Medical Consultant Resume Samples

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ES
E Schamberger
Esperanza
Schamberger
6106 Theresia Estates
Philadelphia
PA
+1 (555) 375 5920
6106 Theresia Estates
Philadelphia
PA
Phone
p +1 (555) 375 5920
Experience Experience
Phoenix, AZ
Medical Consultant
Phoenix, AZ
Berge and Sons
Phoenix, AZ
Medical Consultant
  • Establish scope, protocol and approach to providing both Guest first aid and Cast Member Health Services at SHDR
  • Develop strategies to increase employee engagement in their health and life balance in order to build a resilient and productive workforce for the future
  • Identify, manage and mitigate fundamental occupational medicine issues at the workplace
  • On duration of the project, interface with site management on all Cast Member health-related matters
  • Develop Occupational Health Policies and Procedures
  • Development and presentation of CPD seminars, luncheon presentations to clients or IDEXX staff
  • Consultants are expected to meet caseload and turnaround expectations and to be accessible for client consultations during regular working hours
Houston, TX
Medical Information Consultant
Houston, TX
Bernier Group
Houston, TX
Medical Information Consultant
  • Self-Management, act as a Product and sales expert within the team, provide counselling and mentoring to junior team members
  • Finance Management, set up budget plan and execute accordingly based on company policy
  • Planning: propose, review, design and implement hospital promotion plan through the collaboration with line manager and marketing colleagues
  • Team Collaboration, work closely and collaboratively with other team members
  • Sales Achievement & Business Development
  • Industry & Disease/Therapeutic area
  • Industry & Disease/Therapeutic area knowledge
present
Los Angeles, CA
Professional Medical Affairs Consultant
Los Angeles, CA
Berge, Kirlin and Wilderman
present
Los Angeles, CA
Professional Medical Affairs Consultant
present
  • A significant part of the successful applicant’s working time will be spent in travelling within Turkey
  • To understand clinical and performance differences between JJVC products and key competitor products
  • Assist Turkish PAF & Business team: panel meetings and training, product launches, practice visits etc
  • Teaching ECPs how to communicate and fit new JJVC products, using a benefit driven strategy
  • Support generic educational initiatives to increase knowledge and confidence in contact lens prescribing and fitting
  • To understand the interaction between sales, marketing and national accounts
  • To keep up to date with the latest research and advancements within vision care correction
Education Education
Bachelor’s Degree in Health Related Field
Bachelor’s Degree in Health Related Field
University of Florida
Bachelor’s Degree in Health Related Field
Skills Skills
  • Flexible with a strong ability to multitask
  • Strong literature searching skills and ability to synthesize complex information
  • Excellent medical writing skills/ability to write clearly for a diverse audience
  • Excellent written and verbal communication skills including the ability to present information in to large audiences
  • Ability to identify, evaluate, understand and synthesize clinical evidence from peer reviewed literature
  • Ability to analyze and translate data to develop recommendations for action plans
  • Able to work with minimal supervision
  • Ability to multi-task, shifting back and forth effectively among multiple activities
  • Comfortable speaking and working with Senior Leadership
  • Ability to track and analyze data to report out to management
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15 Medical Consultant resume templates

1

Medical Consultant Resume Examples & Samples

  • Establish scope, protocol and approach to providing both Guest first aid and Cast Member Health Services at SHDR
  • Understand and document as relevant to Disney the local Shanghai and China country specific requirements for worker health and public health
  • Provide medical consultation and expertise for occupational health matters. Document process and protocols and train related partners to include medical surveillance, government mandated exams and certifications, OSHA-required exams, work-related injury/illness management, fitness for duty evaluations, urgent care cases
  • Develop strategies to increase employee engagement in their health and life balance in order to build a resilient and productive workforce for the future
  • Define strategy for determining whether to in source or outsource the Guest First aid services, and take part in hiring or defining outsource vendor
  • Work with Director of Safety, VP of HR and CMO to develop a strategy for Cast Member Health Services including recommendations on physician and nursing staffing and services, operational effectiveness, and clinical effectiveness
  • Develop Occupational Health Policies and Procedures
  • On duration of the project, interface with site management on all Cast Member health-related matters
  • Work with Director of Safety (SHDR) and VP of Safety Services, as well as CMO to create new medical surveillance programs as needed to address novel occupational health hazards
  • Provide wellness services (biometrics, health assessments, wellness lectures) as needed
  • Establish partnership with local hospital; and parameters of that partnership as it relates to green channel for guest and cast medical services, sick leave mgt., maternity situations, work injury, health certification renewals etc
  • Monitor ongoing emerging public health issues in China and work with site leadership and CMO to mitigate exposures to Cast and Guests at SHDR
  • Identify, manage and mitigate fundamental occupational medicine issues at the workplace
  • Fluent in both English and Mandarin
  • Understanding of both Western Medicine as well as Traditional Chinese Medicine
  • Broad perspective on health care delivery and ability to translate the vision to strategy and execution
  • Personal and professional integrity of the highest order
  • High energy and personal presence as a component of leadership ability
  • Effective consensus building and negotiation skills
  • Excellent communicator, both written and oral for multiple audiences
  • Highly developed interpersonal skills with demonstrated ability to manage multiple constituencies
  • Able to collaborate in a global environment with occupational health and wellness leaders from various countries
2

