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Xxxxxx, XXXXXX xxxxxx ￨ (xxx-xxx-xxxx ￨ email@example.com
Practice Management ￨ Managed Healthcare ￨ ACOs ￨ Program Development / Management
Quality / HEDIS Audits ￨ Records Review / Appeals ￨ PQRS Reporting ￨ Regulatory Compliance
Clinical Nursing ￨ Transitional Care ￨ Team Building ￨ RN Training / Development / Instruction ￨ KPIs
Profit / Loss ￨ Multimillion-Dollar Budget Control ￨ Strategic Analysis / Planning ￨ Trends Tracking
Medicare / Medicaid ￨ MACRA ￨ Private Payer Insurance ￨ Value-Based Reimbursement ￨ Medical Marketing
Highly Accomplished, Multi-Credentialed Healthcare Leader who offers judicious decision-making to align with a multi-site facility s strategic vision, value, and goals and continually promote patient-, safety-, quality-, and profit-focused initiatives. Top Performer who contributes solutions-centric critical thinking for insightful, change-oriented patient care results, and who leverages nursing and business management experience to drive success in a competitive healthcare market. Visionary Professional who rises above challenges to achieve winning outcomes, including quickly adapting to evolving scenarios. Excellent Communicator who develops synergistic relationships with cross-geographical healthcare teams, third parties, patients, families, and the community, and who leads peers by example and with ethics and integrity to maximize an employer s success.
Career Highlights Include:
Actively managing multimillion-dollar budgets.
Seamlessly launching go live marketing campaigns.
Strategically creating multimillion-dollar marketing plans.
Continually spearheading product line quality improvements.
Researching Medicare / Medicaid, ACOs, and private payer trends.
Co-launching two new service lines in accordance with Medicare regulations.
Launching a dynamic start-up business unit to maximize bottom-line performance.
Leading development of promotional channels, advertising campaigns, and research projects.
Rapidly identifying market penetration opportunities within the primary care practice segment.
Promoting lucrative multi-channel marketing campaigns via market research and competitor analysis.
Quality Auditor II RN (Contract Role)
Lead forward-thinking quality auditing of medical record charts encompassing hospital services, healthcare treatments, standard Medicare reimbursement, and medical terminology for hospitalization re-admission denial appeals. Evaluate patient medical records, interpret provider documentation to identify quality of care issues (i.e. medical acronyms, abbreviations), and assess patient clinical stability at time of discharge and readmission. Document and prepare audit findings to determine validity of denial and / or quality of care issue.
GPRO ￨ HEDIS Auditor (Contract Role)
Strategically steered HEDIS chart abstraction analysis and medical record review for key plan metrics, clinical procedures, medication, and operational PQRS performance. Expertly audited clinical documentation to ensure assigned ICD codes were accurate and supported by diagnosis and plans of care. Evaluated performance levels, identified performance gaps, and prepared and submitted reports with quality improvement recommendations.
Product Marketing Analyst ￨ EMR Support
Utilized broad scope of industry knowledge toward researching Medicare / Medicaid, ACOs, and private payer trends, as well as the effects of value-based reimbursement on the transformation of private healthcare practices. Led targeted identification of market penetration opportunities in the primary care practice segment, including creating client profiles in Salesforce database, preparing revenue forecasts, and launching go live campaigns. Researched guidelines, developed work-flows and playbook, and contributed to the marketing plan of two new service lines per Medicare regulations. Exhibited skill in providing EMR support, triaging and resolving client user issues, managing multiple electronic interfaces, reconciling IDX errors, and interpreting HL7 messages.
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Delivered excellence in daily medical administration for a 20-resident unit, including performing head-to-toe assessments and developing results-focused patient care plans while managing lab results; ordering, receiving, and accurately administering medication and insulin; and handling wound and / or tracheostomy care.
Planned and presented dynamic nursing science curriculum instruction within a classroom environment of LPN students seeking Associate s Degree in Nursing Science and RN licensure. Designed practice tests and detailed PowerPoint presentations and / or lecture materials, as well as interactive clinical application scenarios.
Marketing Program Manager
Expertly identified and built profit-generating business plans to resolve strategic marketing issues for C-Level clients, including participating in key projects for industry expansion, leveraging existing core competencies into new industries and market segments, analyzing industry competition, and researching quantitative marketing efforts, as well as continually promoting multi-channel marketing campaigns and product development.
Maximized bottom-line performance by directing a top-performing team of five marketing managers and two marketing analysts to promote the strategic direction of a five-brand business unit. Owned a $25-million profit / loss statement while managing a $5-million advertising budget. Developed brand-specific marketing plans.
Led strategic decision-making in driving lucrative profit / loss while developing innovative marketing plans and launching a start-up business unit. Supervised a two-member team of associate marketing managers tasked with product development, marketing channel management, and comprehensive product positioning.
Senior Marketing Manager
Applied strong leadership talents toward directing two unique business lines generating $19 million and $2 million in revenue, respectively. Coordinated and managed a bid department while overseeing a staff of two product managers, one marketing analyst, and one bid department manager. Led development and execution of marketing plans, including promotional channels, advertising campaigns, product line management, and research projects.
Profitably directed marketing initiatives, including driving all product line management, customer acquisition, mail pieces, merchandising, marketing research, financial database management, and monthly KPI reporting initiatives.
Master of Business Administration (Economics) Temple University
Master of Science in Marketing Temple University
Bachelor of Science in Nursing Thomas Jefferson University
Bachelor of Business Administration (Marketing) University of Notre Dame
Registered Nurse (No. 0000 xxxxxx xxxx , xxxx , xxxxx 00000900) State of Xxxxxx (Expires 2019)
EMR Platforms ￨ IDX Systems ￨ Multiple Electronic Interfaces ￨ CPT Coding ￨ ICD-10 ￨ HL7 Messaging
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