Healthcare Consultant Resume Sample
Sandy Windler
124 Aiden Fields,
Houston,
TX
+1 (555) 910 4289
Work Experience
Senior Healthcare Consultant
03/2016
-
PRESENT
Boston, MA
- Experience in customer service, data management, communications, or credentialing verification required, providing contracting within health industry
- STT clientasupports: Enrollment, MOPS, MID, OMS, Test OBC
- Provides laboratory consulting services to clients within an assigned sales region
- Has direct interaction with Regional Vice President, Sales and Account Executives
- Functions as initial point of contact for consultative services within the assigned region
- Participates in regional sales conference calls with Account Executives
- Collaborates with specialty consultants when necessary to provide comprehensive consultative solutions for clients
Healthcare Consultant
10/2012
-
02/2016
Chicago, IL
- Experience with a LHCSA or health plan experience
- Generates letters through the system as needed. Utilizes both fax and phone notification to contact physician's office for the above activities
- Accountable for all aspects of physician recruitment and contracting as well as ad/hoc network contracting, as assigned
- Responsible for re-negotiating or negotiating solo, group, hospital-based and physician contracts in support of network quality, availability and financial goals
- Participates in the strategic recruitment of physicians satisfying specific network goals and objectives
- Proficient in Excel and Word; ability to use Search Engines
Junior Healthcare Consultant
01/2008
-
06/2012
Phoenix, AZ
- Travel: Ability to travel off-site 41%-60% of time
- Generates UM+ (utilization management) reports for clients in designated region
- Monitors the medical management system Case Trakker alert and service request queues and processes authorizations. Monitors the failed fax, and resends faxes to ensure receipt
- Coordinates information about outreach for new prescriptions with appropriate staff and departments who receive the faxes
- Generates letters through the system as needed. Utilizes both fax and phone notification to contact physician''s office for the above activities
- Log into ACD line to respond to requests from LHCSA regarding authorization status
- Make outreach calls to members as needed
Education
American Sentinel University
2002 - 2007
Bachelor's Degree in Business
Professional Skills
- Excellent communication, teaming, writing and presentation skills
- Strong quantitative skills and able to analyze and interpret financial data
- Proven customer service skills and the ability to successfully analyze and procure solutions to problems in a fast paced production based environment
- Previous experience, including experience in five or more building types
- Interpersonal Skills Yes 1 Advanced Currently Using 2 - 4 Years
- Verbal Communication Skills Yes 1 Expert Currently Using 2 - 4 Years
- Written Communication Skills Yes 1 Expert Currently Using 2 - 4 Years
How to write Healthcare Consultant Resume
Healthcare Consultant role is responsible for excel, software, microsoft, modeling, research, credit, languages, leadership, powerpoint, analytical.
To write great resume for healthcare consultant job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Healthcare Consultant Resume
The section contact information is important in your healthcare consultant resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Healthcare Consultant Resume
The section work experience is an essential part of your healthcare consultant resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous healthcare consultant responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular healthcare consultant position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Healthcare Consultant resume experience can include:
- Communication Skills - Strong written and verbal communication skills
- Proven experience developing enterprise class Web applications in Microsoft''s .NET environment (Visual Studio including C# and SQL Server experience)
- Can demonstrate examples of problem solving skills to achieve delivery of a solution or outcome
- Excellent English language skills, proficiency in MS office software programs
- Strong business acumen, project management and analytical skills
- Outstanding oral and written presentation skills
Education on a Healthcare Consultant Resume
Make sure to make education a priority on your healthcare consultant resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your healthcare consultant experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Healthcare Consultant Resume
When listing skills on your healthcare consultant resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical healthcare consultant skills:
- Experience managing practice operations, technology, or experience in heatlh care performance improvement consulting projects
- Computer skills in Windows environment, including MS Word and Excel
- Intermediate Computer skills, medical terminology, Medicare knowledge
- Prior experience working in a standard SDLC (waterfall methodology) & in an AGILE delivery