Retiree Medical Actuarial Consultant Resume Examples & Samples

  • Perform actuarial consulting in the area of retiree health care valuations
  • Assist in the development of standard processes and tools for retiree medical claims and trend assumptions that lead to high quality results
  • Provide actuarial client project leadership focusing on building relationships with clients and/or other internal RFM consultants, working independently and often directing the efforts of others through project management, coaching and mentoring team members
  • Form effective actuarial teams, share client background and goals, share ideas, provide timely and regular coaching and feedback to team members
  • Lead all retiree health care-related actuarial valuation work on client teams, provide technical coaching to other team members, and provide ultimate sign-off on results
  • Additional formal or informal responsibilities may include: people management or mentoring, workflow management, technical expertise
  • Actively engage in peer review to ensure high quality client deliverables
  • College degree (or equivalent experience)
  • Candidate must have ASA/FSA (Associate of the Society of Actuaries or Fellow of the Society of Actuaries) designation
  • 5+ years of health care industry experience (carrier or consulting)
  • People management experience or equivalent skills (depending on people management responsibilities)
3

Medical Economics Consultant Resume Examples & Samples

  • Prior budgeting and planning experience
  • Comprehensive knowledge of Microsoft Office applications including Access, Excel and multi-dimensional databases
  • Must be proficient with SQL Server - build complex queries
  • Must understand CMS reimbursement - Medicare to providers on a FFS basis
  • Strong data manipulation skills
4

Medical Services Consultant Resume Examples & Samples

  • Independent professional standing in a clinical behavioral health field
  • 5-10 years of progressive management experience in managed behavioral health care
  • Ability to collaborate in a joint team framework on achieving overall medical/behavioral goals
  • Master’s degree required
5

Medical Practice Consultant Resume Examples & Samples

  • Professional appearance and disposition
  • Commitment to client service
  • Strong initiative and problem solving abilities
  • Commitment to business development
  • Strong organization and time management abilities
  • Strong Excel skills
  • 5+ years Healthcare industry experience/and or education
  • Solid knowledge of Medicare and third-party payer coding and billing regulations
  • Understanding of operations management for medical clinics
  • Knowledge of various physician compensation arrangements and models
  • Experience in developing and performing presentations
  • Strong project management skills are imperative
6

Medical Quality Consultant Resume Examples & Samples

  • A background in Customer Experience is essential
  • Quality experience
  • 3+ years' experience in the pharmaceutical industry
  • Superior facilitation and presentation skills; excellent written and communication skills
  • Able to travel as required
7

Consultant / Medical / Economics Resume Examples & Samples

  • Degree in health- or business-related field
  • Experience in ecomomics pertaining to the healthcare industry
  • Excellent PC skills required
  • Strong organizational and research skills
  • Able to identify and solve problems quickly and efficiently
  • Advance degree in related field
8

Professional Medical Affairs Consultant Resume Examples & Samples

  • Optimising Eye Care Professionals and key influencers’ awareness of the clinical benefits of Johnson & Johnson Vision Care’s (JJVC’s) products involving both national and independent practices
  • Teaching ECPs how to communicate and fit new JJVC products, using a benefit driven strategy
  • Support generic educational initiatives to increase knowledge and confidence in contact lens prescribing and fitting
  • Assist Turkish PAF & Business team: panel meetings and training, product launches, practice visits etc
  • Support practice visits and peer-to-peer recommendation initiative
  • Actively participate in JJVC involvement in clinical conferences across Turkey and also support Local Professional meetings and ECPs Focus meetings were appropriate
  • Participate in regular dialogue with ECPs designed to help support them and gather their views
  • Graduated from a faculty of Medicine / Pharmacy / Biology / Chemistry
  • Min 3 years experience in Contact Lens / Ophthalmologyindustry
  • Demonstrable experience of working successfully in a team
  • Very good interpersonal and presentation skills
  • High verbal and written communication skills in English & Turkish
  • Computer skills including Power point, Word and Excel
9

