Rn Senior Resume Samples

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S Prohaska

Sadie

Prohaska

6663 Myah Via

Chicago

+1 (555) 136 3122

6663 Myah Via

Chicago

Phone

p +1 (555) 136 3122

Experience Experience

Detroit, MI

Rn Senior

Detroit, MI

Armstrong, Moore and Wisoky

Detroit, MI

Rn Senior

Records patient data prior to each physician visit, including but not limited to, vital signs, height, weight, allergies, medication changes
Assures nursing charges are accurate and complete on patient fee slips. Acts as a resource person to the medical assistants
Review all chemotherapy orders prior to administration to ensure completeness and accuracy
Mixes and administers chemotherapy, hydration and other medications under the direction and supervision of a physician
Follows OSHA guidelines when handling cytotoxic agents, biohazardous waste and any other material potentially infected with a blood borne pathogen. Participates in professional development activities and maintain professional affiliations. Maintains patient confidentiality
Facilitates dose modification by assessing patient, assessing labs, consulting protocol or treatment plan, calculating dose, and consulting physician regarding dosage modifications, problems and symptom management. Performs venipuncture, accesses implanted ports and maintains central lines catheter devices
Confirm the regimen is consistent with currently accepted medical practice as evidenced by safety and efficacy data published in peer reviewed medical literature

Philadelphia, PA

Visiting RN, Senior Living

Philadelphia, PA

Dicki-Bechtelar

Philadelphia, PA

Visiting RN, Senior Living

Case management and coordination
Work as part of an on-call rotation
Performing assigned duties, including administration of medication, wound care, treatments, and procedures
Performing client assessments as necessary
Following up with, executing, and properly documenting doctors' orders
Making home visits to clients in designated senior living communities within specific geographic territories
One (1) weekend per month

present

Houston, TX

Rn-senior Clinical Practice Consultant

Houston, TX

Mills, Batz and Jacobi

present

Houston, TX

Rn-senior Clinical Practice Consultant

present

Monitors monthly and quarterly performance of assigned practices
Analyzes key cost, utilization and quality data and interprets results to assess the performance of the practice; identifies strategies for improvement to include specific outcomes and metrics to monitor progress to a goal; provides feedback and makes recommendations for improvement
Reviews Clinical Action report results to guide practice in identifying care management opportunities and adjust processes to prioritize interventions to achieve clinical and cost outcomes
Utilizing the results of the practice performance analysis and input from the practice, develops/updates performance improvement action plans; monitors practice efforts to address performance and care management opportunities
Serves as a single point of contact to practices for program and operational issues
Establish and maintain a supportive, collegial role with assigned ACO and PCMH practices
Facilitates efficient, effective practice improvement meetings

Education Education

Master’s Degree in Nursing Preferred

University of Florida

Master’s Degree in Nursing Preferred

Skills Skills

Ability to multi-task
Ability to work independently, handle multiple assignments and prioritize workload
Knowledge of community, state and federal laws and resources
Knowledge of healthcare delivery
Ability to create, review and interpret treatment plans
Ability to implement process improvements
Ability to understands the business and financial aspect of case mgmt in a managed care setting
Ability to effectively present information and respond to questions from families, members, and providers
Demonstrated interpersonal/verbal communication skills
Demonstrated time management and priority setting skills

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RN Senior Manager Resume Examples & Samples

