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yyyyyy x. yyyyyy

(xxx-xxx-xxxx • abc@xyz.com

 

 

solutions-focused leader eager to offer cross-functional healthcare administration, auditing, utilization review, quality assurance, and case management experience, as well as strong team building, regulatory compliance, policy development, and patient relations talents, toward supporting an ethical employer in delivering quality care.

 

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profile of qualifications

 

         top performer who offers a diverse background in healthcare administration, utilization review, case management, and auditing.

         integral leader who supports the delivery of responsible patient care for all ages based on industry and / or healthcare facility standards of practices, and demonstrates solid nursing abilities, needs analysis / assessment, and multifaceted treatment skills.

         out-of-the-box thinker who accurately determines key resources, services, and treatment plans per individual patients needs.

         ambitious self-starter who initiates quality staff recruitment that encourages low turnover rates and high levels of organizational loyalty, along with planning and prioritizing core team tasks to maximize use of resources and meet various healthcare goals.

         excellent communicator who seamlessly interfaces between healthcare providers, patients, and families, including establishing nurturing and confidential professional relationships with individuals of varying cultural and economic backgrounds.

 

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areas of expertise

 

utilization review                          auditing processes                         budget / cost control                         team building

hedis / pia contracts                  regulatory compliance                   state / medicare reviews                 healthcare administration

quality assurance / control          nursing care plan reviews            patient / physician relations            psychiatric case management

 

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professional synopsis

 

nurse field reviewer

outcomes, inc., fort collins, co                                                                                                                                           2008 c present

 

         utilize broad scope of industry knowledge and dynamic healthcare support acumen to handle medical data retrieval, audits, utilization review, and analysis within colorado physician offices, hospitals, and long-term care facilities for hedis and pia contract projects to improve health-related outcomes, including traveling extensively throughout colorado to achieve key goals.

 

registered nurse ii / case management (2001 c 2002) • registered nurse ii (2000)

mountain crest hospital a division of poudre valley hospital, fort collins, co                                            2000 / 2001 c 2002

 

         built and sustained productive psychiatric medical care for inpatient adult / adolescent and adolescent residential units, including providing comprehensive assessment and case management encompassing treatment plans, resource referral, and education, as well as handling utilization review, disposition planning, admissions / discharges, and transfers to ensure seamless processes.

         served as an er response team member and initiated 27-10 holds, performed phone triaging, and supported intake coordination.

         applied strong leadership talents toward supervising rns, psychiatric technicians, and certified nursing assistants (cna).

 

nurse recruiter

ready link health care, fort collins, co                                                                                                                                  2000 c 2001

 

         drove healthcare operations success by recruiting top-performing rns for travel positions throughout the united states, including developing, implementing, and managing marketing and advertising endeavors and web design initiatives to boost results.

 

director of nursing

fort collins health care, fort collins, co                                                                                                                                          2000

 

         led targeted management of an 85-bed, long-term facility with psychiatric and assisted living, including conducting in-services, state, and medicare reviews; handling utilization / quality assurance reviews; facilitating accurate chart audits; coordinating nursing care plan reviews; promptly resolving employment and staffing issues; and managing varied medical monthly budgets.

 

nurse manager / assistant administrator

harbor place adult partial hospitalization program, pensacola, fl                                                                                1992 c 1993

 

         strategically steered solutions-driven individual counseling and group therapy, including overseeing all medication management, treatment plans, intakes, admissions / discharges, policy / procedure development, and quality assurance / utilization review.

         interfaced among physicians, therapists, client families, and other residential facilities to provide high-quality services.

 

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resume • page two

(xxx-xxx-xxxx • abc@xyz.com

 

 

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professional synopsis (continued)

 

director of nursing

mary marshall manor, marysville, ks                                                                                                                                        1989 c 1990

 

         directed a 95-bed facility, including supervising teams; handling in-services efforts; managing budgets and inventories; facilitating state, medicare, and pharmacy reviews; overseeing quality assurance and utilization reviews, and coordinating nursing care plans.

 

registered nurse

baptist hospital behavioral medicine, pensacola, fl                                                                                                              1986 c 1988

 

         contributed wide-ranging nursing abilities toward supporting healthcare efforts in substance abuse, eating disorders, and adult / adolescent psychiatric units, including admitting / discharging patients, auditing charts, and providing individual and group therapy.

 

roles between 2002 c 2008 and 1993 c 2000 encompassed real estate, counseling, office management, and administrative support.

 

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education & professional development

 

master of science in education (counseling & school psychology emphasis)                                                            butler university

bachelor of science in psychology & sociology                                                                    state university of new york at albany

associate of science in nursing                                                                                                                          pensacola junior college

 

registered nurse                                                                                                                               state of colorado / state of florida

licensed professional counselor                                                                                                                                    state of colorado

certified professional coder                                                                                                american academy of professional coders

 

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