Clinical Program Consultant for Medical Policy Resume Examples & Samples

  • Triage/prioritize the Medical Policy Executive, Individual physician and Medical Society related Questions/complaints that come into the Medical Policy Questions mailbox (1 business day TAT required for triage; Enter requests in physician complaint tracker
  • Meet with Executive Admin for National Medical Policy, Medical Policy daily(dependent on volume) to review National MD, Medical Policy inbox to filter for direct submission complaints
  • Research and prep National MD, Medical Policy to review question/complaint/legal (1 business day TAT required)
  • Monitor open requests to ensure timely completion of requests (10 business day TAT);updating of tracker for completion/updates
  • Coordinate the upload of society/individual complaints to PEI tool with Director, Physician & Society Engagement
  • Meet with National MD, Medical Policy and Director, Physician & Society Engagement on a scheduled basis—minimum of weekly and interact throughout the week to ensure timelines are met Prepare responses on requests and send to National MD, Medical Policy for editing and finalization
  • Develop sample letter repository that will be stored on the Executive Compliant SharePoint that can be utilized for future requests with modifications
  • Complete and distribute monthly activity reports to leadership
  • EPMC Executive Medical Policy committee: Agenda+ follow up items from previous meetings, completion of minutes and posting of materials to EMPC SharePoint site. All EMPC review and direction should be working with the chairperson
  • Prep chairperson for MTAC meetings—ensure policy summaries are reviewed with the chairperson prior to the meeting. Develop agenda and follow up on action items from previous meetings. Post materials to appropriate SharePoint site
  • Monthly review of MTIS requests—
  • 5+ years of experience working within a managed care organization or health insurer
  • Medical Management, Appeals or Claims experience with a health insurer
  • Proficient in the use of MS Word and PowerPoint. Intermediate to advanced knowledge in Excel
  • Prior experience tracking projects and reporting out of data
  • Ability to multi-task, shifting back and forth effectively among multiple activities
  • Flexible with a strong ability to multitask
  • Ability to analyze and translate data to develop recommendations for action plans
  • Excellent written and verbal communication skills including the ability to present information in to large audiences
  • Ability to identify, evaluate, understand and synthesize clinical evidence from peer reviewed literature
  • Excellent medical writing skills/ability to write clearly for a diverse audience
  • Strong literature searching skills and ability to synthesize complex information
  • Understanding of medical coding concepts (e.g., CPT, HCPCS, ICD-9/10)
  • Comfortable speaking and working with Senior Leadership
  • Ability to track and analyze data to report out to management
10

Senior Medical Consultant Resume Examples & Samples

  • Broad application of principles, theories, and concepts in applicable discipline, plus working knowledge of other related fields
  • Uses professional concepts in accordance with company objectives to solve complex problems in creative and effective ways
  • This job is the fully-qualified, career-oriented, journey-level position
  • Demonstrates functional area business processes and assigned and thoroughly understands crossfunctional areas
  • Directs the analysis of enterprise-wide or very complex client needs in project areas such as new/existing business operating models, innovative approaches to solutions support, market research of emerging or available product functionality and operational readiness assessment
  • Directs the development of comprehensive and strategic business cases with cost/benefit dimensions of proposed projects that are used at management and executive levels for funding and scope decisions
  • Accountable for tracking and/or monitor and report for senior mgmt the results of actualization of benefits
  • Directs/conducts the analysis of current business processes and functional requirements
  • Prepares appropriate documentation to communicate and validate the information
  • May develop project plans
  • Identifies and coordinates within other project managers and implements schedule deadlines as appropriate
  • Manages common resource demands
  • Provides on-going project management and status reporting at all levels
  • Provides advice and input into the project plan
  • Minimum ten (10) years of experience, to include a minimum three (3) years in a consulting role
  • Minimum five (5) years of experience in a relevant environment such as a healthcare environment
  • Certification or advanced qualification by third party association that matches the function or field applicable to the business discipline (such as AHIP or HIAA) preferred
  • Certification by professional society or industry group such as AHIP or HIAA preferred
11

Medical Practice Consultant Resume Examples & Samples

  • Requires a BA/BS. Clinical background and/or MBA not required but a plus
  • 5-10 years health care experience; or any combination of education and experience, which would provide an equivalent background
  • Physician environment experience in practice transformation / quality improvement, ambulatory care setting quality and efficiency metrics, population health and care management structures, data analytics and electronic health records preferred
  • Strongly prefer program management experience
  • Strongly prefer external facing provider relations experience
  • Prefer contracting experience
  • Prefer experience with healthcare analytics
12