Provides leadership in the development, implementation and evaluation of planning structures and processes designed to optimize organizational outcomes. Recruits and retains top talent through effective communication, performance management and professional development. Fosters a team environment by instilling a cooperative atmosphere, promoting collaboration and encouraging constructive conflict. Creates and initiates professional plans for direct reports. Communicates with staff in a manner that is respectful of the diversity of workforce and patients/families
Provides infrastructure and systems to empower staff to contribute to organizational goals and achieve desired outcomes. Creates processes for sharing information and decision-making across care settings and roles. Develops strong relationships and partnerships with key stakeholders across the organization to positively impact business, nursing and patient outcomes. Oversees the management of financial, human and material resources, to ensure alignment with organizational strategies and goals and maintain compliance with regulatory requirements and policies. Creates and supports a clinical practice environment focused on nursing professional autonomy, inter-professional collaboration and innovation
Demonstrates a comprehensive understanding of the processes and desired outcomes from clinical operations and motivates staff to perform at the highest level. Assures a measurable, outcome-focused, systematic approach to care delivery. Leads development, implementation and evaluation of evidenced based, quality clinical nursing practice consistent with current nursing research, organizational and national practice standards. Assumes a leadership role in collaborating and partnering with other health care providers, services and the community, in philanthropic and outreach activities
Leads the integration of innovation and evidence based findings into practice. Creates an environment supportive of innovative solutions. Assumes a leadership role, in partnership with physician and facility leaders, in managing the quality of services provided across the care delivery continuum and within the larger organization. Demonstrates and directs employees in using a systematic approach in analyzing and utilizing data in problem-solving
Produces results that meet or exceed identified strategic and operational targets through leadership. Assures performance in clinical operations, financial, human resources and quality outcomes meet or exceed established targets. Directs and provides oversight to the management of clinical operations, quality and safety programs, and nursing practice with a focus on results and the evaluation of outcomes data. Leads the effective management of human resources to include staff turnover and retention outcomes and staff satisfaction

RN Senior Manager Resume Examples & Samples

Optimization of processes that drive clinical and service excellence for the Program’s patients and referring physicians
Expansion of programs through targeted outreach and the growth of the living donor program
Development of the talented individuals on the Kidney/Pancreas multidisciplinary team
The strategic and management skillsets needed to aggressively execute on the Institute’s strategic plan
Proven process improvement track record
Ability to build strong teams and develop staff
Master’s Degree or progress toward completion of an advanced degree preferred
Manages and facilitates patient centered nursing care for designated patient populations by serving as a real-time clinical expert for unit staff and physicians for escalated problem-solving on patients, processes, and family issues.Manages the operations of the unit to ensure smooth and efficient patient care management and resource utilization
Leads change by developing, implementing and evaluating quality and process improvement initiatives of the department in conjunction with the director. Seeks and utilizes input from staff and oversees change implementation. Ensures compliance with appropriate regulatory agencies
Manages and develops the operational and capital budgets and use of associated resources

Field Based Senior RN Resume Examples & Samples

Collaborates with physicians and assists in the facilitation of healthcare resources to ensure services and care are delivered in a timely manner
Registered Nurse with active unrestricted license in the State of Indiana
Strong understanding of insurance products, benefits, coverage limitations, laws and regulations as it applies to the health plan

Senior Clinical Administration RN Resume Examples & Samples

Coordinates internal reviews on denial letters to determine compliance with contractual and regulatory requirements of the State Medicaid programs, while reviewing for efficiencies and effectiveness of procedures
Serves as a catalyst for implementing an appropriate risk assessment process designed to identify and correct deficiencies
Maintain extensive knowledge of regulatory and applicable accrediting body requirements becoming a Compliance resource for the team
Maintain knowledge of State rules, contracts, and Federal legislation/regulations as well as UHG guidelines
Demonstrate flexibility, availability, and dependability to conform to position responsibilities
Unrestricted RN license required
Saturday schedule availability
3+ years clinical experience in an Acute care environment
Proficiency using Microsoft products including Word, Excel and Outlook
Proven analytical and problem solving skills while managing multiple tasks simultaneously
Ability to work independently or in a team environment
Demonstrated excellent written and verbal communication skills required
Proven ability to handle multiple tasks simultaneously by working independently, as well as part of a team, in a fast paced environment
Knowledge of MCG or Miliman Guidelines
Knowledge of State Medicaid Rules and Long Term Care