- Experience the variety of clients, projects and situations that offer the best of learning environments
- Quality Assurance (QA) Testing IBM Cúram software experience No 1
List of Typical Experience For a Healthcare Consultant Resume
1
Experience For Senior Healthcare Consultant Resume
- Have excellent written and verbal communication skills, including presentation skills
- Proven working knowledge of standard provider contracts, terms and language desired ( ) Background/Experience Desired Education and Certification Requirements
- Critical thinking, and interpersonal skills
- Demonstrated experience designing Web applications
- Demonstrated experience coding Web applications
- Experience in selling and leading delivery of large, comprehensive consulting engagements required
2
Experience For VP-healthcare Consultant Resume
- Direct selling experience to executive-level buyers– preferably selling services
- Have experience working in one or more of the practice’s following focus areas
- Strong working knowledge of Information Governance principles in Healthcare and/or Life Sciences
- Construct evidence-based delivery system, payment, and quality improvement recommendations and solutions
- Assess current solution, solutions available through other State’s efforts and develop the most cost effective and efficient plan
- Maintaining a productive partnership with the headquarter team including undertaking training on the wider portfolio
- Identifying and correcting billing errors and resubmitting claims to insurance carriers
3
Experience For Director Healthcare Consultant Resume
- Obtaining, verifying, and calculating income and resources to determine client financial eligibility
- Understanding of modern/agile IT development lifecycle processes including development and testing
- Marketing and sales evaluations including mystery shopping
- Assisting patients in applying for financial assistance through Medicaid on behalf of our client facility
- Documenting case records using automated systems to form a record for each client
- Completing/following up on all forms related to Medicaid eligibility
- Providing mentoring and/or project management function as required
- Being the key point of contact with a customer and developing a long term sustainable partnership
- Maintaining a working knowledge of radiology informatics and to apply this to the clinical context of a project
4
Experience For Manager Healthcare Consultant Resume
- Understanding of basic cost accounting and financial principles
- Building/creating project deliverables with the ability to manage 2+ complex work-streams
- Developing and providing mock survey activities related to CMS, TJC, HFAP, etc
- Developing and providing mock survey activities related to CMS, TJC, HFAP, DNV etc
- Interviewing patients or authorized representatives via phone or in person to gather information to determine eligibility for medical benefits
5
Experience For Junior Healthcare Consultant Resume
- Following up with applicants to obtain accurate and complete information within strict timeframes
- Performing any additional tasks related to the position assigned by the Manager
- Working in a team to delivery successful client assignments that achieve and exceed clients’ expectations
- Ongoing evaluation of approach with process changed dictated by the industry standards
- Understanding of IT development and implementation projects Yes 1 Intermediate Within 1 Year 2 - 4 Years
- Working some additional or irregular hours as needed
- Providing review and remittance advice for payment errors, denials, and under payments
- Following up on denied or unpaid claims
6
Experience For Financial Systems / Healthcare Consultant Resume
- Calling insurance companies to follow up on claims
- Submitting denials and appeals when necessary
- Supports sales calls and assisting in closing of sales, including preparing leave behind and qualification packages
- Support the Firm’s marketing initiatives as related to the Senior Living Consulting Practice and the related growth strategy
- Implement testing programs to perform quality assurance on technical applications including negative testing and usability
- Supports internal Quality and Regulatory staff mentoring and enhancing their learning capabilities / efforts
- Be professionally challenged while working with, and being coached by, an outstanding team of Consultants
- Working in a Management Consulting/Professional Consulting organization
- Provide ongoing consulting for preparation for maintaining regulatory compliance, as well as remediation and mitigation of negative regulatory findings
7
Experience For Healthcare Consultant Epic Trainers Resume
- Prepare written analyses, white papers, and research finding in a manner that projects a detailed and expert understanding of assigned topics
- Track attendance using the client’s learning management system
- Assist with proposals (scope of work and budgets) for Senior Living Consulting engagements
- Participate in professional development, training and networking events internally and externally
- Design and support user interface testing application and regression testing software
