Michael Prontiker
McKeesport
Summary
Diligent professional with 12+ years of experience and a proven knowledge of conflict resolution, customer communications, and customer retention. Strong focus on team collaboration and achieving results by adapting to changing needs. Skilled in medical coding, insurance protocols, and patient advocacy. Known for reliability and effective communication.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Prior Authorization Nurse
Evernorth
03.2022 - Current
Complete medical and pharmacy prior authorizations
Quality review
Saturday lead, Review spread sheets to ensure turn around times are met.
Utilize knowledge exchange and standard operating procedures to assist colleagues and provide support and guidance.
Collaborate with supervisors and team leads to help with process improvement.
Nurse Case Management lead analyst
CIGNA
09.2016 - Current
- Management of care for customers.
- Advocates for customer's health
- Assists to lower healthcare costs
- Collaborates with medical team to ensure best care is being delivered and managed
Staff Nurse
UPMC
01.2012 - 04.2016
- Deliver care to critically ill patients
- Code team
- Wound care
- IABP
- CRRT
- Charge Nurse
Education
BSN - Nursing
Aspen University
Denver, CO01-2030
Associates - Nursing
Community College of Allegheny County
West Mifflin, PA01.2012
Skills
- Computer and program savvy
- Works well in team environment
- Resource to peers
- Proactive and looks for ways to innovate processes
- approachable and open minded
- work well under pressure to meet time sensitive projects
Accomplishments
Cogito pilot (2019)
best in class pilot project (2018)
Certification
Certification in Case Management
Timeline
Prior Authorization Nurse
Evernorth
03.2022 - Current
Nurse Case Management lead analyst
CIGNA
09.2016 - Current
Staff Nurse
UPMC
01.2012 - 04.2016
Associates - Nursing
Community College of Allegheny County
BSN - Nursing
Aspen University
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