Senior Field Based Case Mgr Rn-harris County Resume Examples & Samples

Identify, coordinate, or provide appropriate levels of care under the direct supervision of an RN or MD
Function is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting
Function may also be responsible for providing health education, coaching and treatment decision support for members. Includes Health Coach, Health Educator, and Health Advocate roles that require an RN
Employees in jobs labeled with “SCA” must support a government Service Contract Act (SCA) agreement
Develops innovative approaches
Sought out as expert
Current, unrestricted RN license for the state of Texas
Experience working with the needs of member populations who have disabilities
Experience as a Charge Nurse or in Case Management
Bilingual skills: Spanish / English

Rn-senior Clinical Practice Consultant Resume Examples & Samples

Accountable for successful deployment of program at the practice level, including, attribution, provider rosters and performance and clinical reporting; introduces and educates practice on the value/use of reporting tools and delivery of reports via Physician Portal; provides assistance with HIT, EMR, disease registries and other technology
Using results of practice readiness assessment, designs practice transformation plan and implements appropriate training modules designed to assist practice in achieving contractually required transformation milestones; monitors progress of practice in milestone achievement and insures practice accountability for successful completion
Consults with and guides practice on developing innovative solutions to practice organization and structural challenges in order to achieve desired program outcomes. Brings best practice experience and connects practices with other high performing practices to spur innovation. Helps practice meet and exceed expectations/milestones for achieving success as a PCMH or ACO
Monitors monthly and quarterly performance of assigned practices
Analyzes key cost, utilization and quality data and interprets results to assess the performance of the practice; identifies strategies for improvement to include specific outcomes and metrics to monitor progress to a goal; provides feedback and makes recommendations for improvement
Reviews Clinical Action report results to guide practice in identifying care management opportunities and adjust processes to prioritize interventions to achieve clinical and cost outcomes
Meets regularly with assigned practices to review available practice reports, present practice performance synopsis and identify opportunities for improvement
Utilizing the results of the practice performance analysis and input from the practice, develops/updates performance improvement action plans; monitors practice efforts to address performance and care management opportunities
Works with the practice and OptumHealth to align and integrate OptumHealth care/disease management programs and population health services to augment the practice's capabilities, support their care management efforts and add value to the patient care experience
Serves as a single point of contact to practices for program and operational issues
Establish and maintain a supportive, collegial role with assigned ACO and PCMH practices
Facilitates efficient, effective practice improvement meetings
Maintains databases directly associated with role
Effectively collaborates with HLM, PCMH and ACO team members including assigned PMOs, ECMs; CRS's, Medical Directors, local Network leads, HCE Analysts and Clinical Analysts in support of the program
Assists and supports HLM, PCMH and ACO leaders in summarizing and disseminating experience-related learning by way of team updates, written reports/articles, and/or presentations as called for by directors
BS/BA
Demonstrated experience in analyzing health care practice performance data and identifying opportunities for improvement and innovation
Excellent verbal, written, presentation, and group facilitation skills required, with the ability to convey complex or technical information in a manner that others can understand
Strong critical thinking skills necessary to evaluate and respond to practice challenges and related team dynamics
Superior interpersonal skills with the ability to build positive relationships with key practice representatives and team members across the enterprise
Health care quality improvement, practice management experience
5+ years of experience in either practice or medical management, health care analytics, managed care contracting or experience in a primary care or multi-specialty practice that has successfully implemented PCMH or ACO programs or quality improvement initiatives

Senior RN Cardiovascular Resume Examples & Samples

1) Professional knowledge of nursing theory and practice at a level normally acquired through completion of two years training at an accredited School of Nursing in order to be eligible for licensure as a Registered Nurse
2) Current California Registered Nurse license
3) Current ACLS/BCLS certification
4) Minimum of two years current Cardiac Cath Lab experience necessary in order to acquire and effectively utilize knowledge of unit and departmental policies and procedures, and to fulfill established quality and quantity standards for the job

Lvl IV Senior Rn-neuro Resume Examples & Samples

Knowledge of surgical procedures, instrumentation and post-surgical care required
If performing Procedural Sedation, current ACLS card required
Ability to quickly and efficiently evaluate and develop a plan of care for acute critical situation in the ambulatory care setting
Knowledge EMR, Word and Excel
Proficient in message management including e-mail correspondence