- Follows standardized best practices for documenting and executing test plans
- Basic understanding of Medicare regulations, particularly those pertaining to the provision of Part B services
- Deep understanding of various healthcare planning strategies
8
Experience For Healthcare Consultant Analyst Resume
- Leadership in coaching and managing staff (directly or indirectly)
- Mastery of provider contracts, contracting options, PADU (alternate language manual) guidelines as well as provider configurations
- In-depth knowledge of the managed care industry and practices, as well as a strong understanding of Client competitor strategies, practices, and financial/contracting arrangements
- Business knowledge including health care
- Create and support trainings and training materials
- Ensures business needs are understood and Cerner’s information technology strategies are enhancing client objectives
9
Experience For M HIS Healthcare Consultant Resume
- Responsibility for the progress of projects and guaranteeing a high level of customer satisfaction
- Perform the day to day activities of projects including interaction with client personnel and SD team members
- Assists in preparation of proposals, including project approach, schedule and definition of deliverables
- Participates in Long Distance Learning ( LDL) programs
- Conduct market research and related analyses including preparation of market assessment reports
- Obtain, summarize and analyze competitor data from a variety of sources including telephone surveys, website research and on-site visits
10
Experience For Senior Managing Healthcare Consultant Resume
- Utilize proprietary model for assessing market depth
- Organize consulting engagement meetings, coordinate logistics and prepare advance materials
- Conduct research, develop presentation outlines and prepare presentation slides for client engagements and industry public speaking opportunities
- Identify areas for improvement in market research processes including evaluation of software and industry data sources
- Design and/or run automated testing scripts with oversight for deployment of tests
List of Typical Skills For a Healthcare Consultant Resume
1
Skills For Senior Healthcare Consultant Resume
- Demonstrated ability to work effectively in a team setting having diverse professional backgrounds including business, technical and/clinical knowledge
- Proven success at managing internal delivery teams as well as client and third party resources effectively
- Strong computer skills and comfort with various computer applications, including Windows, Adobe, Internet applications and other
- Previous consulting experience at a healthcare consulting firm, CPA firm, or a combination of industry and consulting experience
- Experience working within healthcare on the provider side and/or broader professional services consulting experience
- Applicable experience; healthcare operations or consulting; manage operating departments in a hospital or experience in operations
- Proven project management experience, leading large engagements
2
Skills For VP-healthcare Consultant Resume
- Advanced influencing and interpersonal skills
- Able to work effectively with all members of project teams
- Proven experience in Lab Operations
- Proven experience analyzing large data sets and making - basic Excel knowledge
- Proficiency in standard business IT office systems and Advanced IT skills in business intelligence/information systems
- Effectively build and maintain relationships with internal and external clients
3
Skills For Director Healthcare Consultant Resume
- Consulting experience on large business process or systems integration projects
- Previous experience supporting sales processes and leading delivery of large, comprehensive consulting engagements
- Experience working in a management consulting / professional consulting organization
- Experience taking directions from others and executing upon a project plan in a timely manner
- Some years of experience leading and managing projects with outcome focused deliverables
- Experience in delivering and implementing healthcare project solutions for defined client base
4
Skills For Manager Healthcare Consultant Resume
- Experience designing and using analytics to inform and drive process change
- Experience leading cross functional teams and managing quality improvement projects, ideally across multiple locations
- Coventry Platform Testing team creates Ticket/Service requests and prioritize work on submitted requests
- Coventry platform attends Trainer all when material is reviewed prior to being released to end users
- Experience testing IBM Cúram software
- Develop effective working relationships with client and trust to identify areas to further support member needs and services
- Experience in client services, application roadmap development, program training, and enterprise analytics
- Analytical thinker with experience of using different sources of data
5
Skills For Junior Healthcare Consultant Resume
- Report writing experience, appropriate to different audiences
- Healthcare experience in any of the following
- Experience working in a management role at a health plan or provider organization
