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Online Resumes with "Utilization Management"



Registered Nurse - 19 Years of Experience

Tags for this Online Resume: Medicare, Services, Management, Medical, Social Service, Utilization Management, Medical Records, Coding, Compliance, Computer Aided Software Engineering

Registered Nurse

Tags for this Online Resume: Documentation, Management, Utilization Management, Managed Care, Acute Rehabilitation, Compliance, Home Care, Home Health, Insurance, Occupational Therapy

Medical or Health Services Manager

Tags for this Online Resume: Management, Utilization Management, Audit, Staffing, Staffing & Recruitment, Travel, Quality Assurance, Test, Process Improvements, Amazon Elastic MapReduce

Featured Profile

Health Technologist - 18 Years of Experience - Near 07079

Experienced results-driven professional with strong leadership and relationship-building skills. Accomplished program manager and application architect with extensive experience in front office and back office operations due to extended exposure to SDLC program delivery in the Fortune 100 business sector.

Ideal Companies: CVS Caremark, Aetna, OptumRx, United Health Group, Humana Pharmacy Solutions, Envolve, Centene, Envision Rx, Anthem, Ingenio, WellCare, Tufts Health Plan, Harvard Pilgrim Healthcare, Healthfirst, McKesson, Amerisource Bergen

Tags for this Online Resume: Acquisitions, Annuity, Architect, Back Office, Compaq, Data Conversion, Data Warehouse, e-Commerce, Financial, Financial Services, PBM, Government Programs, HIPPA Compliant, Operations, Business Process Management, Business Systems Analysis, Shared Services, Lean Six Sigma, Scrum Master, MS Project, MS SharePoint, MS PowerPoint, MS Excel, MS Visio, Relational Database Management, Business Process Modeling Notation, MEGA, Agile Project Management, Waterfall Project Management, Medicare, Health Care Reform, Process Improvement, Formulary, Claims Adjudication, Utilization Management, Business Requirements, Strategy, Salesforce, CRM, EPMO, CMMI, Veeva, Data Science, Data Lake, Business Cases, Procurement, Oracle, Data Governance, Managed Markets, Supply Chain, ROI, Compliance, Vendor Management, Metrics, Reporting, Dashboarding, SDLC, KPI, COE, Trend Analysis, Executive Reporting, Trainer, Remediation, Business Owner, Consulting Services, Affordable Care Act (ACA), Agile Methodology, Applications Architecture, Applications Delivery, Benefits Strategy, Big Data, Budgeting, Business Process Change Management, Business Process Design, Business Processes Improvements, Business Process Flows, Business Process Management Bpm Software, Business Process Mapping, Business Process Modeling Notation (BPMN), Business Process Strategy, Business Process Transformations, Business Systems Consulting, Business Systems Design, Business Systems Implementation, business use case, Capability and Maturity Integration (CMMI) Requirement Management and Requirement Development Training Certification, Capability Maturity Model Integration (CMMI) Assessments, Center of Excellence, Claims Processing, Client Presentations, Client-Server, Collaborative Innovation, Continuous Process Improvement Initiatives, Cross Trainers, Customer Experiences, Customer Relationship Management (CRM), Data Definition Language (DDL), Data Warehousing Systems, DB2, Drug Information, Drug Utilization Reviews, Enterprise Solutions Architecture, Executive Presentations, Gaps Analysis, Government Affairs, HIPAA Compliance, HIPAA Guidelines, HIPPA Regulations, Information Systems Analysis, Internal Consulting, IT Systems Analysis, Key Performance Indicators (KPIs), Leadership, Leadership Mentoring, Mainframes, Management Consulting, Management Dashboards, Matrix Management, Medicare Claims, Medicare Part D, Medicare Prescription Drug Plans, Medication Therapy Management, Mentoring Programs, Microsoft Access, Microsoft Excel, Microsoft Office, Microsoft PowerPoint, Microsoft SharePoint, Microsoft SQL Server, Microsoft Visio, Microsoft Word, multi-tiered communication, Needs Assessment, New Product Introduction (NPI), Object-Relational Database, Object-Relational Databases (ORD), People Leadership, Performance Management Reporting, Performance Metrics, Pharmacy Benefits Management (PBM), Pivot Tables, Portfolio Management, Predictive Analytics, Prescriber, Prescription Drugs, Process Improvement Management, Process Reengineering, Procurement Operations, Project Management Life Cycle, Relational Database Management System (RDBMS), Requirements Traceability Matrix (RTM), Return on Investment (ROI), Scrum Methodology, Solution Architecture, SQL Relational Databases, Strategy Creation, Structured Query Language (SQL), Sybase, Systems Development Life Cycle (SDLC), Technical Project Management, Therapeutics Committee, Training the Trainer, Unified Modeling Language (UML), Use Cases, Waterfall Model, Web Based Services, Writing User Stories

Case Manager

Tags for this Online Resume: Nursing, Audit, Documentation, Inpatient Care, Management, Microsoft Outlook, PEDIATRIC, Risk Assessment, Video, VITAL SIGNS

Case Manager

Tags for this Online Resume: Computer Aided Software Engineering, Management, Medical, PEDIATRIC, Physical Therapy, Pricing, Radiology, Therapy, Utilization Management, Neurological

Project Manager - 0 Years of Experience

Team Leadership: Proven Senior Manager for project and program management, controlling budgets, allocating resources, team utilization, team training, service delivery and client satisfaction. Defined team strategy, competencies and technical resource allocation for targeted customers. Managed and developed project managers / business analyst teams, cross functional teams, contractors, customers and vendors. Result: Success...

Tags for this Online Resume: Applications, Budgeting, Leadership, Microsoft Windows, Support, Surgical, Training, Consulting, Critical Care - Vascular, Information Technology

Medical or Health Services Manager

Tags for this Online Resume: Management, Nursing, Behavioral Health, Medicare, Utilization Management, Long Term Care, Talent Acquisition, Therapy, Colostomy Care, Computer Aided Software Engineering

Registered Nurse

Tags for this Online Resume: Telemetry, CCU, Leadership, Policies and Procedures, Documentation, Management, BLS, Scheduling, Process Improvement, Radiology

Medical or Health Services Manager - 10 Years of Experience - Near 60827

Ideal Companies: Chicago Family Medical, Ingalls Hospital, Northwestern Memorial Hospital

Tags for this Online Resume: Billing, Critical Care, Family Practice, General Surgery, Management, Medical, Medical Billing, OB/GYN, Oncology, Payroll

Licensed Nurse

Tags for this Online Resume: Home Care, Acute Rehabilitation, Home Health, Management, Patient Education, PEDIATRIC, Pediatric Care, Phlebotomy, Rehabilitation, Utilization Management

Licensed Nurse

Tags for this Online Resume: Lifecare, Vista, Home Health, Computer Aided Software Engineering, Nursing, Health Care Industry, Insurance, Management, Medicare, Utilization Management