Medical Economics Consultant Resume Examples & Samples

  • Responsible for analyses and profitability determination of contracts, business and billing rules; includes fee-for-service to full risk contracting arrangements
  • Responsible for familiarity with a variety of Apria's business concepts, practices, and procedures and their impact on profitability
  • Generate reports as requested using departmental databases
  • Performs other related duties as directed by supervisor
  • Education or experience equivalent to a four year college degree is required
  • At least 1 years related work experience
  • Proficient with Microsoft Office products, particularly Excel, and Access
  • SQL experience is a plus
13

Regional Lead-medical Economics Senior Consultant Resume Examples & Samples

  • Undergraduate degree in business, finance, related field preferred or 3 to 5 years equivalent work experience in the healthcare industry
  • Demonstrated leadership and project management experience
  • Understanding of medical cost drivers and provider contracting methods
  • Knowledge of Medicare Advantage products and services
  • Advanced software and programming skills: proficient in Excel
14

Medical Economics Consultant Resume Examples & Samples

  • Being able to manage complex projects that will compete for priority
  • Knowledge of provider contracting and reimbursement methods
  • Financial modeling in Microsoft Excel
  • Turning data into usable information
15

Medical Consultant Resume Examples & Samples

  • Responsible for telephone consultation with clients regarding choice of appropriate diagnostic testing, interpretation of laboratory results (both reference laboratory and in house testing) and potentially treatment and long-term management of medical cases
  • Responsible for knowing tests offered by IDEXX (reference labs and in house tests), specimen requirements and clinical utility of each test and how to interpret results
  • Consultants are expected to meet caseload and turnaround expectations and to be accessible for client consultations during regular working hours
  • Maintain proficiency and continually develop medical knowledge base by attending continuing professional development meetings and maintain familiarity with current literature
  • Participate in scheduled consulting service meetings and other educational or organizational meetings as they arise
16

Senior Medical Economics Consultant Resume Examples & Samples

  • Perform utilization analyses for accounts, payor types and products
  • Participate in meetings to discuss pricing strategy in support of contract negotiations
  • Predict and ensures timely provision of rate quotations and financial analysis reports
  • Maintain historical versions of models and completed analytics
  • Assist less experienced Medical Economics Consultants
  • Mentor less seasoned staff
  • Education or experience equivalent to a four year degree is required
  • At least three years related work experience is required
  • Developing reporting and analytics in SQL/SSAS
  • Healthcare industry experience is a plus
  • Must occasionally lift and/or move up to 10 pounds
17

Senior Acta Medical Economics Customer Consultant Resume Examples & Samples

  • Minimum of 5 years experience performing complex healthcare analytics
  • Strong technical skills in Excel, Access, PowerPoint required. SAS/SQL knowledge a plus
  • Excellent communication skills (written and verbally)
  • Previous experience and ability to drive a cross matrix team to achieve results
18

Acta Medical Economics Customer Consultant Resume Examples & Samples

  • Minimum of 2 years experience performing complex healthcare analytics
  • In depth knowledge of healthcare financial concepts
  • Excellent independent worker in addition have a strong ability to work well in a team environment
19

Senior Medical Cost Management Consultant Resume Examples & Samples

  • Develops strategy to improve member outcomes and reduce medical costs for the business line(s). Develops and implements tactical plans to achieve strategic objectives
  • Works independently across departments to coordinate development of strategy and implementation
  • Reviews and analyzes reports including MLR, claims trend data, and other actuarial data. Commissions new reports as needed working with different functions such as informatics, actuary and departmental analytical teams
  • Participates as subject matter expert in departmental care cost committee
  • Provides reports to senior leadership identifying cost trends, cost reduction targets
  • 10+ years' experience in health care management/administration/consulting
  • Excellent problem solving skills with ability to address problems that are broad, complex and abstract, often involving company-wide issues and requiring substantial creativity, resourcefulness, staff engagement, Lean diagnostic techniques, negotiation and diplomacy to develop solutions
  • Knowledge and experience in health plan business managed care processes and operations
  • Excellent computer skills including Microsoft Excel and PowerPoint
  • ------------------------------------------------------------------------------------
20