- Experience putting together financial models and projections
- Experience working in an operations role at a health plan
- Health Care Information Technology (HCIT) consulting and/or equivalent work experience
- Experience in any of the following areas
6
Skills For Financial Systems / Healthcare Consultant Resume
- Consulting and/or support work experience
- Experience in any of the following areas: Business Analysis, Systems Analysis, Project Management, and/or Business Process Improvement
- Client-facing experience
- Health care information technology (HCIT) consulting and/or support work experience
- Experience of working in a clinical or healthcare related role
- Applicable experience; healthcare operations or consulting
7
Skills For Healthcare Consultant Epic Trainers Resume
- Progressive experience in healthcare operations or consulting
- Applicable experience; healthcare operations or consulting
- Medical Coding experience with ICD-9/10, CPT and HCPCS
- Detailed understanding and/or experience of Healthcare delivery, to include processes and economics
- Extensive project and practical experience in healthcare and/or consulting
8
Skills For Healthcare Consultant Analyst Resume
- Solid understanding of the Software Development Life-Cycle (SDLC) and/or exposure to the Agile development methodology
- Training delivery experience in a healthcare context
- Experience working in a management role at a health plan or provider organization
- Experience in one or more of the following
- Experience working with relational databases such as Access and/or SQL
9
Skills For M HIS Healthcare Consultant Resume
- Expand your full-picture healthcare industry experience
- Become insightful and effective as a problem solver
- Medicaid eligibility system/business operations experience
- Medicaid Management Information System (MMIS) experience
- Public sector and/or academic environment experience
- Relevant experience in the NHS, social care or consultancy environment
- Demonstrated initiative and the ability to successfully identify new business opportunities
10
Skills For Senior Managing Healthcare Consultant Resume
- Applicable experience required
- Consulting experience, preferably in finance
- Experience with online computer systems and Microsoft Office
- Phone customer service experience
- Medicaid operations experience
- Experience in Labor Management
- Healthcare industry experience with preference for payer claims operations
List of Typical Responsibilities For a Healthcare Consultant Resume
1
Responsibilities For Senior Healthcare Consultant Resume
- Excellent analytical and problem solving skills; Technical – Microsoft Excel/Word/PDF/Text/Access
- Demonstrated client management experience
- Software implementation work experience, scientific or clinical research or health care information technology (HCIT) work experience
- Demonstrate maturity level in dealing with client leadership throughout the research process
- Solid proficiency in Word, Excel, PowerPoint, and Access
- Able to work independently and consistently achieve excellent results
- Experience in over-sight of Quality Process in acute and non-acute arenas of Healthcare
2
Responsibilities For VP-healthcare Consultant Resume
- Five or more years required experience in specialty insurance collections in a medical facility/practice or for a revenue cycle management company
- Laboratory management experience required
- Healthcare experience with emphasis in health insurance including Pre authorizations, benefits and eligibility, billing
- Experience working with a Physician Practice
- Experience in a behavioral health or related industry
- 5+ healthcare industry experience with preference for payer claims operations
- Validates test results, documents discrepancies, and follows through with resolutions to ensure all issues are resolved
3
Responsibilities For Director Healthcare Consultant Resume
- Taking meeting minutes and assisting in tracking follow-up items
- Collecting information for various SMEs and creating PP decks
- Printing and faxing requests for medical records to providers
- Checking FAXCOM and printing records and faxes
- Seeking and proactively developing innovative solutions to renew and refresh clinical performance improvement program offerings
- Developing and promoting collaborative focus within and across PPP and Information Technology Services
- Identifying client needs and tailoring program and sales approach accordingly; and
- Collaborating with PPP leadership and marketing/ sales resources to achieve objectives on a regular basis
- Running reports from various databases
4
Responsibilities For Manager Healthcare Consultant Resume
- Assisting HEDIS team with day to day operations
- Processing medical record invoices
- Providing daily/weekly updates on Verscend measure buckets
- Working with the public with emphasis on problem solving and conflict resolution
- Identify and document business process re-engineering opportunities including current and future state process flows
- Claims adjudication / processing activities for a core claims administrative system (Facets, QNXT, HealthRules, Ika, etc.)