Senior Clinical RN Resume Examples & Samples

Ability to communicate effectively with CMO, medical directors and VP of Health Services coordinate and manage the Provider Lock-In / Rx Lock-In programs
Assume responsibility for facilitating medical / behavioral inter-disciplinary care team meetings across populations
Coordinates and ensure transitional care activities are completed by self and others; focus on HEDIS, STARS, and state performance measures
Excel expertise with review of reports
Basic financial understanding of Health Plan state reports as well as Delivery System Improvement Fund withholds and how a population health focus can impact this
Current unrestricted RN licensure required in New Mexico
Ability to communicate effectively with Clinicians and clinical office staff to influence behavior and improve STARS scores
Excellent interpersonal oral and written communication skills

Senior Quality Rn-kauai, HI Resume Examples & Samples

Solicit identification of barriers the office faces in providing care to members
Supports the HEDIS medical record chase to support optimum HEDIS and quality metric reporting
Performs annual medical record evaluation, follow-up education, practitioner intervention, measurement as required
Generally works independently, under the supervision of the Quality Management leader
Bachelor's degree in Science or equivalent work experience
2+ years of quality improvement experience (chart review, compliance, HEDIS, STAR, investigation, etc.)
Knowledge of one or more of: clinical standards of care, preventive health standards, HEDIS, NCQA, governing and regulatory agency requirements and the managed care industry
Ability to evaluate medical records with attention to detail
Ability to interact with medical staff, peers and internal company staff at all levels

Senior Quality Rn-kona, HI Resume Examples & Samples

Current unrestricted RN licensure required in Hawaii
Ability to make formal presentations in front of committee and work group environments
Proficiency in software applications that include, but are not limited to, Microsoft Word, Microsoft Excel, Microsoft Outlook and Internet browsers
Masters degree
Must be self-motivated and have ability to work autonomously

Business Analyst, RN Senior Resume Examples & Samples

Serves as subject matter expert associated with content, processes and procedures associated with enterprise applications
Implements, modifies, tests and administer business system applications
Troubleshoots complex situations and relationships
Liaison between IS and users to resolve workflow or functional questions
Completion of Epic proficiency/certification and general onboarding as needed within 6 months of hire

Lvl IV Senior Rn-urology Resume Examples & Samples

Documentation: Conducts audits & ensures that documentation reflects thorough assessments, incorporates physical & psychosocial findings, diagnostic tests, learning needs, barriers, multidisciplinary education plans & age appropriate care
Workplace Safety: Adjusts/Identifies staffing needs of the department, in coordination w/ department manager, to assure quality patient care, patient & staff safety, efficiency, productivity & working conditions of providers & staff. Actively models LMP Workplace Safety principles & practices
Patient Care Experience/Customer Service: Acts as a role model for staff by providing a patient care exp that exceeds members' expectations. Ensures timely & appropriate management of patients. Coordinates smooth transition for patients across the care continuum
Minimum one (1) year recent (within the last three (3) years) full time equivalent experience in acute care, ambulatory care or home health/palliative/hospice care
Urology experience inpatient or outpatient preferred
Flexible and willing to learn and be a team player
Ability to learn all parts of the Urology department and willing to train in all areas as well
Ability to learn leadership skills and be a team Leader
Problem solver, priorizational skills, and time management skills

RN House Senior Manager Resume Examples & Samples

Assesses overall staffing effectiveness and adequate throughput by ensuring the appropriate number, competency and skill mix of staff are involved in the provision of needed health care services according to census, acuity, and responsible use of labor budget
Demonstrates an expectation and support for continuous quality improvement
Demonstrates leadership through coaching, performance evaluations, corrective actions and development opportunities to create a culture of learning. Functions as a role model and encourages staff to participate in their own development
May be responsible for selection, orientation, on-boarding, and retention