Medical Economics Consultant Resume Examples & Samples

  • Coordinate the oversight and monitoring of the Home and Community Services operating margin improvement effort, driving cross-functional team work efforts to identify, design, implement and monitor initiatives that improve the Organization’s revenue, claims and administrative expenses
  • Use medical economics experience and knowledge to facilitate idea generation and quantification of savings initiatives (areas of focus include provider contracting, utilization management, care management, risk adjustment, operational efficiency, product design, etc.)
  • Provide timely insight into claim cost drivers for the business segment leaders and identification of new improvement opportunities
  • Understand the larger medical cost picture, and create process to identify and quantify interactions and dependencies of the different initiatives
  • Use medical economics experience and knowledge to develop and implement infrastructure to align and explicitly link initiatives’ savings estimates with the financial plans/forecasts, emerging financial results and product pricing
  • Partner with Finance, Actuary, FP&A and the business and functional partner leaders to ensure that the initiatives are appropriately contemplated in current/future year projections and pricing models as well as monitored in the emerging financial results
  • Coordinate savings opportunity projections and post implementation savings measurement with other areas
  • Regularly interact with Senior leadership to set and adjust overall goals and objectives of the process
  • Provide greater ability to more timely engage, analyze, and implement beneficial but complex financial arrangements with new vendor business partners
  • Help develop and implement improved infrastructure and processes to provide management with regular performance scorecards highlighting initiative implementation successes, accountability, “capture” of initiative benefits, activity, progress and identification of barriers
  • Consistently work with the business and functional area partners to develop a pipeline of new initiatives, seeking to achieve our multi-year financial improvement targets. This effort focused on operating margin improvement is positioned to become a normal part of the way HCS does business
  • Train business partners in the use of business case return on investment measurement, developing a self-service culture that enables a broad base of support to initiative owners in their efforts to identify potential operating margin improvement initiatives
  • Develop improved business case and savings estimate capabilities to enable more accurate and deeper projections
  • Assist in the deployment of an employee-wide communications strategy, highlighting the operating margin improvement challenge and providing regular status reports with respect to achievement of targeted improvements
  • Influence other departments where you do not have direct authority
  • Be persistent in following up with senior management and staff from numerous departments
  • Collaborate with P&L owners and functional leaders. This will require strong communication skills (verbal and executive quality presentations)
  • Be able to determine when projections seem unreasonable and constructively push back until satisfied with the analysis
  • Bachelor's Degree - Finance, Accounting, Analytics or other related field
  • 5 years’ progressive experience in finance, accounting or analytics/informatics in the health care payer sector with a focus on medical economics
  • Master’s degree in health care management, decision sciences, or quantitative field is preferred
  • Demonstrated expertise in particularly-relevant analytical methods or health care business domain (payer/provider)
  • Demonstrate consistent application of strong problem solving skills in the creation and interpretation of quantitative analyses, and to assist the supervisor in development of analysis plans
  • Experience in all aspects of health service research including extracting, understanding, and proper analysis of health insurance or health care delivery data
  • Working experience with analytical (SAS, R, Python), visualization (Tableau, Spotfire, Cognos), and data (Oracle, Teradata, Hadoop) software
  • Excellent written and oral communication skills, with the ability to communicate and interpret complex strategic and technical findings to management and colleagues, verbally and through written reports, the results of complex, quantitative analysis
  • Ability to influence senior decision makers with demonstrated leadership experience in a healthcare industry consulting role
  • Ability to establish collaborative working relationships across business units that include colleagues with diverse clinical and business skill sets and analytics acumen
  • Person must demonstrate a high degree of professionalism, enthusiasm, and initiative on a daily basis
  • Ability to work in a fast-paced, complex environment is a must
21

Medical Economics Consultant Resume Examples & Samples

  • Use medical economics experience and knowledge to facilitate idea generation and quantification of savings initiatives (areas of focus include provider contracting, utilization management, care management, risk adjustment, operational efficiencies, product design, etc.)
  • Partner with Market Segment Finance, Actuary, FP-A and the business and functional partner leaders to ensure that the initiatives are appropriately contemplated in current/future year projections and pricing models as well as monitored in the emerging financial results
  • Regularly interact with Senior Finance leadership, including the Chief Actuary and CFO of the Health Plan as well as other leadership and staff, to set and adjust overall goals and objectives of the process. Provide greater ability to more timely engage, analyze, and implement beneficial but complex financial arrangements with new vendor business partners
  • 5+ years' progressive experience in finance, accounting or analytics/informatics in the health care payer sector with a focus on medical economics
  • Medical economics
  • Financial analysis/modeling
  • Statistical/quantitative modeling
  • Executive communication
  • Direct report development/talent management
  • Collaboration across matrix organizational structure
22

Medical Economics Associate Consultant Resume Examples & Samples

  • An understanding of the healthcare industry; Required
  • The ability to demonstrate critical thinking; Required
  • Analytical ability with financial and healthcare concepts; Required
  • Express ideas clearly and the desire to achieve results; Required
  • Microsoft Office Proficiency; Required
23