- Clinical editing systems (ClaimCheck, CES) configuration and operations
- Claims Third Party Liability and subrogation processing
- Claims system configuration: processing rules, edits and pends
5
Responsibilities For Junior Healthcare Consultant Resume
- Other health plan operations impacts on claims: provider contracting, referrals and authorizations, benefit plan design and configuration
- Education and training for clients related to Quality, regulatory and accreditation issues
- Possess the ability to communicate with billing managers or client management to resolve issues
- A broad spectrum of Market research services including demographic trend evaluations, economic profiles, competitive analyses and demand methodologies
- Supportive work for strategic planning engagements
- Technology based “heat” mapping
- Quantitative and Qualitative research employing multiple research methodologies
- Consumer research including surveys and focus groups
6
Responsibilities For Financial Systems / Healthcare Consultant Resume
- Lead the research and analysis process for developing insightful analytics for quality improvement within specified area
- Proficient in Atlas Sian tool suite including JIRA and Confluence
- CANNOT miss any work during first 90 days
- Other standard office equipment including telephone, copy machines, personal computer software and mainframe/LAN data systems
- Client Platform updates Clear Quest with findings o Coventry Platform updates a Finding document
- Supports Medicare Plan Services System Support team; communicate issues identified during UAT
- Client platform receives a copy of preliminary training material to review for accuracy
7
Responsibilities For Healthcare Consultant Epic Trainers Resume
- Calls members to support SBU''''s Facility Scheduling Program
- Track record in supporting the delivery of complex projects in health and /or social care on time and on budget
- Motivation, enthusiasm, drive and commitment to the role in supporting healthcare clients and to our team
- Support leads, pursuits, and proposals
- Support the identification of opportunities for sales and business development collaboration with other Optum business segments
- Delivery of successful client assignments that achieve and exceed clients’ expectations
- Provides subject matter expertise and the ability to provide instruction and maneuverability in the use of the following CDMP® tools and software’s i.e. Severity-Complexity worksheet, Docu-Promptersã, Decision Treesã, CDMPGuide®, Cerner Imbedded Guide, Cerner Imbedded CDI, Encoders, Clintegrity® etc
- Participates in continuous learning opportunities and maintains solution expertise (i.e. Certification, WBT’s, knowledge transfer events, coaching/mentoring associates, expansion of current skill set)
- Performs other responsibilities as needed Be a part of something that matters. Something that affects every single person, every single day—people’s health and the care they receive
8
Responsibilities For Healthcare Consultant Analyst Resume
- Identification, acquisition and implementation of projects
- Project-related personnel management and development e.g. a clinical expert seconded to a project or inclusion of team members from HQ
- Management & appropriate escalation of risks and opportunities for relevant projects
- Promote the portfolio externally and within internal divisions to help develop the business
- Provide client service delivery and operations execution
- Excel in either structured or unstructured client project environments
- Collaborate with and manage project teams comprised of multi-vendor or client staff to execute a portion of the project scope
9
Responsibilities For M HIS Healthcare Consultant Resume
- Provide business expertise on engagements related but not limited to Healthcare Operations, Product Management & Go To Market, Customer Experience, and Organizational Management
- Lead one or more work streams on large engagements of moderate size and complexity
- Lead deliverables creation, directs and reviews the work of others for quality and accuracy
- Generate project milestones and delivery schedule
- Provide senior-level subject matter expertise
10
Responsibilities For Senior Managing Healthcare Consultant Resume
- Provide executive level communications
- Bring experience in strategic planning, enterprise and employee performance management, business transformation, organization design, change management, management consulting, and executive advisory services to advise and support your team
- Provide ongoing operational oversight and direct sales support for clinical performance improvement programs and select quality consulting projects within the assigned product lines
- Manage product line performance, including development of programmatic offerings, new business development, quality and consistency of implementation, and customer satisfaction
- Actively identify growth opportunities that span the entire Premier Performance Services portfolio; and
- Support service line leadership goal to maintain a high level of staff utilization and appropriate margin level on all engagements
- Provide engagement management oversight and act as a subject matter expert
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