Medical Consultant Resume Sample
Irwin Dietrich
151 Luettgen Islands,
New York,
NY
+1 (555) 391 4905
Work Experience
Senior Medical Economics Consultant
12/2017
-
PRESENT
Detroit, MI
- Analyzes various forms of provider reimbursement using pricing tools
- Compares Aetna and Humana contracts for the superior unit price position
- Produces ad-hoc data and information to support network negotiations
- Prioritizes analytics based on projected synergy
- Tracks completed negotiations for both the impact on unit price trend (P Model) and the progress to achieving the total synergy target
- Runs ad-hoc data analysis as needed
- 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 develop and implement infrastructure to align and explicitly link initiatives’ savings estimates with the financial plans/forecasts, emerging financial results and product pricing
- Progressive experience in finance, accounting or analytics/informatics in the health care payer sector with a focus on medical economics
Medical Consultant
01/2012
-
10/2017
Phoenix, AZ
- Performance Management: Understand company business strategy, set working objective and promotion task, motivate team to ensure achievement of Company objectives. Build cooperative and collaborative team spirit to align well with company’s culture
- Self-Management: Develop leadership/people management skills to realize continuous self-improvement and effective team management. Demonstrate professional leadership and commitment in administering company’s values
- The coordination of infrastructure development to link initiatives with financial plans/forecasts, emerging results and pricing
- Infrastructure and process development to link medical economic related analytics (trend reporting, medical cost, conditions,
- Function as point person for all business segment medical economic analytics
- Functional - Information Technology/Research/4-6 Years
- Functional - Information Management/Medical economics/4-6 Years
- Functional - Learning/Administration, support & reporting/4-6 Years
- Technical - Aetna Applications/Strategic Contracts Manager
Medical Device & Diagnostics Consultant
05/2007
-
10/2011
Los Angeles, CA
- Technical - Desktop Tools/TE Microsoft Excel//
- Technical - Aetna Applications/Enterprise Provider Database System
- Coordinate the oversight and monitoring of the “Creating Customer Value” 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
- Regularly interact with Senior Finance leadership, including the Chief Actuary and CFO, as well as other leadership and staff, to set and adjust overall goals and objectives of the process
- Help drive a culture change from “reporting the past” to “creating the solutions for future."
- Consult with HR and Development Leadership Team members to identify training requirements and making appropriate recommendations
- Develop, recommend and implement training programs within Europe Medical Information to increases morale and drive employee retention
- Medical validation of lab reports
Education
Globe University / Minnesota School of Business
2002 - 2006
Bachelor's Degree in Health Care Management
Professional Skills
- Excellent analytical and communication skills, particularly writing skills, are essential
- Excellent time management, project management, prioritization and organizational skills
- Computer skills, or ability and desire to learn required skills are necessary
- Prior experience working with a data warehouse and strong proficiency in SQL or PL/SQL
- Strong public speaking and presentation skills - effective communicator, both written and oral
- Strong PC skills; Excel, PowerPoint, Visio, Word, and internet based programs
- Experience mentoring either in 1:1 relationship with a new hire or by sharing best practices and skills with peers and team as a whole
How to write Medical Consultant Resume
Medical Consultant role is responsible for training, research, finance, database, security, compensation, reporting, design, digital, modeling.
