Strong/efficient initial patient assessment * Experience driven ability to provide best patient outcome * Competent/Timely documentation of patie...
Ideal Companies: Baylor Scott & White Health, Baylor All Saints, UT Southwestern, Health Trust, Hendrick Health System, Huguley Memorial Medical Center, Medical Center Alliance, Hospital Corporation of America
Tags for this Online Resume: Management, Support, Surgical, Triage, Critical Thinking, Dependable, Medical/Surgical, IV Infusion, Medical Referals, Electronic Health Records, BSN, Patient Care, Advocate, Compassion, Commitment, Clinical Knowledge, Clinical Experience, Evidence-Based Practice, RN, Registered Nurse, Bachelor of Science in Nursing, Assess Change, Corrective Action, Caring, Accountable, Responsible, Emotionally Stable, Willing and able to collaborate, Able to Communicate
Professional Summary I have spent an accumulation of a year working with prior authorization at Phoenix Children's Hospital endocrinology clinic and at Centene insurance. I have great organizational skills, leadership abilities, and am great with people. My unique experience of doing prior authorization in a clinic setting as well as with insurance in office and remotely makes me a great asset to this position.
• Gain employment as a pharmacist with a pharmacy benefit manager (PBM), managed care company, pharmaceutical company, community health organization, or other non-traditional role that offers opportunities for professional growth and career advancement. • Become a valuable contributor to the team or department to which I am assigned and utilize my expertise in pharmacotherapy and community pharmacy practice to either impro...
Tags for this Online Resume: Inventory, Insurance, Management, Clinical Programs, Pharmacist, Pharmacy, Managed Care Organization, Pharmacy Benefit Management, Pharmaceutical, Prior Authorization, Drug Utilization Review, Medication Therapy Management
Possess excellent time management and adaptation skills very organized responsible with an attention to detail. Organized and takes initiative to be a leader very logical precise and analytical Able to work unsupervised or in a team environment. Experienced in use of Microsoft Office Suite on an executive level Type 60 wpm extensive Customer Service experience considerable knowledge of various insurances benefits verificati...
SUMMARY OF QUALIFICATIONS * Front End Management - Adept administrative manager with over 10 years of experience in healthcare management, with a high level of diplomacy, professionalism and problem solving skills. * Complex Insurance Processing - Expert knowledge of processing insurance claims for Primary Care, Specialty services and Worker's Comp including management of referrals, prior authorizations and correspondence t...
Tags for this Online Resume: Amazon Elastic MapReduce, Benefits, EMR, Health Care Industry, Health Insurance Portability And Accountability Act, Human Resources, Insurance, Insurance Claims, Insurance processing, Management, physical therapy, surgical scheduling, Worker's Comp claims, Healthcare specialties, Primary Care manager
Professional Summary BAYADA Home Health Care - 2013 Infection Prevention Delegate - managed annual corporate compliance initiative project and achieved 100% compliance before deadline. Growth in supervision and team management from interdepartmental context to cover statewide team of nurses providing clinical case review for prior authorization services. Throughout all supervisory, direct client care and client case managem...
Tags for this Online Resume: rn, registered nurse, nurse, healthcare, Supervisor, Clinical supervisor, Case management, Case manager, ASN, Home care, Health IT, Health insurance, Informatics, Health Informatics, Nursing informatics, Clinic nurse, Home care nurse, School nurse, Charge nurse, LTC, Internship, Manager, Health care
Skilled strategist who transforms ideas into solutions and benchmarks performance against key targets/goals. * Highly familiar with medical terminology prior authorization medical devices infusion services hospital protocol and Regulatory requirements. * Award winning sales leader with the ability to drive growth and ensure success. * Lead aggressive marketing strategies to align perception and create distinction among comp...
Tags for this Online Resume: Drug Utilization, Orthopedic, Orthopedics, Managed Care, Nursing, Critical Care - Neurology, Neurology, Presentation Skills, Retail, Sales, sales, sales representative, outside sales, technical sales
Summary of Experience * Management/HR: Solid background in project management, client relationship management and high-level support leadership. Advanced communication skills. Successful in the areas of recruiting, staff development, training and process development/execution. 10+ years' management experience with teams of up to 400 people. Versed in multiple disciplines of scheduling and logistics. * Administrative/Executi...
Tags for this Online Resume: Training, Audit, Accounting, Analytics, Data, Healthcare, Medical Coding, AR/AP, Reconciliation/Daily/Month End, Staff Management, Human Resources, Recruiting, Retention and Development, Project Management, Office/Practice Management, Records Management, CRM, EMR/EHR, Electronic Filing, Legal Support, Documentation Specialist, Logistics, Executive Support, Medical Claims Specialist
Areas of Expertise: * Staff Training and Leadership * M TM Services * D ocumentation and Reporting * Compounding * Patience Satisfaction and Retention * D UR and QA/QC * Patient Counseling and I nventory Control * Regulatory Compliance * Prescription V erification and D ispensing * Workflow M anagement PROFESSI ON AL EXPERI ENCE Bizmart Pharmacy H ouston, TX PRN / Relief Pharmacist 2017 - Present * Liaise between patients a...
Career Summary: Over 20 years of experience in Acute Care and Health Service programs including Utilization Review, Provider Dispute Resolution, Quality Management, Inpatient and Ambulatory Case Management, and Grievance and Appeals in a managed care environment for both Health Plan and IPA/MSO settings using evidence based nationally recognized criteria such as ACOG, NCCN, MCG, InterQual and Health Plan Medical guidelines ...
PROFESSIONAL SUMMARY * 12 years of vast experience in Agile methodologies, Waterfall methodologies, Resource Management, Team Building, Technical Project Manager, Application Support, Production Support, Technical System Analysis and Evaluation, Senior Technical Business Analyst, Rules Architect, Rules Analyst, Blaze Advisor with Dot net Version, Blaze advisor with Java Version, iLOG Jrules ILOG with Dotnet version and BRMS...