Rn-senior Clinical Practice Consultant Resume Examples & Samples

Investigates gaps in clinical documentation where system variation has impact on rate calculation, provides
Feedback to appropriate team members where issues are verified, and monitors resolution to conclusion
Based on medical record audit findings, provides follow - up education, practitioner intervention, and measurement as needed to drive quality improvement
Educates providers and office staff on proper clinical documentation, coding, and billing practices, state - mandated quality metrics specifications, provider profiling and pay for performance measurement, and medical record review criteria
Documents and refers providers’ non - clinical / service issues to the appropriate internal parties, to include Provider Relations and the Plan Chief Medical Officer
If required, supports state specific medical record collection and abstraction processes to drive optimum measurement and quality metric reporting during ambulatory medical record review, HEDIS data collection, or for other focus studies as directed by the Plan Quality Director
Supports quality improvement program studies with work that ranges from accessing and analyzing provider records, maintaining databases, and researching to identify members' encounter history
Participates in or coordinates with other department projects as needed
Needs to works independently and within an integrated team in a highly matrix environment
Current unrestricted RN licensure in the state of Ohio
2+ years of quality improvement experience or other relevant experience
Knowledge & demonstrated experience with continuous QI concepts and tools i.e. audits, chart review, knowledge of current CPT and ICD10 coding
Experience preparing and presenting information to clinical and executive level leadership
Intermediate computer literate and have MS Word, Excel, Outlook and Internet demonstrated skills
Ability to work independently with minimal supervision and within a team
Proper etiquette including customer service relation techniques, superior verbal and communications skills
Strong decision making, accuracy and attention to detail
Experience in meeting strict deadlines and adhering to strict standards
Role requires travel to physician offices locally up to 75% of their time
Clinical process improvement experience
Clinical quality improvement experience
Population Health (PCMH) experience

RN Telephonic Case Management for Senior Population Resume Examples & Samples

Active RN license in TX without restrictions
Prior clinical experience in an acute care, skilled or rehabilitation clinical setting conducting patient education and discharge planning
Strong computer proficience and professional communication skills

Senior Clinical Quality Analyst, RN Resume Examples & Samples

Experience working with clinical survey or process improvement initiatives is a plus
Certified Professional in Health Quality (CPHQ) preferred
RN (Registered Nurse) preferred
5+ years’ experience in managed healthcare, Medicare Advantage, including at least 2 years in health plan quality improvement or equivalent/related experience
3+ years health care information systems experience or in a role as an liaison/contact for QI projects
HEDIS quality reporting or collection experience
Medicare STARS experience
CAHPS survey improvement experience
PCMH ( Patient Centered Medical Home) NCQA certification experience
Proficiency with Excel and Visio (flow chart equivalent) and demonstrated ability to learn new information systems and software programs
Proficiency with clinical data Analysis, manipulation, and interpretation and validation
Knowledge of basic statistics
Knowledge of medical terminology, Medical Claims
Performs aspects of the Quality Program including STARs, CAHPS, PCMH as well the operation and coordination of Quality Improvement processes
Defines, develops, organizes and communicates program interventions and analytical plans to support 5 Star Quality Improvement initiatives, Quality Improvement Programs (QIP) and Performance Improvement Projects (PIP)
Completes all needed reporting to meet corporate end user needs on a timely and effective basis including HEDIS and P4P (Pay for Performance Bonus/internal scorecards; reports associated with QI activities vs. revenue; trending over time and progress over year; tracking of touches, visits, refusals, reason codes, rendered services, encounters or other data
Manages the day-to-day workflows for quality reporting that may include design, change management, requirements gathering, end-user communications. and release schedule
Must be personable and able to communicate well with physicians and other clinical and technical staff
Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies

RN Consultant Senior Resume Examples & Samples

Handles complex or high exposure claim issues; advises and leads Nurse Consultant - PL colleagues
Interviews practitioners involved in medical malpractice claims at hospital facilities weekly as needed
Participates in follow-up review and investigation as directed and assists in discovery requests as needed
Technical claims knowledge of medical malpractice claims procedures and practices
Ability to meet or exceed Performance Competencies

