• Dashboard
  • Resumes
  • Cover Letters
  • Resumes
    • Resumes
    • Resume Builder
    • Resume Examples
      • Resume Examples
      • Nursing
      • Customer Service
      • Education
      • Sales
      • Manager
      • View All
    • Resume Search
    • Resume Templates
      • Resume Templates
      • Microsoft Word
      • Professional
      • Modern
      • Traditional
      • Creative
      • View All
    • Resume Services
    • Resume Formats
      • Resume Formats
      • Chronological
      • Functional
      • Combination
    • Resume Review
    • How to Write a Resume
      • How to Write a Resume
      • Summary
      • Experience
      • Education
      • Skills
        • Skills
        • Hard Skills
        • Soft Skills
    • Resume Objectives
  • CV
    • CV
    • CV Examples
    • CV Formats
    • CV Templates
    • How to Write a CV
  • Cover Letters
    • Cover Letters
    • Cover Letter Builder
    • Cover Letter Examples
      • Cover Letter Examples
      • Customer Service
      • Marketing
      • Sales
      • Education
      • Accounting
      • View All
    • Cover Letter Services
    • Cover Letter Templates
    • Cover Letter Formats
    • How to Write a Cover Letter
  • Questions
  • Resources
  • About
    • About
    • Reviews
  • Contact
  • jane
    • Settings
    • Help & Support
    • Sign Out
  • Sign In
Member Login
  • LiveCareer
  • Resume Search
  • Quality/Utilization Administrator
Please provide a type of job or location to search!
SEARCH

Quality/Utilization Administrator Resume Example

Love this resume?Build Your Own Now
QUALITY/UTILIZATION ADMINISTRATOR
Professional Summary

Self-motivated, future oriented administrative professional seeking a full-time position in the healthcare industry. Bringing 6+ years of professional and educational experience to the table I specialize in leadership and have a proven success rate in improving processes used in small and large healthcare corporations. Motivated by the opportunity to learn, grow, excel and be apart of a wonderful team in the healthcare industry, working together to change the healthcare field for the better.