To write great resume for medical consultant job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Medical Consultant Resume
The section contact information is important in your medical 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 Medical Consultant Resume
The section work experience is an essential part of your medical 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 medical 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 medical consultant position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Medical Consultant resume experience can include:
- Demonstrate ability to manage and complete high volumes of assigned work, maintain consistently good turnaround times, and operate with a sense of urgency
- Strong MS Access/ MS Excel skills required
- Keyboard skills and basic computer literacy are essential
- Effectively communicate with constituents
- Experience summarizing data and creating executive summaries with analysis
- Previous experience with hospital/facility contracting and modeling
Education on a Medical Consultant Resume
Make sure to make education a priority on your medical consultant resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your medical 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 Medical Consultant Resume
When listing skills on your medical 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 medical consultant skills:
- 3+ yrs of client-facing experience (internal or external), demonstrating excellent written and verbal communication skills presenting analytical results
- Sound reasoning skills enabling both sound scientific judgment and appropriate management decisions
- Prior experience working in provider contracting analytics and financial analysis
- Apply critical thinking skills to medical policy interpretation and implementation
- Excellent demonstrated knowledge of issues affecting regulatory affairs for clinical trials are required
- Progressive experience in Finance, Accounting or Analytics/Informatics with experience in Healthcare and a focus on medical economics
List of Typical Experience For a Medical Consultant Resume
1
Experience For Medical Economics Consultant Resume
- Engaging in prospective or retrospective studies utilizing Reference Laboratory case material or archives. Publication or presentation of scientific findings is encouraged
- Skills to supervise medical personnel, senior researchers, and senior employees directly; indirectly supervises lower-level employees
- Strong writing and editing medical and scientific papers
- Skill in analysis of data and problem identification
- Manages and executes necessary logistics prior, during and after patient’s treatment according to Foundation’s guidelines
- Assures that patients and authorized travel companions obtain all required documentation prior to treatment
2
Experience For Medical Device & Diagnostics Consultant Resume
- Participating in laboratory extension programs to further the post-graduate education of laboratory clients
- Make timely and appropriate referrals for second opinion reviews when appropriate or required according to current guidelines and best practices
- Review requests for medical waivers for intra-state commercial driving for the CDL Waiver of Physical Disqualification Program
- Review and comment upon proposed state and federal laws and rules pertaining to driver medical issues
- Inform and educate physicians throughout the state regarding the At-Risk Driver Program
- HMO Claim system and/or processing needed
- Apply critical thinking and expresses ideas clearly
- Provider contracting and SCM
- Provide timely, clear medical direction and opinions to team partners, with reasoned forensic analysis to support the medical opinions
3
Experience For Senior Medical Economics Consultant Resume
- Partner/consult with fellow medical consultants when appropriate to ensure the completion of a whole person analysis
- Apply medical knowledge to determine functional capacity through assessment of medical and other data related to impairment, regarding accuracy of diagnoses, treatment plans, duration guidelines, and prognosis
- Provide relevant medical education and knowledge to others in terms appropriate and understandable to the intended audience
- Perform telephone contacts with the insured’s healthcare providers to gather medical information and to facilitate a better understanding of the claimant's functional abilities
- Receive feedback and follow through with appropriate behaviors/actions
- Perform telephone contacts with the insured's healthcare providers to gather medical information and to facilitate a better understanding of the claimant's functional abilities
- Review medical files on a schedule to ensure all cases are reviewed within approved timelines
- Attend contested case hearings or other judicial cases, if called upon
4
Experience For Medical Rehabilitation Consultant Resume
- Review and update medical criteria and waiver guidelines on an annual basis
- Serve on ODOT work groups and other institutional committees established to evaluate driver medical issues and the At-Risk Driver Program
- Testify at legislative hearings, as requested
- Areas of focus for the (S) role include internal medicine, family practice, or psychology