Rn Senior Resume Examples & Samples

Mixes and administers chemotherapy, hydration and other medications under the direction and supervision of a physician
Assists physician with exams and procedures. Maintains efficient and appropriate patient flow in and out of exam rooms
Records patient data prior to each physician visit, including but not limited to, vital signs, height, weight, allergies, medication changes
Facilitates dose modification by assessing patient, assessing labs, consulting protocol or treatment plan, calculating dose, and consulting physician regarding dosage modifications, problems and symptom management. Performs venipuncture, accesses implanted ports and maintains central lines catheter devices
Assures nursing charges are accurate and complete on patient fee slips. Acts as a resource person to the medical assistants
Triages patient phone calls as needed and documents relevant information in the patient's chart
Maintains a clean work environment and restocks the supply area as needed. Provides nursing coverage for the satellite offices as needed
Follows OSHA guidelines when handling cytotoxic agents, biohazardous waste and any other material potentially infected with a blood borne pathogen. Participates in professional development activities and maintain professional affiliations. Maintains patient confidentiality

Rn Senior Resume Examples & Samples

Review all chemotherapy orders prior to administration to ensure completeness and accuracy
Confirm the regimen is consistent with currently accepted medical practice as evidenced by safety and efficacy data published in peer reviewed medical literature
Review all initial orders, clinical information and treatment plans
Confirm BSA calculation based on height and weight
Assess the medication use process and recommend process improvements as needed
Serve as a practice-wide resource for chemotherapy safety issues
Registered Nurse with at least five years of oncology-related experience
Must be Oncology Certified Nurse or must obtain OCN status within one year from date of hire

RN Um-medical Management, / II / Senior VMJ Resume Examples & Samples

Ability to talk and type at the same time
Demonstrate critical thinking skills when interacting with members
Ability to manage, review and respond to emails/instant messages in a timely fashion

Senior Clinical Consultant RN Resume Examples & Samples

Proficiency in Jiva, including CM/DM/UM workflows and reporting
Experience in capability development and/or system implementation
Knowledge of CMS, ERISA and NCQA compliance requirements
Knowledge of InterQual criteria

Rn-senior Clinical Practice Consultant Resume Examples & Samples

*Candidate must live in Akron, Ohio as this is a telecommuter position working with providers in these areas***
6+ years clinical experience
3+ years of quality improvement experience, or other relevant experience
Proficient with Excel, Intermediate computer literate and have MS Word, Outlook, and Internet demonstrated skills

Visiting RN, Senior Living Resume Examples & Samples

Making home visits to clients in designated senior living communities within specific geographic territories
Monitoring clients' conditions; reporting changes to Clinical or Client Services Manager as well as to the appropriate senior living community personnel and to the client’s family members/POAs
Following up with, executing, and properly documenting doctors' orders
Performing client assessments as necessary
Case management and coordination
Work as part of an on-call rotation
One (1) weekend per month
Two (2) holidays per year
A current license as a Registered Nurse in Pennsylvania
A minimum of one (1) year of recent, verifiable clinical (medical/surgical, long-term care, rehab, or home health/visits) experience is required
Demonstrated ability to read, write, and effectively communicate in English
Ability to work independently and manage time effectively
Strong interpersonal skills and a strong desire to form relationships with interdisciplinary team mates and senior living community personnel for the benefit of improved care quality for community residents

RN Senior Practicum Student Faculty Resume Examples & Samples

Must be a senior Seattle University or Bellevue College nursing student
Must be selected by university/college to be part of program
Willingness to learn

Senior Clinical Trials RN Resume Examples & Samples

BSN or RN
Possession of a valid Louisiana license required by the State of Louisiana to practice nursing
Minimum of 5 years clinical RN experience
Oncology Certified
Clinical trials experience
RN with 10 years experience inclusive of Oncology, Clinical Trials, Surveillance/Auditing, and/or EMR/Data Management experience

