Change number. Delivered entirely by email, you can participate from anywhere in the world. Provides feedback to manager to ensure work is in compliance, Acts as resource to PRS staff as content expert in reviewing claims for emergency benefit, Participates in supervisor meetings with Northern and Southern CCA, HR and Clinical Review, Works on special projects that require knowledge of multiple systems, Responsible for training new PRS staff to review claims based on routing criteria. Resume Services in New Orleans, LA. Search form. It’s actually very simple. My urologist recommended Urolift, but I have concerns about the procedure. "The Resume Review has an outstanding sense of what details should stand out and which attributes get the most attention and positive feedback, and then draw those items out in a visually appealing format. - Select from thousands of pre-written bullet points. Providing as much detail about your request as possible encourages the right, quality pros to contact you quickly about your requirements. - Instantly download in PDF format or share a custom link. Professionals will only be given your details once they've sent you a quote. com does an exceptional job for affordable prices. Of the 300+ clients I've sent to this firm, they have boasted a 100% satisfaction rate. Resume Genius has 5 stars! - Choose from 15 Leading Templates. Documents all aspects of the patient management according to hospital and practice standards/policies, Understands appropriate interventions that are provided in the clinical setting to include all aspects of the clinical management of the patient, Assists Care Coordination/UR staff by researching patient information as assigned, Performs ongoing patient screening, and planning through effective collaboration the appropriate clinician, Provides telephonic follow-up management of patient per protocol/policy to include but not limited to visits scheduled at time of discharge and Patient/Family notification of next appointment as assigned, Organizes and distributes paperwork to all Care Coordination staff in an effective and timely manner, Provides support for activities related to Care Coordination to facilitate on-going communications and efficient departmental operations, Coordinates patient educational materials and ensures their availability, Provides and distributes all appropriate patient education as directed, Documents patient interaction per standard/policy, Assume other duties and responsibilities as assigned, Coordinates patient education material and follow up as directed, Duties are adequately performed as needed or seeks out supervisor for guidelines, Performs all other assigned duties as directed by supervisor, Maintains certification and BLS certifications. Hello Log In. Quand la bonne santé des malades se résume à un constat simple: les médicaments ne marchent pas dans la BPCO s’ils ne sont pas bien pris. Clinic Rn-west Endoscopy Resume Examples & Samples Prepares and evaluates outpatients prior to the procedure in an efficient and caring manner to provide for a smooth patient flow. RÉSUMÉ. Les Infections du Site Opératoire(ISO) sont les principales causes de mortalité et de morbidité en chirurgie. Having worked with the head writer since 2004, I can say he has an impressive industry reputation for integrity and customer service. Tailor your resume by picking relevant responsibilities from the examples below and then add your accomplishments. If you have an old resume, you only need to complete those areas of the form that are not addressed at all or not addressed sufficiently on the older document. Clinic Manager Resume. Guide the recruiter to the conclusion that you are the best candidate for the clinical review job. I received the finished product in a weeks time of submitting my draft and immediately began applying for jobs. Monthly statistics are completed within the assigned time frame, Maintains appropriate departmental records, coordinates mail distribution and establishes departmental filing system to ensure the expeditious retrieval of information so that staff can accomplish their responsibilities, Adheres to established organization policies and procedures to include but not limited to HIPAA regulations, Code of Conduct etc., as per EMHS IDD/PCD policies and Beacon Health policies, Assure patients get appropriate and timely services by making referrals and motivating / teaching people to seek care, Bridge community, cultural, linguistic and educational barriers to encourage self-care and participation in the program, Participates and attend regularly scheduled clinic and other assigned meetings, Complete all required documentation inclusive of electronic documentation, in a timely fashion in accordance with regulations and office standards, All other duties as assigned by regional manager or designee, Current Registered Nursing License in state of New York required, 5+ years of clinical experience in acute care environment, Data abstraction Quality Management experience desired, Proficiency with relevant computer programs necessary, Medical background and knowledge of clinical trials terminology, Ability to effectively apply knowledge and skills in a highly organized fashion utilizing adherence to regulatory guidelines, procedures and client expectations, Experience that demonstrates strong attention to detail and skill with numbersStrong command of English language and grammar, 2-3 years of relevant clinical trials or similar experience that demonstrates strong attention to details, Proven good organizational and analytical problem-solving skills, Ability to work effectively under pressure, Observe and comply with policies and procedures for assigned scope, Minimum 3 year Healthcare/Health Plan experience, Demonstrated ability to assist with focusing activities toward a strategic direction and achieve targets, Performs Medi Cal clinical medical file review of hospital documentation for necessary clinical treatment and patient severity of illness to warrant admissions and continued acute inpatient level of care, Conducts clinical review of cases that do not meet criteria, Collects and enters confidential information ensuring the highest level of confidentiality in all areas, Maintains written documentation according to TOG’S documentation policy, Provides ongoing to TAR related to TOG’s Clinical Review process, Ability to use independent judgment related to medical record review, Must possess current RN/LPN licensure in state of Florida, Bachelor degree or above preferred, Prior experience in denials/appeals preferred, At least 3 years of experience as a Case Manager/UR Nurse (any field), At least 3 years of experience in clinical nursing (any field), Manage a team of nurses, coders, auditors and other staff in the performance of contract requirements, Conduct