- Board certification required for physicians in their area of specialty
5
Experience For Medical Risk Consultant Resume
- Engaging in prospective or retrospective studies utilizing Reference Laboratory case material or archives Publication or presentation of scientific findings is encouraged
- Validation of medical results
- New test development and validation
- Health care experience or any combination of education and
- O Review cases and summarize the facts of each case and assess issues involved in the case to certify or non-certify requested treatments
- Proven leadership experience and track record of collaborating with senior management in creating a motivating vision which supports the organization’s values and attributes
- Registered Nurse with active license required
6
Experience For Medical Policy Consultant Senior Resume
- Coordinate the oversight and monitoring of the Health Plan “Creating Customer Value” 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
- Help develop and implement improved infrastructure and processes to provide Health Plan and Enterprise management with regular performance scorecards highlighting initiative implementation successes, accountability, “capture” of initiative benefits, activity, progress and identification of barriers
- Telephone consultations with laboratory clients regarding interpretation of laboratory data or other laboratory-related, clinical issues
- Determine when projections seem unreasonable and constructively push back until satisfied with the analysis
- Responsible for knowing tests offered by IDEXX (reference labs and In-House diagnostic tests), specimen requirements, and clinical utility of each test and how to interpret results
7
Experience For Medical Economics Associate Consultant Resume
- Comply with the laboratory Quality Policy and best practice management objectives
- Interpretation of laboratory results
- Provide scientific support to lab technicians
- Participation in the laboratory internal and external Quality Assurance programs
- Maintenance of personal professional competency and participation in the continued professional development of other IDEXX staff by self-study, attendance at scientific meetings, and participation in internal seminar programs
8
Experience For Senior Medical Cost Management Consultant Resume
- 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
- To understand the professional and clinical support needed key independent Eye Care Professionals
- Advanced knowledge of veterinary medicine
- Fundierte Fachkenntnisse sowie praktische Erfahrung im Bereich Kleintiermedizin / Innere Medizin
- Vorzugsweise Fachtierarztausbildung oder grosse Bereitschaft zur fachlichen und persönlichen Weiterentwicklung
- Freude an der fachlichen Beratung und Weitervermittlung von Wissen
- Ein offenes und sicheres Auftreten sowie Freude an der Kommunikation mit Kunden und Kollegen
- Active, unrestricted US medical license
9
Experience For Senior Medical Consultant Resume
- A physician, nurse practitioner, or physician's assistant licensed to provide health care services by the State of Oregon
- Board Certification with the European College of Veterinary Internal Medicine or American College of Veterinary Internal Medicine or board eligible. Alternatively, a Diploma/Certificate in Small Animal Medicine
- Represent European Medical Information at various forums where business and quality personnel collaborate on quality and compliance plans
- Support affiliate audits and inspections and facilitate audits and inspections in Cork
- Analyze trends, identify areas of weaknesses/gaps and recommend corrective actions
- Professional presentations to small and large audiences
10
Experience For Kaplan Medical Enrollment Consultant Resume
- Knowledge of the risks and benefits of medications
- Knowledge of the effects of impairments and conditions on physical or mental functions
- 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
- Experience in the managed care industry with knowledge of provider contracting, provider reimbursement, patient management, product and benefits design
- Considerable knowledge of the theory, principles and practices of general, preventive medicine and techniques involved; developments in medicine; and the practice of the medical specialty or sub-specialty to which assigned
- Demonstrated ability to compile clear and concise notes and case analysis; and to discuss cases with other medical professionals, hearing officers, examiners, and administrative staff
- Knowledge of the principles and practices of public administration as applied to government programs and the ability to work in an administrative, regulatory system involving established rules and restrictions
- Demonstrated ability to establish and maintain effective working relationships with associate personnel, program applicants, and the general public. Ability to exercise judgment and discretion in establishing, applying and interpreting a wide range of policies and procedures
List of Typical Skills For a Medical Consultant Resume
1
Skills For Medical Economics Consultant Resume
- Strong team and collaborative skills
- Technical skills to conduct analyses, write reports, prepare briefing s, and coherently present results
