4 resumes matching Concurrent Review Nurse Resume Samples

Concurrent Review Nurse II

Superior Health Plan Tolar,Texas

diverse needs . 6 years of solid clinical , utilization review and case management experience as Medicaid Concurrent Review Nurse . Seeking position in a facility that diagnoses and manages.... High level of personal accountability Qualified in healthcare billing Work History Concurrent Review Nurse II 12/2010 to Current Superior Health Plan – 7202 Slide Road Suite 202 Performed onsite/...with debridement and skin grafts Delegated staff nurse duties Instructed patients and family members on proper discharge care . Education Registered Nurse Diploma : Nursing 2009 Covenant School of

Last updated on January 02 2017 Resume Score: 70%

Concurrent Review Nurse

DPCI/Aetna Medicaid Company West Grove,Pennsylvania

Professional Experience DPCI/Aetna Medicaid Company July 2013 to Current Concurrent Review Nurse Newark , DE Perform daily utilization review and discharge planning for medicaid members in acute and sub acute...January 2003 Neonatal Intensive Care Nurse Newark , DE Provided for neonates in a clinical setting . During time at Christiana I also obtained a weekend Utilization Review position and became Mc Kesson certified...Kesson Certified in 2001 . Skill Highlights Able to review and analyze medical records efficiently and quickly to ensure timely Utilization Review . Excellent documentation skills of pertinent information

Last updated on November 01 2014 Resume Score: 70%

Quality Management Nurse Consultant

Middletown,Pennsylvania

Served as mentor for new staff and resource for other staff members Precertification Nurse , Concurrent Review Nurse , 09/2005 to 09/2011 Health America/Coventry – Harrisburg , PA Displayed... Cotiviti edits and clinical review to determine payment appropriateness on the QNXT platform , Most current experience is in Medicaid claim review , Lead Nurse reviewer for PA Medicaid ,...editing Working with Claim Check editing Certified Professional Coder Registered Nurse Documentation Management Correct coding review Mentoring new team members Collaboration with various departments Time management

Last updated on January 29 2021 Resume Score: 80%

Director Utilization Management

Centers Plan for Healthy Living Pennington,New Jersey

process . Concurrent Review Nurse 01/1996 to 01/1998 Horizon NJ Health Trenton , NJ Conducted daily concurrent review of hospitalized members . Promoted to Senior Concurrent Review Nurse and performed...NJ Supervisor Concurrent Review\Prior Authorization . Management and oversight of the concurrent review and prior authorization day to day activities . Supervised the concurrent review and prior au...the daily function of health care management services inclusive of prior authorization , concurrent review , inpatient rehabilitation and medical appeals . Accountable for management of supervisors

Last updated on January 13 2017 Resume Score: 80%

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