Medical Policy Consultant Senior Resume Examples & Samples

  • 1) Present and provide implementation input to key government programs and medical policy committees
  • Medical and Behavioral Health Policy Committee
  • Coverage Committee
  • Operational committees as assigned, for example the Coding and Reimbursement Committee
  • Government Program committees including the PAMMP meetings and Rules meetings
  • 2) Prepare final policy documents and tools for implementation
  • 3) Implement medical policies ­ integrates with all systems to ensure accurate claims processing
  • 4) Ensure that changes in the medical policy positions are communicated to all related business areas
  • 5) Research and apply appropriate and regular updates of CPT, HCPCS, and ICD-9/ICD- 10 coding to the medical policies
  • 6) Maintain Blue Cross's intranet and internet medical policy databases with current policy decisions and coding
  • 7) Produce standard reports and assist in the analysis and impact of these reports as they relate to policy implementation process. This will require training in several Blue Cross systems such as the utilization management platform, claims processing application, ViPS STARS and others as necessary
  • 8) Serve as a liaison to other divisions (e.g., Network Management, Account Management, and Service) for medical policy issues on government programs
  • 9) Research issues on an ad hoc basis to determine coverage status of other payers and FDA approval status; this may also require limited research of evidence-based literature
  • 10) Lead work groups, as needed
  • 11) Lead projects that support Medical Policy Department and/or Government Market Solutions
  • 12) Serve as a subject matter expert on Government Programs medical policy implementation and claims processing to team members and BCBSM
24

Medical Risk Consultant Resume Examples & Samples

  • Collaborate with underwriters to proactively evaluate and price potential ongoing risks that will affect the loss ratio of a group
  • Provide medical input on claim payment interpretations
  • Demonstrated competency to work in conjunction with the underwriters to come up with creative risk solutions
  • Demonstrated knowledge of medical technology and the related cost
  • Extensive knowledge of facility inpatient and outpatient coding and/or claim review, facility and benefit contracts, language and implications
  • Advanced knowledge of medical and surgical procedures and other healthcare practices required
  • Demonstrated understanding of standard office and business practices and desktop applications; excellent computer skills and proficiency working software programs (e.g., Microsoft Word and Excel, and database query tools)
  • Able to function efficiently in multiple claim systems
  • Demonstrated math aptitude, analytical ability, competent in performing complex and detailed work with high level of accuracy and independently without direct supervision
  • Strong communication skills; clear and succinct, both orally and in writing, with peers and colleagues, regarding complex and sensitive issues
  • Experience leading complex internal projects and initiatives impacting business operations and product decision making
  • Demonstrated research and documentation skills
  • Advanced knowledge of health plan cost containment strategies including medical management interventions, provider contracting methodologies, and benefit design alternatives
  • Demonstrated competency in analyzing cost of care based on highly individualized data
  • Demonstrated competency to interpret risk with varying factors that are individual and group specific
  • Strong knowledge of case management functions and the ability to be a resource to that team
25

Medical Economics Senior Consultant Resume Examples & Samples

  • 3-6 years of SAS programming and data analysis experience
  • Prior experience with Aetna data systems preferred but not required
  • This is a telework position and can be located near any Aetna office**
26

Medical Economics Consultant Resume Examples & Samples

  • Strong SQL experience and Advanced Excel experience is required
  • 3+ years of data interpretation and analysis experience
  • Extensive experience with databases as well interpretation and manipulation of related data
  • Healthcare background preferred
27

Medical Device & Diagnostics Consultant Resume Examples & Samples

  • Assist Global Head, Regulatory Affairs, in assuming primary or secondary regulatory responsibility for assigned clinical research projects in medical devices/diagnostics by providing to the project team regulatory information, guidance, training, support and strategic planning based on applicable regulations and guidances issued by the applicable regulatory agency(ies)
  • Manage/oversee assembly and submission of applications to competent authorities
  • Identify and interpret regulations, guidelines, and other pertinent information issued by applicable regulatory agencies and other regulatory organizations
  • Directs the performance of the regulatory affairs staff. Develops project timelines, develops strategic goals with staff, and provides guidance as needed for completion of tasks. Assesses performance and recommends salary adjustments
  • Review protocols, consent forms, reports, scientific documents, publications, and related papers, etc., as appropriate for various clinical research projects to ensure compliance with regulations
  • Ensure the compilation and maintenance of pertinent documentation (e.g., files) required for regulatory compliance for assigned clinical research projects
  • Keep abreast of, interpret and communicate applicable regulatory agency regulations and statutes with internal departments and ensures Novella compliance
  • Serve as a member of groups, teams, or committees related to regulatory affairs, and quality assurance or other designated Novella activities, as appropriate
  • Participates in business development activities to grow Novella business. Participates in new business development activities including, but not limited to, client meetings and proposal preparation/presentation
  • Extensive knowledge of clinical research and product development life cycles for medical devices, diagnostics, combination products, and related products
  • Extensive working knowledge of activities related to regulatory affairs, reimbursement and quality assurance, both domestic and international
  • Robust experience in medical device regulatory affairs for class II and III devices and diagnostics in the US and ROW
  • Good interpersonal skills with the ability to communicate effectively, both orally and in writing, with all levels of staff, and with the public
  • Ability to be detail oriented with background adequate to deal with scientific issues related to technical regulations and SOPs
  • Demonstrated ability to motivate, lead, and grow a regulatory affairs team
  • Extensive demonstrated experience directing and supervising staff
  • Ability to read and synthesize technical material and to prepare clear and concise written documents
  • Comprehensive knowledge of US Good Clinical Practice (GCP), ISO 14155-2011 (GCP), Good Manufacturing Practices (GMP),Quality Systems Management (ISO 13485) and Good Laboratory Practices (GLP) requirements,
  • Demonstrated experience in client service in the clinical research business
  • Demonstrated high energy level
  • Ability to handle multiple tasks and challenges simultaneously
  • Demonstrated ability to form strong working relationships across functional boundaries
  • Exceptional ability to conceptualize, develop and manage timelines
  • Ability and willingness to travel internationally
  • Ability to travel internationally for extended periods of time
28

