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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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