- Computer Programming skills (highly desirable)
- Experience of delivering training.Medical Affairs
- Establish effective working relations with others in a team environment
- Demonstrates initiative, innovation and leadership in achieving results
- +10 years of clinical experience preferable in a payer setting on medical management
- Previous experience working with healthcare data
- Five (5) years work experience in healthcare analytics/data modeling
2
Skills For Medical Device & Diagnostics Consultant Resume
- Experience with Microsoft SQL reporting and relational databases
- Experience with pricing specialty care and ancillary lines
- Claim processing and audit experience
- Work independently; well-organized and able to set priorities with minimal direction
- Evaluate effectiveness of treatment regimes
- Gute bis sehr gute französische Sprachkenntnisse sowie solide Englischkenntnisse
- Support Medical Economics initiatives around efficiency, data validation, automation, and next-generation analytics
- Advanced level experience with Microsoft Excel and Access
3
Skills For Senior Medical Economics Consultant Resume
- Experience with Medicare and/or Medicaid insurance
- Progressive experience in finance, accounting or analytics/informatics in the health care payer sector with a focus on medical economics
- Licensed in good standing with the Arizona Medical Board
- Statistical/quantitative modeling – extensive experience with R and/or Python
- Progressive experience in Finance, Accounting or Analytics/Informatics in the Healthcare payer sector with a focus on Medical Economics
- Clinical experience preferable in a payer setting on medical management
- Experience in using Microsoft Office software (MS Outlook, MS Word, MS Excel, and MS PowerPoint)
- SAS EG/SAS programming and data analysis experience
- Demonstrates initiative in achieving results
4
Skills For Medical Rehabilitation Consultant Resume
- Review medical certification program data in an effort to evaluate the effectiveness of the program
- Experience with Advanced Analytics tools such as Python or R
- Experience with Application Development (work with R-Shiny or HTML & Javascript)
- Work experience in related occupation
- Demonstrated analytical ability with financial and healthcare concepts
- Participating in practice visits with the commercial team and other client facing activities dependent on workload and staffing availability
- Understanding of CMS reimbursement - Medicare to providers on a FFS basis
5
Skills For Medical Risk Consultant Resume
- Participating in IDEXX committees or meetings to ensure quality of laboratory offerings and consulting services
- Interacting with other IDEXX scientists to research or develop new IDEXX products or technologies
- Giving medical opinions to domestic / international patients
- Understanding of the healthcare industry is required
- Build an accurate profile, including contact details, for each prospective student by asking consultative
- Hospital Pricing: Develop pricing models and conduct contract reviews to support contract negotiations and measure contract performance
- Quality BoB (51 % of Direct Net BoB from enrollments that are paid in full or on installment billing)
- General Business/Applying Reasoned Judgment/ADVANCED
6
Skills For Medical Policy Consultant Senior Resume
- General Business/Maximizing Work Practices/ADVANCED
- Develop reporting and tools to assist senior management in provider contract negotiations
- Prepare and present financial data and trends to management for review and decision making
- Create and maintain dashboards and other reporting tools to identify trends as the basis for managerial action
- Work closely with provider relations and contracting associates to ensure timely and actionable deliverables that align with the end-users goals
- Implement medical policies-integrates with all systems to ensure accurate claims processing
7
Skills For Medical Economics Associate Consultant Resume
- Assure that changes in Blue Cross medical policies are communicated to all lines of business, including Medicare, and others as needed
- Research and apply appropriate and regular updates of CPT, HCPCS, and ICD-9/ICD-10 coding to the medical policies
- Maintain Blue Cross’s intranet and internet medical policy databases with current policy decisions and coding
- Creatively translates information using business knowledge and identify additional information needed to support analytical objectives
- Deliver a cohesive Digital Marketing Strategy
- Engage HCPs in a new and interesting ways of conversation with consistency
- Net BoB ( Direct)
- Build plans for follow up with leads that do not purchase Kaplan products on their first contact
- Understand and use the data warehouse and relational databases
8
Skills For Senior Medical Cost Management Consultant Resume
- Develop and work on several projects at one time in a fast paced environment
- Maintain relationships with internal and external stakeholders, clinicians, and others
- Demonstrated positive professionalism in all work-related behaviors as demonstrated by adaptability, contributing to team success, customer focus, skillful communication, and efficiently managing work