Senior Coordinator Clinical Data RN Resume Examples & Samples

Data Collection Oversight and Analysis: Directs and coordinates all aspects of the National Cardiovascular Data Registry (NCDR) functions, including data collection, data submission, data validation, outcomes report review and analysis. Assures accurate data collection so that databases accept a complete submission and harvest of charts with all required data elements. Ensures that data meets or exceeds requirements of NCDR registry and other CV-related databases or payer requests-for-information, by participating in internal or external audits of data integrity. Acts as a key liaison with internal and external parties, including Sutter/Cardiovascular IS, LumedX (Apollo), or external data abstraction partners, etc., pertaining to hardware, software, reports, access, end-user training/education, service agreements and troubleshooting of issues
Performance Improvement and Project Management: Supervises and coordinates quality improvement efforts, within departments or larger quality improvement (QI) efforts, such as the Cardiovascular Co-Management teams. Works with physicians and management to identify and coordinate QI efforts based on NCDR outcomes and other CV data. Develops materials using data analysis to generate presentations for QI committees, administrative and/or CV Co-Management teams. Collaborates with physicians and management teams regarding variance from top-decile performance and/or best practices. Makes recommendations and/or helps drive action plans for improvement. Completes projects/tasks with a high level of independence, in consultation with the Cardiovascular Service Line Director and/or QI Director/Manager
3-5 Years Experience working as an RN in an acute care and/or critical care setting
3-5 Years Quality Improvement, Quality Assurance / Peer Review - chart abstraction, preferably with Epic
3-5 Years Experience with data management systems and familiarity with clinical data analysis and reporting
0-2 Years Significant experience with facilitating Quality Improvement projects in an acute hospital setting
0-2 Years Understanding and current experience with NCDR registries of focus

Field Service Coordination, Senior, RN Resume Examples & Samples

Assists with implementation of new and expanding healthcare case management initiatives
Assists in implementation of market specific strategies that improve on the quality and outcomes of member's care
Represents supervisors and management in meetings or on special assignments
Helps establish process improvements leading to best practice and assist in implementing change movement
Trains, mentors and provides guidance to new and current Field Service Coordinators regarding policy and procedure, systemic tools, workload and care plan development
Applies case management standards, maintains HIPAA standards and confidentiality of protected health information and reports critical incidents and information regarding quality of care issues
Ensures compliance with all state and federal regulations as well as Corporate guidelines in day-to-day activities
Travel to inpatient bedside, member’s home, provider’s office, hospitals, etc required with dependable car
May spend up to 70% of time traveling with exposure to inclement weather and normal road hazards
Required A Bachelor's Degree in Health Services or Nursing or equivalent work experience
5+ years of experience in clinical acute care is required
3+ years of experience in current case management is required
3+ years of experience in managed care is required
Prior utilization management experience preferred in some geographic regions
Experience in care of the elderly is required in some geographic regions
Experience in home health, physician's office or public health is preferred
Ability to understands the business and financial aspect of case mgmt in a managed care setting
Maintain required contact hours to fulfill regulatory requirements is required
Certified Case Manager (CCM) is preferred
Proficient in Microsoft Office including MS Excel, MS Word, MS PowerPoint, and MS Outlook Express is required

Senior RN Consultant Resume Examples & Samples

Handles complex or high exposure general liability claim issues
Receives requests for investigation; reviews and develops action plans and investigates cases accordingly
Collects data from Company and clients to document and communicate results as appropriate
Prepares reports summarizing medical records and interviews; outlines issues related to summary reports; and provides analysis and recommendations for further claims handling

RN Senior Hal-saguaro / Glendale Resume Examples & Samples

Maintains all exam room disinfection protocols. Assesses patients for changes in condition, including but not limited to abnormal labs, x-rays, scans, drug reactions and initiates appropriate action
Maintains knowledge of reimbursement procedures. Completes all chemotherapy charge forms. Assures pre-authorization and appropriate consent forms are obtained prior to administration of therapies. Demonstrates knowledge of ambulatory infusion pump use and maintenance, cleaning pumps after use, and proper documentation of pump usage
Administers all medications/blood products using correct medication/blood product, dosage/amount, route, time and technique. Displays appropriate technical skills for the administration of chemotherapy, medications and blood products, to include, but not limited to: venipuncture, central line access and infusion devices
Programs portable infusion pumps for continuous drug delivery and provides instruction to the patient and/or caregiver in the use of the pump at home. Documents nursing assessments, patient teaching and fluid and medication administration in the patient chart. Communicates all pertinent information and any interventions to the physician
Assesses patient/family needs and provides teaching and other instructional material. Demonstrates awareness of community resources available to patients and assists with referrals if necessary. Manages patient medication refill requests from the pharmacy telephone line and records the information in the patient chart

