Quality Management Clinical Analyst Resume

SUMMARY:

To pursue a career as a RN Consultant and offers opportunities for professional growth and career advancement.

PROFESSIONAL EXPERIENCE:

Confidential

Quality Management Clinical Analyst

Responsibilities:

Experience using a variety of health care software systems for a major health insurance carrier and supplier of Medicare senior products including Medicare Advantage.
Recent experience with laptop computer usage for the purpose of the documentation of healthcare information regarding health plan members.
Experience with managing software in a managed care and medical informatics environment.
Served as a primary point of contact for three facilities, providing both guidance and customer service to both providers (hospitals and physician offices long - term care facilities and nursing homes) and members of a fortune 100 health plan.
Provide clinical support to the Humana case management and sales team.
Available for travel (local, regional, or national) at 80-100%.
Delivered provider education and consultation regarding product line of health insurance services and serves as a support system to Humana Marketpoint sales team.
Excellent customer service skills. Passion to complete projects and acquire new information.
Experience in performing patient referrals, health assessments, and patient interviewing.
Excellent customer service skills.
Completion of the American Association of Managed Care Nurses Introductory Home Study Program—August 2008
More than 34years of progressively responsible experience in all aspects of nursing care.
Current experience in the areas of medical record review and quality management.
Occupational and home care management background.