Disability Medical Consultant Resume Examples & Samples

  • Multiple positions may be filled based on the availability of funding
  • Criminal record check required
  • Individuals selected for positions with the NC Disability Determination Service (DDS) will go through a complete federal background investigation. A suitability determination by the Social Security Administration is necessary to determine whether an employee can be issued credentials in order to have access to Social Security disability data, records, and systems. A pre-screen will be conducted through SSA Office of Human Resources (DCHR). If the pre-screen is favorable, a job offer can be extended. However, the job offer is still contingent upon a full suitability clearance through DCHR
  • This classification requires graduation from an accredited school of medicine and a current license to practice medicine in the State of North Carolina
  • Must possess a comprehensive knowledge of theory, principles and practices of general, preventative medicine, techniques involved and recent developments in medicine
  • Effective communication skills, both orally and written, with the ability to establish and maintain effective working relationships with others
  • The ability to work in an administrative, regulatory system involving established rules and restrictions
  • Candidates must possess the ability to compile clear and concise notes and case analysis
  • Successful candidates must possess and be able to demonstrate computer proficiency and keyboarding skills, as work requires the ability to navigate between various applications/programs/screens
29

Medical Quality Consultant Resume Examples & Samples

  • Manages outsourced services for virtual/vended medical and vocational case managers, by providing governance and oversight of all vended managed care services to ensure the delivery of appropriate, high quality services
  • Provide vendor service level expectations and standards by establishing and maintaining service level agreements
  • Responsible for QA oversight of internal and external vended case management, and utilization review activities by reviewing and analyzing vendor/in-house quality metric reporting on a monthly basis and reporting results
  • Ensures accuracy and quality standards are achieved by completing ongoing quality reviews for vendor and internal MCM services, Utilization Review and Medical Billing
  • Drives quality and operational effectiveness by identifying and collaborating with the appropriate internal and/or external resources or teams to execute appropriate action plans to address identified improvement opportunities
  • Builds strong relationships with vendor partners by hosting and/or participating in regular operational and/or stewardship meetings
  • Acts as a point of contact to both internal and vendor by fielding and addressing vendor issues impacting claim performance
  • Performs activity reviews on outsourced assignments as necessary by providing technical direction to our vendor partners to bring successful resolution of the referral
  • Acts as a change agent by supporting the strategic direction of medical management, ensuring appropriate communication to stakeholders and by building collaboration and commitment to the efforts
  • Enhances industry knowledge by keeping current on state/territory/national regulations, trends and issues and acts as a technical mentor to the organization
  • Solid knowledge of the insurance industry, in-depth knowledge of managed care services/products, case management techniques, medical terminology, and conditions, disability management and workers compensation claims
  • Ability to exercise professional judgment and assume responsibility for decisions which have an impact on people, costs and quality of service
  • Excellent verbal, written, and presentation skills with the ability to convey technical issues in a clear, concise and effective manner
  • Strong interpersonal skills with the ability to effectively interact with internal and external business partners
  • Detail oriented with strong organizational and analytical skills as well as the ability to prioritize and coordinate multiple tasks
  • Knowledge of Microsoft Office Suite, Official Disability Guidelines, Presley Reed Medical Disability Advisor and other business-related software
  • Bachelor's degree or equivalent work experience
  • Typically a minimum of five to eight years of experience in conducting quality assessment evaluations of technical and professional case management / vocational services is preferred
  • Previous vendor management / oversight experience preferred
30

