Nurse Medical
Resume:
Personnel Office
Human Resource Director,
I would like to apply an in terview for the open position of Care Review Clinician. I
am a L icensed Practical Nurse. I have over 8 years of experience in Managed Care
working as a Clinical Review Specialist and Care Coordinator for T riWest
Healthcare and Molina Healthcare. I also have experience as a Clinical Liaison
being the primary contact for Providers and healthcare facilities conducting onsite
v isits, t raining and facilitating questions, issues and problem resolution for
P roviders and/or their office personnel.
As a L icensed Practical Nurse and mili tary retiree I have worked in a wide variety
of health care settings to include acute, post acute, long term acute care and skilled
n ursing. I have a strong clinical background. I am very knowledgeable of
McKesson and interqual review criteria, CPT, HCPC, ICD-9, ICD-10 codes and
claims.
I t hink my healthcare experiences, clinical background and Managed
Care/Utilization Management knowledge makes me a strong and viable candidate
for the Care Review Clinician position. I welcome the opportunity to interview and
d iscuss my experiences further. I have included my resume with this cover letter. I
look forward to speaking with you soon in reference to the position.
Thank you for your consideration.
Albert C. Jennings
**********@*******.***
A lbert C. Jennings
**********@*******.***
Objective:
To obtain a position as a Care Review Clinician
Employment H istory:
Nurse Clinical Review Specialist; T riWest Healthcare Alliance, Tacoma,
Washington. Responsibilities included conducting prior authorization, medical
necessity reviews for inpatient and outpatient services; care coordination and
resolutions of claims issues (January 2008 – March 31, 2013).
Nurse Authorization Specialist ; Molina Healthcare, Bothell, Washington.
Responsibilities included conducting prior authorization medical necessity reviews
for inpatient and outpatient services and resolution of claims issues (2003-2007).
Kindred healthcare; over a 7 year period served in various upward mobility
positions at Kindred healthcare to include medical/surgical nurse, Case
M anager/Marketing Sales and Admissions L iaison.
Active duty military; working in the capacity as a Licensed Practical Nurse
assignments include intensive care nursing, oncology nursing, team leader,
emergency department nursing and medical surgical nursing
E ducational Summary:
Pending admission: Master’s of Healthcare Administration (MHA) Western
Governors University, Seattle Campus, Seattle, Washington. Anticipated start date
February 2014.
Bachelors of Science degree, Southern I l linois at Carbondale, I L with a field of
s tudy Curriculum design adult education. Graduated Aug 2003
Active L icensed Practical Nurse
Certified Instructor, Academy of Health Science, San Antonio, TX
Contact this candidate