Michael PrestwichMichael Prestwich
Nixa, MO | 417.725.4323 | mprestwich@sbcglobal.net
Management Professional
Nursing | Ut...
Michael PrestwichMichael Prestwich
417.725.4323 | mprestwich@sbcglobal.net | Page 2 of 2
Professional Experience Continued...
of 2


Published on: Mar 4, 2016

Transcripts - Prestwich_Michael_Res

  • 1. Michael PrestwichMichael Prestwich Nixa, MO | 417.725.4323 | mprestwich@sbcglobal.net Management Professional Nursing | Utilization Management | Quality Care Proactive, quality-driven Management Professional leveraging 18 years of experience in healthcare management, utilization management, nursing care, and quality assurance. Drives healthcare system quality and efficiency through the appropriate mix of programs, facilities, and staff. Exhibits high-level expertise in reporting, data analysis, resource allocation, program planning, service delivery, and healthcare staffing. As a team leader and collaborator, values mentoring, coaching, and training departmental staff to elevate team performance and quality of care. Core Competencies ▪ Medical Management ▪ Nursing Care and Administration ▪ Utilization Review ▪ Staffing and Training ▪ Case Management ▪ Reporting and Chart Review ▪ Quality Care ▪ Health Plans ▪ Policies and Procedures ▪ Physician Relations ▪ Health Education ▪ Supervisory Leadership Professional Experience MERCY 1994 – 2015 Regional Director, Inpatient Care Management (2013 – 2015) Provided management and strategic leadership, ensuring staff clearly understood the vision, goals, quality, and performance standards of Mercy Care Management, as well as the safety and financial expectations of the organization. Drove needs assessments, resource gap identification, and facilitated access to services, which included collaborative practices/arrangements with other departments.  Improved the level of appropriateness and effectiveness of care management interventions, as well as ensured regulatory compliance by evaluating and interpreting data and reports.  Motivated, coached, counseled, and disciplined departmental staff, in addition to promoting and facilitating continuing education in order to support performance and quality control measures.  Cultivated value-added partnerships with Care Management, local hospital, community, and regional leadership. Director, Utilization Management | Health Plans Medical Management (2008 – 2013) In conjunction with fellow directors and the Vice President of Medical Management Services, execute strategies aimed at improving the delivery, cost-effectiveness, and quality of care in the integrated health system. Lead the planning, direction, and evaluation of managed care contracts. Managed staff and boosted team morale through coaching and mentoring, in addition to implementing appropriate disciplinary action.  Overhauled interventions and processes by assessing needs, analyzing literature and data, identifying resources, and facilitating access to needed services.  Measured the appropriateness and effectiveness of medical management interventions by evaluating and interpreting reports.  Applied knowledge of medical standards of care to implement quality control measures.  Maintained high-level medical practices by promoting continuing education and professional development training and opportunities amongst departmental staff, physicians, nurses, and other healthcare providers. Continued…
  • 2. Michael PrestwichMichael Prestwich 417.725.4323 | mprestwich@sbcglobal.net | Page 2 of 2 Professional Experience Continued Supervisor, Utilization Management | Health Plans Medical Management (2003 – 2008) Directed program development and reporting activities focused on ensuring health care services, procedures, and facilities were necessary and efficient. Provided insight and recommendations regarding new programs and health plan programs.  Supervised nursing and clerical staff including: hiring, training, and termination.  Increased efficiency by reducing the services that required pre-certification and removed pre- certification requirements for services identified as approved.  Supported the development of new claims software, which improved documentation and reporting efforts. Additional Leadership Experience  Director | ORTHOPAEDIC NURSES CERTIFICATION BOARD (2008 – 2009, 2004 – 2005)  President | ORTHOPAEDIC NURSES CERTIFICATION BOARD (2005 – 2008) Education Dual Master’s Degree Program, Nursing and Healthcare Administration University of Phoenix Bachelor of Science, Nursing Sciences (Registered General Nurse) University of Hull Certification and Training Courses: Certificate, Orthopaedic Nursing Robert Jones and Agnes Hunt Orthopaedic Hospital Licenses and Credentials Board Certified Case Management, American Nurses Credentialing Center Registered Nurse, New Zealand (inactive) Registered General Nurse, UK (inactive) Registered Nurse, USA Professional Affiliations Sigma Theta Tau International Parent Teacher Student Association Volunteer Experience Member, Nixa Schools Health Advisory Council

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