- Prior work or strong interest in government programs (Medicare, Medicaid and/or FEP)
- Experience in use of medical code sets (CPT; ICD; HCPCS)
9
Skills For Senior Medical Consultant Resume
- High energy level, tenacity, confident and optimistic demeanor and the ability to thrive in a fast-paced
- 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
- Initiate and oversee return to work programmes with employers
- To actively encourage knowledge transfer into the claims departments to raise handlers level of medical competence and confidence
- Arizona Statues and the Medical Practice Act
- Administrative principles and practices
10
Skills For Kaplan Medical Enrollment Consultant Resume
- Possess an above average knowledge of medical disabilities and diseases of the human body and their possible effects on the ability to safely operate a motor vehicle
- Present and provide implementation input to key medical policy committees: Medical and Behavioral Health Policy Committee, Coverage Committee, Operational committees as assigned for example, Coding and Reimbursement Committee, and Medical Policy Prep Committees
- Prepare final policy documents and tools for implementation
- Serve as a liaison to other divisions (e.g., Network Management, Account Management, and Service) for medical policy issues
- Lead work groups as needed
- Lead projects that support Medical Policy Department and/or Medical Affairs Department
- Serve as a subject matter expert to team members and BCBSM
- Familiarity with current topics in clinical veterinary medicine
- Able to sit at computer for extended periods
List of Typical Responsibilities For a Medical Consultant Resume
1
Responsibilities For Medical Economics Consultant Resume
- Solid knowledge in epidemiology, preventive medicine and public health (or infectious disease, internal medicine, or general family medicine), and stays current on public health events
- Strong skills in Excel, , Strategic Contract Management (SCM). Ability to learn new technologies
- Demonstrates critical thinking and expresses ideas clearly, concisely and logically from a cross functional perspective
- Experience with DoD health-related databases to perform longitudinal analyses
- Strong analytical ability to analyze data for trends and translates data into meaningful information
- MEU and SAS/Data experience required
- Technical experience with such as SQL, SAS and Crystal Reports
- Prepares, coordinates, structures, and presents patient grant requests files to President/VP of the Foundation with direct recommendations regarding case details
- Demonstrated ability to compile clear and concise notes and case analysis
2
Responsibilities For Medical Device & Diagnostics Consultant Resume
- An established and demonstrated safe and quiet home work environment
- Matches patients to right treatment facility, whether in USA or internationally, ensuring best care as well as responsible usage of Foundation's resources
- Provides medical expertise in the review of adverse experiences and discussion of patient management issues with the Foundation’s management team, Board of Directors, PDVSA’s Health Committee and others
- Prepares reports, formats, templates, spreadsheets and any necessary documents to track projects and programs and presents them to the Management Team, Board of Directors, PDVSA’s Health Committee and others
- Supports the Financial/Administrative Analyst in the preparation of budget reports
- Travels on behalf of the Foundation, domestically and internationally, to represent it at hospitals & medical facilities, conferences and meetings with healthcare professionals
- Considerable knowledge of the theory, principles and practices of general, preventive medicine and techniques involved
3
Responsibilities For Senior Medical Economics Consultant Resume
- Thorough knowledge of normal and abnormal physical development and the impact of physical disorders at different stages of life
- Knowledge of the principles and practices of public administration as applied to government programs
- Remote Workers are responsible to make the appropriate work arrangements that maintain separation between the employee's private life and business activities
- The work hours are flexible and intermittent at approximately 10-15 hours per month
- These positions are unclassified and not represented by a union (non-union)
4
Responsibilities For Medical Rehabilitation Consultant Resume
- These positions are currently included in a statewide classification study. The classification and salary are subject to change
- Responsible for telephone consultation with clients regarding choice of appropriate diagnostic testing, interpretation of laboratory results (both reference laboratory and in house testing), treatment and long-term management of medical cases
- This is a telework position and can be located near any Aetna office
- Provide an integrated technology approach
- Specialization in ophthalmology
5
Responsibilities For Medical Risk Consultant Resume
- Active unrestricted US license
- Work in a fast paced, team based, corporate environment
- Relational database structure
- Intermediate in PowerPoint
- Dollars Per Opportunity
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