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Yyyyyy x. yyyyyy

0000 xxxxxx xxxx , xxxx , xxxxx 00000
xxx-xxx-xxxx
abc@xyz.com

                                                                                                                                             

 

 

Nursing Manager ▪ Utilization Review Manager

Highly professional healthcare manager who has demonstrated continuous growth, achievements and impressive leadership in the management of complex activities within the healthcare industry. Solid business insight with the ability to ascertain and analyze needs, streamline processes and ensure timely deliveries while maintaining customer satisfaction. Excellent interpersonal and communication skills serve as a foundation to effectively network, collaborate, negotiate and maintain positive relationships with physicians, staff, vendors and clients.

 

Areas of Strength

 

MANAGED CARE ▪ COST REDUCTION ▪ QUALITY IMPROVEMENT ▪ CASE MANAGEMENT ▪ REGULATION COMPLIANCE ▪ SUPERIOR PATIENT OUTCOMES ▪ TIMELY DELIVERIES

 

Professional Experience

 

Allied Managed Care                                                                                          2002-2004/2009-Present

Utilization Review Manager, 2009-current

Director of Nursing Services, 2002-2004

  Successfully help clients save money at every stage of their claim by assisting the Medical Director in managing the entire UR process from referral to distribution of UR determinations

  Effectively respond to all DWC audit inquiries while providing full compliance with audit standards

  Proactively ensure UR standard timelines are met by efficiently managing UR nursing and non-nursing review assignments

  Play a solid role in growing business and maintaining client satisfaction by overseeing responsiveness to provider, vendor, customer inquiries and appeals

  Facilitate positive client outcomes through quality assurance review of UR determinations

 

Dialysis Clinics Inc.                                                                                                1998-2002/2004-2009

Home Dialysis Nurse Manager, 2004-2009

  Effectively managed a 50-patient caseload resulting in award winning patient outcomes and low infection rates

 

Hemodialysis Charge Nurse/Clinic Nurse Manager, 1998-2002

  Superior job performance resulted in being promoted from Charge Nurse to Clinic Manager

  Ensured patient comfort while overseeing the case management of 75 chronically ill patients

  Received accolades for award winning anemia management

 

Intracorp                                                                                                                                 2002-2004

Field Case Manager

  Reduced employer insurance costs by facilitating early return to work of injured workers through proactive, action-oriented medical management interventions

 

Education

 

Registered Nurse, Sierra College Nursing School, Rocklin, CA                                                    1998

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