Kaplan Medical Enrollment Consultant Resume Examples & Samples

  • Use a consultative sales approach with prospective students
  • Provide accurate & timely information regarding Kaplan programs, I-20 applications, enrollment procedures and
  • Reach sales targets by making outbound calls, receiving inbound calls, and conducting advising sessions with prospective and current students in person and over video chat
  • Actively retain current students for their next step prep with Kaplan
  • Build mutually beneficial relationships through a consultative approach that leads to top line growth
  • Drive top line growth while being empathetic and maintaining customer focus
  • Use test prep expertise to close sales
  • Use metrics and key performance indicators to set and reach personal goals
  • Excellent presentation and public speaking skills, ability to provide a comfortable sales environment for
31

Medical Economics Associate Consultant Resume Examples & Samples

  • The ability to demonstrate critical thinking
  • Analytical ability with financial and healthcare concepts
  • Microsoft Office proficiency (Excel & Access)
  • The ability to communicate ideas and results clearly
  • An understanding of the healthcare industry
32

Senior Medical Economics Consultant Resume Examples & Samples

  • EDUCATION AND EXPERIENCE REQUIREMENTS
  • Building profitability models and performing strategic analysis
  • Command of Microsoft Office products, particularly Excel, PowerPoint and Access
  • Developing reporting and analytics in SQL or SSAS
  • Experience with database and programming, such as SQL and Access
  • Experience in Healthcare, managed markets, and analytics
  • Working with other teams and good communication skills both verbal and written
  • Telecommuting OK
33

Medical Rehabilitation Consultant Resume Examples & Samples

  • To assist in the rehabilitation management of income protection claims made through group risk products and provide propositional support as well as training and development for the team of claims case managers
  • Manage a minimum portfolio of 60 rehabilitation referrals over a 12 month period
  • Work with the ZCR Claims Case Manager, employers and employees and their medical advisors to draw up rehabilitation plans and graded return to work plans and support these through to successful outcomes and customer satisfaction
  • To fully demonstrate medical skills, knowledge, best practice guidelines and research based evidence in all rehabilitation activities
  • When indicated enable, support and evaluate appropriate effective treatment provision through the Zurich provider network
  • To act as a point of specialist referral for non-medical employees of ZCR
  • To actively encourage knowledge transfer into Zurich claims and rehabilitation service departments to progress and update all colleagues levels of medical competence and confidence
  • Ideal pre requisites for us are experience of Insurance based Medical/Vocational Rehabilitation or Occupational Health working experience
  • Previous experience of group risk desirable
  • Understanding of claims functions and processes is again desirable
  • Ability to work with our customers to enable solutions in work place issues is essential
  • Broad medical knowledge particularly in relation, psychiatric illness, to musculo-skeletal conditions and cancer
  • Good working knowledge of the NHS and understanding of how to circumnavigate potential treatment delays
  • Good understanding of the private medical sector and the services available
  • Ability to communicate to all levels
  • Ability to form working relationships quickly and professionally and to use these relationships to positively impact upon the claims departments function
  • To be able to embrace change and demonstrate adaptability
34

Medical Economics Consultant Resume Examples & Samples

  • IDX Claim system and/or processing needed
  • Strong Analytical background
  • Provider contracting
35

Medical Information Consultant Resume Examples & Samples

  • Planning: propose, review, design and implement hospital promotion plan through the collaboration with line manager and marketing colleagues
  • Account & Brand Management: build strong relationships and credibility with Medical Practitioners, Nurses and Pharmacists to influence the prescription of Roche products, visit nurse to collect market feedback and build product advocacy
  • Performance Management, align with line manager to set working objective and task, collect and analyze data information on time based on business requirements
  • Finance Management, set up budget plan and execute accordingly based on company policy
  • Team Collaboration, work closely and collaboratively with other team members
  • Self-Management, act as a Product and sales expert within the team, provide counselling and mentoring to junior team members
  • Sales Achievement & Business Development
  • Product knowledge
  • Industry & Disease/Therapeutic area
  • Customer
  • Sales Force Effectiveness and capability development
  • RDPAC qualification within probation
  • Pass all Roche mandatory training courses before required timeline within probation
  • Good Selling skills and familiar with product knowledge
  • Industry & Disease/Therapeutic area knowledge
  • Good customer management ability and teamwork spirit
36

Senior Medical Cost Consultant Resume Examples & Samples

  • Serves as a business line expert and provides management consultation to senior leadership in the areas of medical loss ratio, medical cost reductions, strategy development, product and benefit development, and care management
  • Reviews and synthesizes literature and technical developments in the field of care management, medical cost management and medical informatics. Applies these new techniques to the continued improvement in medical cost management
  • Leads special projects and directs activities of project teams through a matrixed reporting structure as needed to implement cost containment strategies
  • Demonstrated experience working in matrixed environment
  • Demonstrated experience in business performance analytics, reporting, operational analysis and business performance optimization
  • Ability to lead and influence at all levels of the organization
  • Excellent communication skills including oral and written