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Clinical Business Consultant

Location:
Safety Harbor, FL
Posted:
September 21, 2021

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Resume:

Hector Leonardo Beltran Dechner

*** *********** *** ****

Oldsmar FL 34677

727-***-****

adorpq@r.postjobfree.com

September 15, 2021

Dear Hiring Manager,

I am applying for a position at your company. Based on the posted description, I am confident that I am fully qualified for the position and will be a strong addition to your team. I look forward to a job interview at your earliest convenience. Please find my resume attached. I can be reached at the number above or at my email address. Sincerely,

Hector Leonardo Beltran Dechner

September 2017- Present

Hector Leonardo Beltran Dechner

245 Countryside key blvd Oldsmar FL 34677

727-***-**** • adorpq@r.postjobfree.com

Objective

Creative and resourceful individual with 11+ years of clinical, and business management experience. Coming with a broad knowledge of clinical business/technical consulting, high-level commitment to quality, problem-solving, analytical skills, and strong project management skills. Key Qualifications

● Accomplished Clinical business consultant – Over 11 years of clinical experience and 6+ years of experience assisting clients in analyzing, implementing and evaluating business projects to exceed performance expectations utilizing varied business practices, core competencies, and key skills include:

● Decision maker – Collecting facts, discovering issues and providing sound solutions.

● Planner Self-motivated Strategist Analytical Problem solver

● Communication and presentation skills

● Able to build strong customer relationship

● Out of the box thinking: thinking beyond existing practices and mindsets

● A planner and a strategist

● Self motivated

● Superb presentation skills

● Able to cooperate with diverse professionals

● Effective networking skills to deal with customers

● Creative thinking and critical thinking abilities

● Knowledge about latest trends in order to formulate strategies. Work Experience

Product Manager / Case Manager SME

Mhk – Tampa, FL

● Led multiple code upgrades for the UM / CM & Provider Portal solutions.

● Managed the Care Management implementation of multiple multimillion Dollar Health plans implementations.

● Participated in and/or lead in the strategic direction, feature design, user interaction, requirements, and roadmap of one or more products and solutions.

● Worked with development, implementation, testing, support, sales, and field engineering team members to bring new features and products to successful release.

● Communicated with current and potential customers on a regular basis to understand their processes and needs.

● Translated those into product requirements, understood needed changes over time, and helped customers get the greatest value from mhk solutions.

● Represented the “voice of the customer” internally, using healthcare domain experience in guiding product design and development.

● Collaborated on overall mhk product strategy, roadmap, and cohesiveness with colleagues on the Product Management team possessing a range of health and technology expertise.

● Served as an internal subject matter expert in one or more health domain areas.

● Understood and advised on relevant industry trends, including new products, regulatory changes, scientific and medical advances.

● Provided real-time analysis and updates prior, during, and post implementations as to better defined gains and areas of improvement.

May 2019 - Sept 2019

April 2016 - Dec 2018

Feb 2013 - Sept 2015

July 2006 - July 2015

Behavioral Health Staff Registered Nurse

UHS – Pinellas Park FL

● Collaborated with a clinical team of 3 clinical specialists to assist patients through a period of mental crisis.

● Conducted quality reviews for the all psychiatric units.

● Conducted patient psychiatric admissions, assessment, psych orders review, obtained & interpreted appropriate lab tests.

● Chronic patient care in med-surg unit, adeptly handling all aspects of treatment from medication administration to monitoring critical patients per shift.

● Supervised and managed number clinical and support staff in patient care activities while maintaining a high level of staff morale & professionalism.

● Encouraged the use of traditional and non-traditional effective mindful practices during regular patients lifestyle, and moments of crisis.

Utilization Clinical Reviewer

Healthcare Integrated

● Let the coordination and completion of efficient clinical reviews of inpatient and outpatient authorizations.

● Consistently followed with applicable laws and regulations and ensured facility adhered to Medicare, Medicaid and independent health plan regulations.

● Continually maintained and improved the company's reputation and positive image in the markets served.

● Achieved high staff morale/retention through effective communication and facilitating a proactive environment.

