Pediatrician resume examples

• Perform daily transactional work of individual cases from concurrent review and prior authorization processes.
• Conduct hospital rounds with team of CR nurses  to meet strategic direction for quality and cost outcomes.
• Conduct Peer-to-Peer reviews with providers, facilities and DME suppliers.
• Provide medical review and support for case management and care coordination staff to ensure optimal care for members.
• Chair medical and pharmacologic Appeals and Grievances committee hearings.
• Participate in Quality Assurance and Improvement activities such as identifying quality of care and adverse events as well as HEDIS rate project planning.
• Medical lead for national NICU corporate savings initiative project at our local level.
• Staff education and training via presentations, written guidelines and coaching.
• Proposed new corporate savings action initiative for converting members from TANF (temporary assistance for needy families) to ABD (aged, blind and/or disabled) benefits.

• Reviewed and adjudicated both pediatric and adult applications for initial and continuing SSI benefits.
• Reviewed medical records of pediatric and adult applicants. and when needed ordered diagnostic studies necessary to adjudicate claims.
• Supported disability counselors and administrators in local office as well as across the state by providing medical consultations on individual claimant cases and educational seminars for topics in areas of need.
  

• Diagnosed and treated a variety of diseases and injuries in a general pediatric practice setting. and small community hospital.
• Managed in-patient pediatric patients including newborns with a variety of medical conditions stabilizing and arranging transport for those who required specialty or a higher level of care.
• Attended cesarean sections and other complicated deliveries with stabilization of neonates.
• Provided consultations for medical staff in the emergency department, in-patient and out-patient settings as well as the local health department and Oklahoma Child Protective Services.

• Reviewed and adjudicated pediatric applications for initial and continuing SSI benefits.
• Reviewed medical records of pediatric applicants and whenneeded ordered diagnostic studies necessary to adjudicate the claim.
• Supported disability counselors and administrators in local office as well as across the state by providing medical consultations on individual cases and with educational seminars for topics in areas of need.

• Developed pediatric department for federally qualified health center (FQHC).
• Diagnosed and treated a variety of diseases and injuries of high risk population of pediatric patients.
• Provided pediatric consultations to on-site family practice providers and health department staff.
• Participated in an integrated physical health/dental program.
• Developed, formatted  and updated pediatric well child and common pediatric illness electronic medical records templates with ICD and CPT codes for clinic-wide use.
• Identified opportunities to implement best practice  approaches and target affected patient populations to better improve outcomes for members with various diseases.
• Organized and led a back-to-school health fair, picnic and carnival promoting vaccinations and health screenings for over 600 children.
• Served as liaison between FQHC.area hospital, local health departments as well as community pediatricians/sub-specialists.

• Diagnosed and managed pediatric patients in a variety of settings including out-patient practice, urgent care, emergency department and in-patient while employed in academic, hospital-employed and private practices.
• Assisted in the development and  implementation of a pediatric urgent care noted for its one hour "treat to street" care within a children's hospital.
• Provided general medical care at a large university student health clinic with a student population >25,000 .
• Attending physician for medical students and residents rotating through general pediatric wards, out-patient clinics, pediatric private practices and emergency departments.
• Served as the pediatric clerkship director for a large medical school with four campuses providing core pediatric clerkships.
• Member of the Core Clerkships ,Progress & Promotions and Admissions Committee at two medical schools.

Examine patients and order, perform, and interpret diagnostic tests to obtain information on medical conditions and determine diagnoses

Prescribe and administer treatment, therapy,medication, vaccinations, and other specialized medical care to treat or prevent illness, or injury in infants and children

Collect, record, and maintain patient information, such as medical history, reports, and examination results

• Appropriately diagnosed and treated a variety of diseases and injuries in a general practice setting.
• Treated pediatric patients with minor illnesses, acute and chronic health problems and growth and development concerns.