reviews of medical records and associated pre-pay or post-pay claims in the course of fraud, waste and abuse investigations or carrying out other program integrity initiatives, Use knowledge of healthcare coding conventions, fraud schemes, and areas of vulnerability, reimbursement methodologies, and relevant laws to help detect suspicious patterns in claims data, provider enrollment data, and other sources, Remain up to date on published fraud cases, Perform proactive data analysis and record review by applying knowledge of coding guidelines, medical procedures, medical policies, Medicare / Medicaid policies, etc, Demonstrate strong communication skills to prepare superior written investigative summaries for submission to customers' staff and healthcare providers, May be the client’s primary point of contact or serve as the lead representing GDHS during customer conversations, At least 5 years of supervisory or management experience required, Minimum of 8 years of experience in healthcare fraud, waste and abuse reviews (professional, facility), Extensive and thorough knowledge of ICD, CPT, HCPCS, APC, DRG, Revenue Codes, NDCs, and Medicare guidelines (including NCCI), Other certifications a plus: COC, CEMC, AHFI, CHCA, CCS, ART, RHIT, AHFI, CFE, Healthcare claims adjudication experience, Strong knowledge of Medicaid regulations and Medicare coverage determinations, Dynamic leader with excellent verbal and written communication skills, Impeccable work ethic, completely dependable, and proactive; a problem solver and thought leader, Professional representative of GDIT illustrating polish, integrity, and creating trust, Demonstrated ability to provide coaching and performance management of staff, Must have no adverse actions pending or taken against him/her by any State or Federal licensing board or program, Presentation skills to communicate with management and customers, Willingness to travel approximately 20% of the time, Attention to detail and high level of accuracy, Demonstrated organizational and prioritization skills with ability to manage multiple priorities effectively, Innovative; introduces new ideas and processes that improve performance, productivity and benefit integrity, Works independently; collaborates well with peers and customers, Responsible for oversight of the daily workflow of emergency claims and ambulance claims in the Clinical Review Department, Working under direction of the Clinical Review Manager, assigns work to the Provider Reimbursement Specialists, Runs reports during the day to ensure timeliness, Works with the Ambulance Coordinator to assure compliance in the review of ambulance claims, Responsible for training new staff, under the direction of the Medical Audit Manager, Plans, organizes and distributes work to PRS staff based on compliance timeframes. Previously he had mentioned Rezum for prostates between 30 and 90 ml. In addition, bring your resume in for a review during our Career Studio Hours (for current eligible students only) Home; Pursue Your Goals; Resume Samples Upcoming Programs. This is an impeccable service. Venture For America 101. This team of professionals worked diligently to ensure that I was completely satisfied (having made several revisions) with the final product of both my federal and private sector resumes. Tailor your resume by picking relevant responsibilities from the examples below and then add your accomplishments. Who could ask for anything more? Drama centering around the work and private lives of the doctors, medical professionals and staff attached to a busy Dublin clinic. Plus, they give free and thoughtful resume evaluations. . Sign in. iHire sent many great jobs but at least… iHire sent many great jobs but at least half weren't even close to what I was seeking. Have a great weekend! ), Ability to construct grammatically correct correspondence and reports using standard medical terminology, Proven analytical and problem solving skills, ability to problem solve, engage in abstract thought, and successfully manage conflicts. « Chronic obstructive pulmonary disease exacerbation and inhaler device handling: real-life assessment of 2935 patients. Who could ask for anything more? I received the finished product in a weeks time of submitting my draft and immediately began applying for jobs. Of the 300+ clients I've sent to this firm, they have boasted a 100% satisfaction rate. Clinic Director. Check Out Total: $0.00. A.). Such changes are generally implemented only after notice is given to affected employees.g, professional satisfaction and development of staff through training, work assignments, increased responsibility/autonomy and mentoring, Minimum seven (7) years of directly related financial experience with a variety of projects, Experience with SAS and Microsoft access helpful, CPA, master's degree, or a minimum five (5) years of experience in the health care industry preferred, Manages the operations of the member grievance programs for commercial claims for northern and Southern California, Manages a direct staff of approximately 5-7 people (35 indirect) in Northern and Southern regions, Develops goals, objectives, and career paths for staff, Interacts with Health Plan and external regulatory services on at least a weekly basis representing Kaiser Clinical Review in relationship to appeals from members, Provides recommendations and assists director with budget preparation and monitoring, Tracks and trends data related to appeal reasons and overturns and reports data to senior management on a quarterly basis, Minimum two (2) years in a supervisory capacity, Experience managing in an environment with high production, Experience dealing with Federal and State regulators, Clinical and/or Health Education experience, Minimum of 1 year proven success managing, implementing or auditing quality programs, Strong time management and prioritization skills, Experience working with international resources for clinical process operations, Contribute to annual project plan to achieve all HEDIS Clinical Review tasks and objectives, Observe and comply with policies and procedures for, Minimum 4 year degree or equivalent experience, Minimum 3 years Clinical and / or Health Education experience, Minimum 4 year Healthcare / Health Plan experience, Basic statistical knowledge and application of continuous quality improvement concepts, such as Six Sigma or PDCA, Collects, reviews and documents patient's current health status and history according to standard/policy, 100% documented evidence of attendance of staff/department meetings, and/or reading/initializing the minutes, all other memos and postings, Is knowledgeable in identifying patients in need of further follow up and refers to the appropriate clinician as indicated. 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