Education
Oklahoma State UniversityCity, StateExpected in 05/2022MBA: Healthcare Administration
  • Minor Global Health
Madonna UniversityCity, State12/2019Bachelor of Science: Health Services Administration
  • Graduated magna cum laude
Skills
  • Office administration
  • Project Management
  • Customer service
  • Population/ Community Health
  • Health Insurance
  • Problem Solving
  • Team Leader
  • Performance improvement
  • MS Office
  • Time Management
  • Risk Management
  • Medical Billing
  • EMR
  • Project organization
  • Healthcare facility management
  • Business operations
Certifications
  • MICMT Complex Care Management (CM)
  • Motivational Interviewing
  • Interpersonal Communication
  • Medical Assistant (MA)
  • First Aid/CPR/AED Certified
  • HIPPA Professional
  • Million Hearts Fellow
  • Basic Medical Billing (CPT, ICD10)
  • Blood Borne Pathogens
Volunteer Work
  • Ronald McDonald House
  • American Good Fellows (No Child Without a Christmas)
  • St. Edith Church Free Health Screenings
  • Gleaners Food Pantry
  • Mentor for High School Youth
  • Love Your Mellon (Madonna University
  • Meals on Wheels
  • DMC Children's Hospital Volunteer (Activities, Patient Sitting, Room Decorating, ect.)
Work History
Atlantic Health System- Quality/Utilization Administrator
Oakland , NJ03/2016 - Current
  • Supervise and maintain all quality, utilization, and HEDIS documentation for 4 providers.
  • Develop monthly reports of data done with MS Access to stay on track with quarterly/ yearly office targets.
  • Evaluate medical guidelines and benefit coverage to determine appropriateness of services.
  • Successfully juggled multiple projects simultaneously to aid patient satisfaction and keep office running smoothly and effectively.
  • Certified Care Manager serving all eligible patients presenting with Complex Medical Conditions or in need of services.
  • Keep patients, parents, and colleagues up-to-date on latest healthcare knowledge.
  • Utilized proven problem-solving methods in accordance with company policy to enhance client satisfaction.
  • Represent office during physician organization (PO) and community meetings, delivering supporting information and announcing new facility programs and initiative methods.
  • Maintain affective communication/ interaction with all cultures and age groups.
  • Supervise, recruiting, hiring and training of all staff, providing direct supervision, ongoing staff development and continuing education to employees.
  • Developed and updated policies and procedures maintaining compliance to PCMH, HIPPA, and state/ local/ federal guidelines.
  • Managed quality assurance program, including on-site evaluations, internal audits and customer surveys.
Atlantic Health System- Healthcare Administrative Intern
Pompton Lakes , NJ09/2019 - 12/2019
  • Editor and advisor for 900+ page document submission of the Pathway to Excellence Certification through the ANCC for Trinity Health PACE. (Document was accepted in January 2020)
  • Created Pathway Education Booklet to educate information represented in document and recognize the hard work of staff members at all East Coast and Mid-West PACE sites.
  • Project management rollout of Trip Master and Policy Tech.
  • Organized and monitored medical education training programs for new staff and collected data to track performance and efficiency.
  • Supported project managers in managing schedules and milestones.
  • Tracked project performance to analyze successful completion of short- and long-term goals.
  • Did extensive process mapping through Visio to keep projects organized.
  • Attended daily meetings with executive leaders from across country.
  • Created and edited presentations for senior leaders used for weekly huddles.
Green Tree Pediatrics- Healthcare Administrative Intern
City , STATE01/2019 - 05/2019
  • Incorporating new and enhancing already used processes to meet insurance quality improvement measures to hit incentive targets. (Closed 150+ gaps in 5 months)
  • Updating administrative policies and procedures for front office staff and nursing staff.
  • Creating/ incorporating patient registry to keep track of care patients receive and close any gaps patients might have to maintain quality care.
  • Administrative meetings with all contracted insurance companies to gain knowledge of value based incentive programs offered and presenting to in-office physicians to keep them up-to-date.
  • Modified office/ patient workflow to improve patient experience.
  • Project manager in roll-out of digital, contact free, patient sign in.
  • Made sure all trainings / updates made were consistent and maintained at both offices.
  • Collaboration of rural and urban settings.
Build Your Own Now

DISCLAIMER

Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.

How this resume score could be improved?

Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:

89Good
Resume Strength
  • Word choice
  • Strong summary

Resume Overview

School Attended

  • Oklahoma State University
  • Madonna University

Job Titles Held:

  • Quality/Utilization Administrator
  • Healthcare Administrative Intern

Degrees

  • MBA : Healthcare Administration
    Bachelor of Science : Health Services Administration

Create a job alert for [job role title] at [location].

×

Advertisement

Similar Resumes

View All
Performance-&-Utilization-Management-Coordinator-resume-sample

Performance & Utilization Management Coordinator

City Of Miami Beach

Miami Beach , FL

Performance-&-Utilization-Management-Coordinator-resume-sample

Performance & Utilization Management Coordinator

Department Of Veterans Affairs

Eugene , OR

Administrator-resume-sample

Administrator

The Kemtah Group

Hillsboro , OR

  • About Us
  • Privacy Policy
  • Terms of Use
  • Sitemap
  • Work Here
  • Contact Us
  • FAQs
  • Accessibility
  • EN
  • UK
  • ES
  • FR
  • IT
  • DE
  • NL
  • PT
  • PL
customerservice@livecareer.com
800-652-8430 Mon- Fri 8am - 8pm CST
Sat 8am - 5pm CST, Sun 10am - 6pm CST
  • Stay in touch with us
Site jabber winner award

© 2022, Bold Limited. All rights reserved.