Experienced Medical Professional with 10+ years of experience and a significant background in progressive administrative and nursing roles within the medical industry. Experienced in reviewing complex healthcare claims, coordinating new hire training, and leading cross-functional teams. Equipped with a keen ability to manage large-scale projects, implement process improvements, and foster positive rapport with vendors, patients, co-workers, and members of executive management.

Utilization Management Project Management Training / Development Policy Development

HIPAA Regulations Medical Claim Management Team Leadership Case Management

Process Improvement Discharge Planning Emergency Management Medical Chart Management

  Direct day to day administrative operations within a fast-paced environment with a concentration on increasing productivity and efficiency levels

  Review documentation related to submitted medical claims, coordinate patient discharge planning, and work closely with both in-house and outside teams as needed

  Utilize superior communication and interpersonal abilities to coordinate staff training in addition to reviewing and revising current training documentation/templates

  Coordinated daily medical functions within a pediatric ICU which required providing individualized patient care while simultaneously ensuring high levels of patient care levels are attained

  Provided coaching and guidance to patients in regards to treatment plans, assisted with medical procedures, and assessed patient medical status changes

  Facilitated nursing operations within an interventional radiology unit which required administering medication both orally and via IV in addition to performing sedation procedures

  Completed patient rounds on a regular basis in order to obtain patient vital signs, ensured treatment plans were followed, and educated both patients and families on both treatment and discharge plans

  Managed administrative operations within the organization which included reviewing detailed medical charts and identifying needed medical history

  Entered complex data into a database, identified potential inaccuracies within the patient s medical files, and assisted with special projects as needed

  Administered medications to patients via IV and/or IM such as antibiotics and monoclonal antibodies which were targeted for immune mediated inflammatory disorders

  Performed constant assessments of the appropriateness of prescribed medication, documented responses to treatment, and supervised administrative staff members

  Completed detailed industry research as needed, worked with insurance companies to obtain pre-authorizations, and managed office medication inventory

  Oversaw daily nursing tasks within an emergency room environment which required assessing patients with life threatening injuries/illnesses and developing treatment plans

  Administered medication to patients, updated/revised treatment plans, coached patients on treatment plans, and implemented streamlined operating procedures within the facility

  Supported nursing operations within a high stress environment which focused on caring for critically ill pediatric patients with a variety of ailments such as congenital heart defects, trauma, and medical illnesses (both chronic and acute)

  Played a lead role in training new staff members, monitored patient quality levels, updated medical charts, and maintained communication with both patients and guardians

  Cared for critically ill patients within the organization which required identifying and implementing stabilization treatments, monitoring for complications, and achieving optimal patient responses

  Worked closely with internal medical teams in the revision of treatment plans, updated medical records, and provided discharge planning