RN Transfer Services Senior Director Resume Examples & Samples

Plans, directs and monitors the regional patient placement program. Provides advice, counsel, feedback and coordination to promote a collegiality between staff, physicians and the company leadership teams. Develops and fosters excellent relationships with rural providers to facilitate clinically appropriate patient transfers and improve continuity of care
Directs, supervises, and evaluates the work of staff and managers as assigned. Holds staff accountable for achieving plans and performance targets. Works with staff to identify and resolve the most complex issues and problems impacting care coordination programs. Supports development and continued professional growth to meet company and individual goals for long-term success. Demonstrates an expectation for continuous quality improvement utilizing processes that include consideration of all stakeholders
Builds and supports effective relationships with internal and external stakeholders and organizations. Develops partnerships, coordinates activities, reviews work, exchanges information, and/or resolves problems related to care coordination programs
Directs and participates in the development, implementation, and consistent application of effective organizational policies, procedures, and practices. Develops and supports internal controls to ensure that assets are safeguarded, policies and operating procedures are followed, necessary controls are effective and efficient, and compliance with current laws and regulations is achieved
Develops and oversees appropriate budgets to meet corporate goals and objectives. Meets annual budgetary goals. Translates organizational plans, goals, and initiatives into assumptions for annual operating and/or capital budgets. Negotiates contracts with external vendors for products and/or services and monitors/evaluates quality and/or performance. Manages and reports expenditures
Communicates the department vision, translating it into actionable projects and activities. Maximizes management staffs contributions and assures timely decision-making reflecting the mission, vision, and values of the system
Reviews, prepares, analyzes, and presents reports and recommendations to senior leadership regarding operations, programs, services, and/or other applicable areas of interest in order to provide concise and accurate information that aids in decision-making
Participates as a subject-matter expert and may lead or facilitate task forces, teams, and/or councils to plan, implement and coordinate programs, services, and/or activities for the organization. May serve as a staff resource to the organizations Senior Management and/or applicable committees. In the course of the work, the Sr Director, Transfer Services will work collaboratively with Banner and non-Banner facilities to create safe and appropriate patient transfers with a focus on appropriate level of care, continuity and coordination of care, both into and out of the acute care space. Monitor efficiency, quality and experience metrics of the transfer process to assure effective and efficient provision of service. Work collaboratively with Regional C-suites, BMG leadership, BHURD and independent physicians to develop a premier transfer service to provide best-in-class service and compete strategically in the marketplace

RN Telephonic Senior Case Manager Resume Examples & Samples

At least 3 years clinical experience in an acute care setting
Previous experience in case management, discharge planning
Experience meeting or exceeding metrics in a dynamic environment
Strong computer and communication skills

RN Senior Operations Manager Resume Examples & Samples

Develops and maintains effective business relationships with key contacts at each LT Medical Clinic and their respective staff
In partnership with the implementation and operations team, works to establish a client specific opening and support plan
Develops an implementation schedule, communications plan and issues tracking method for the client
Develops clinical resources and continuing education for implementation
Serves as the primary contact for the clients onsite RN Clinic Manager
Works with the client to establish clinical work flows, supplies, and other resources based on contractual relationship
Compiles all details of client’s profile and agreements and disseminates details to appropriate parties in order to set up, administer and provide ongoing support for clients
Adheres to contractual obligations - ensuring LT Medical’s performance and works with implementation team to develop reports to measure actual performance against guarantees
Works cross-functionally with legal, operations, and other teams to ensure business objectives are met
Addresses ongoing challenges and determines solutions
Complete other duties and projects as assigned