Published on: Mar 4, 2016
Transcripts - Prestwich_Michael_Res
Michael PrestwichMichael Prestwich
Nixa, MO | 417.725.4323 | firstname.lastname@example.org
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.
▪ 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
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
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
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.
Michael PrestwichMichael Prestwich
417.725.4323 | email@example.com | 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
Additional Leadership Experience
Director | ORTHOPAEDIC NURSES CERTIFICATION BOARD (2008 – 2009, 2004 – 2005)
President | ORTHOPAEDIC NURSES CERTIFICATION BOARD (2005 – 2008)
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
Sigma Theta Tau International
Parent Teacher Student Association
Member, Nixa Schools Health Advisory Council