● Assisted in the resolution of patients and providers related operational discrepancies.

● Coordinated patient discharges, and post discharge care management tasks.

● Identified inpatient and service request process improvement ideas that led to changes in processes. Clinical Supervisor

Carecentrix/SMS – Tampa, FL

● Led the Clinical and non clinical teams on key production initiatives.

● Conducted multiple prior authorization management studies & proposals which led to more efficient processes.

● Interpreted, and communicated new or revised Medicare, and indecent health plan guidelines.

● Strategically planned methods to achieve operational goals.

● Continually maintained & improved the company's reputation in the markets served.

● Encouraged creative thinking, and empowered the teams to collaborate on providing news ideas and development of better processes.

● Achieved high staff morale & retention through effective communication and proactive supervisory practices.

● Routinely collaborated with department managers to correct discrepancies & improve services.

● Supervised and managed the daily activities of the clinical team consisting of a number nurses and support staff.

● Assisted in identifying, resolving & satisfying client requests and internal operational issues.

● Conducted daily & weekly meetings with front working clinicians, non-clinicians, & the utilization executive team.

Staff Nurse/LPN Supervisor

Manor Care – Palm Harbor, 34684, FL

● Completed patient admissions to long-term and rehab care units.

● Completed daily assessments, orders, obtained/interpreted appropriate lab results, provided wound care treatments, IV antibiotic therapies, TPN therapy, trach care, G-tube care, & G-tube feedings.

● Supervised a number of clinical and support staff.

● Provided pharmacological and non-pharmacological management for the treatment of various disorders.

● Made recommendations for professional development based on performance reviews.

● Ensured compliance with prescribed standards of practice.

● Collaborated with patient care team to yield positive patient outcomes Feb 2012 - Feb 2013

2009 - 2011

Jan 2008 - Jan 2011

2018 - Present

2014 - 2016

2006-2007

Concurrent Review Nurse

Universal Health Care Insurance – Saint Petersburg, FL

● Coordinated and completed efficient clinical reviews of inpatient and outpatient authorizations.

● Consistently complied with applicable laws and regulations and ensured facility adhered to Medicare and Medicaid regulations.

● Continually maintained and improved the company's reputation and positive image in the markets served.

● Achieved high staff morale/retention through effective communication and facilitating a proactive environment.

● Assisted in the resolution of patients and providers related operational discrepancies.

● Coordinated patient discharges, and post discharge care management tasks. Home Health Nurse

American Nurses - Pinellas Park, FL

● Served as a clinical resource to our patients and their caregivers.

● Collaborated with multi departmental teams to address multiple critical events as a result of patients exacerbated medical conditions.

● Ensured a smooth transition of services upon a patients initial assessment and discharge.

● Collaborated with the interdisciplinary team in the management of the patients care.

● Provided best nursing related teaching based the clients pharmacological and non pharmacological needs.

● Obtained/interpreted appropriate lab results. Povided wound care treatments, IV antibiotic therapies, Trach care, G-tube care & G-tube feedings. Staff Nurse

Freedom Square – Seminole, FL

● Collaborated with other to complete efficient patient admissions to long term care, rehabilitation care, and memory care-units.

● Completed daily assessments, orders, obtained/interpreted appropriate lab results, provided wound care treatments, IV antibiotic therapies, TPN therapy, trach care, G-tube care, & G-tube feedings.

● Oversaw and led a team of clinicians and support staff.

● Collaborated with patient care team to yield positive patient outcomes.

● Made recommendations for professional development based on performance reviews.

● Ensured compliance with prescribed standards of practice. Education

RN / BSN

Medical Prep Institute of Tampa Bay

RN / ADN

Medical Prep Institute of Tampa Bay

LPN

Pinellas Technical Education Center, St. Petersburg, FL Other Skills

● Bilingual (Spanish & English).

● Strong interpersonal and communication skills; computer experience.

● Knowledge of Interqual, McKesson and CMS guidelines.

● Proficient with Microsoft office, and multiple clinical platforms/applications.

● Proficient with Agile, and Waterfall project management methodologies.



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