Cosmetic facial rejuvenation including laser, microneedling, Injectables, fillers and spa treatments.

•Oversee all related activities for the case management functions •Ensure program is providing quality outcomes at reduced costs through meeting targets for the annual operating plan/financial management•Manage the delivery of services to members, ensuring services are appropriate and cost effective•Ensure compliance with government and company requirements in the case management function •Develop and implement new procedures, regulatory filings and manage compliance issues.•Develop, implement, and oversee case management policies and procedures and•Develop, implement, and maintain case management programs to facilitate the use of appropriate services and resources in order to maintain memberships

*Provides management and direction to one or more health services areas including, staffing, training, monitoring, and evaluating. *Reviews the timeliness, appropriateness, and medical necessity of the utilization processes performed by the staff. *Actively participates in the development, implementation, and oversight of thedepartment's activities; serves in an adjunct role for policy and procedure development and implementation. *Assists in the identification of issues which may adversely impact the attainment of department goals/initiatives (i.e., inpatient bed days per thousand, outpatient surgery utilization, etc.) *Collaborates with other departments to educate providers, vendors, and members regarding network providers/specialists benefits and utilization management policies and procedures. Attends meetings with internal workgroups and external business parties. *Assists in the identification and triage of potential quality improvement issues. *Responsible for compliance with State and Federal law regarding the handling of utilization management decisions and/or appeals. *Ensures compliance with national accrediting body standards regarding utilization management decisions and/or grievances. *Recruits, develops, and motivates staff. Initiates and communicates a variety of personnel actions including employment, termination, performance reviews, salary reviews, and disciplinary actions.

Responsible for revenue attainment in Rental Therapy product lines. Secure, Grow and Convert assigned rental targets. Responsible for the clinical and financial management in assigned rental accounts. Strategize with Account Executive to achieve assigned capital revenue goal. Provide clinical consultation to acute care customer base. Responsible for clinical rounds in priority customer locations. Responsible for utilization of sales collateral to support clinical and financial solutions. Conduct Prevalence Studies and present findings to key customers. Report regularly on current rental revenue trends, conversion status and competitive issues to the Area Vice President. Maintain expertise on products and sales collateral. Completion of assigned objectives as assigned by manager. Keep current on Healthcare Trends. Responsible for monthly billing activities which include review of the billing report (Unbilled-596), open purchase orders (PO), days sales outstanding (DSO),Capitation Summary Reports, Revenue and AIU trending & Sales Forecasting. Problem identification and resolution. Clinical Consultative Services via pager. Collaboratively develop/implement clinical account protocols. Present continuing education programs to RNs, RTs and Clinical Staff. Product Demonstration and Clinical Inservicing

I have18 years of Neonatal and Pediatric ICU nursing including management.I have 4 years of Special Procedure, Interventional, Outpatient and Endoscopy nursing.I work as a medical expert; defense only.