Philip J. DeSimone
Raleigh,NC
Summary
Dynamic and results-driven healthcare professional with over 10 years of experience in clinical education, client support, and medical consulting. Proven expertise in driving product adoption, enhancing client satisfaction, and achieving set targets through impactful training and educational initiatives.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Utilization Management Clinical Case Reviewer
AmeriHealth Caritas
Raleigh, NC
08.2023 - Current
- Conducted over 50 clinical case reviews weekly, ensuring medical necessity and appropriateness of care
- Evaluated patient care plans against established guidelines and regulatory standards, improving compliance
- Facilitated clear communication with healthcare providers, patients, and insurance companies, resolving 95% of queries
- Accurately documented over 100 clinical decisions per week in EMR data systems
- Collaborated with multidisciplinary teams, resulting in improvement in patient outcomes and resource utilization
- Utilized strong analytical and critical thinking skills, improving utilization-management processes
- Maintained 100% adherence to patient confidentiality and privacy regulations (HIPAA), ensuring compliance in all reviews.
Clinical Education Specialist (Contract)
Edwards Life Sciences
Irvine, CA
01.2022 - 03.2023
- Designed and delivered training programs for anesthesiologists and CRNAs on Edwards Life Science products, enhancing procedural efficiency
- Provided expert consultation and technical support during FDA research trials, ensuring 100% compliance with clinical protocols
- Developed and updated training materials, leveraging clinical insights to enhance learning outcomes
- Collaborated with cross-functional teams, supporting the development and launch of 2 next-generation medical devices
- Maintained a strong field presence with 75% travel, ensuring optimal site support and achieving 95% client satisfaction.
- Tracked participant attendance at training events and maintained accurate records of trainings conducted.
Nurse Educator (Full-time)
IQVIA
Durham, NC
01.2019 - 01.2022
- Led educational initiatives, increasing disease state awareness and product knowledge among 500+ patients and healthcare providers
- Collaborated with sales teams, identifying opportunities for product adoption and upselling within targeted practices
- Served as the primary point of contact for 120+ clients, providing personalized support and addressing needs within 24 hours
- Mentored junior educators and led district training programs, enhancing team capabilities
- Documented all project-related activities accurately and communicated effectively, ensuring project alignment.
Emergency Department RN (Full-time)
UNC Rex Healthcare
Raleigh, NC
01.2014 - 01.2019
- Precepted new nurses, fostering a culture of excellence and continuous improvement, reducing onboarding time
- Managed acute care for diverse patient populations, implementing innovative care strategies and improving patient outcomes
- Pioneered 5 new policies for psychiatric-crisis management using LEAN Six-Sigma methodologies, reducing crisis intervention time by 15%
- Engaged in high-stakes crisis interventions, demonstrating exceptional critical thinking and response capabilities, reducing incidents
- Championed patient safety and quality improvement initiatives, adhering to the highest ethical standards and improving safety compliance.
Epic Consultant (Contract)
TekSystems
Kansas City, MO
03.2014 - 05.2014
- Delivered expert floor support in EPIC systems, optimizing clinical workflows and enhancing staff efficiency
- Acted as a vital link between clinical and IT teams, driving seamless integration and process improvement, reducing system errors
- Developed and disseminated 10+ practical tip-sheets, leading key project initiatives with excellence, improving user adoption
- Provided strategic troubleshooting and support, adhering to standard operating procedures, resolving 95% of issues within SLA.
- Facilitated end user training sessions to ensure successful adoption of new systems or upgrades.
- Conducted workflow analysis sessions to identify opportunities for process improvement within existing Epic modules.
Education
Bachelor of Science - Nursing
Western Carolina University
Cullowhee, NC12.2018
Skills
- Product Education & Training
- Product Demonstrations
- Client Support & Relationship Management
- Sales Support
- Regulatory Compliance
- Communication Skills
- Technical Support
- Database Management
- Data Evaluation
Certification
- Registered Nurse Compact License (#267495)
- Valid Driver’s License
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference
Work Type
Full TimeWork Location
RemoteHybridOn-SiteImportant To Me
Work-life balanceWork from home optionHealthcare benefitsFlexible work hoursPaid time offCompany CultureCareer advancementPaid sick leaveLanguages
English
Native language
Software
Epic
Microsoft Office
Teams
Sales Force
Citrix
VPN
OSX
Windows
Outlook
Microsoft Word
Excel
People Soft
Timeline
Utilization Management Clinical Case Reviewer
AmeriHealth Caritas
08.2023 - Current
Clinical Education Specialist (Contract)
Edwards Life Sciences
01.2022 - 03.2023
Nurse Educator (Full-time)
IQVIA
01.2019 - 01.2022
Epic Consultant (Contract)
TekSystems
03.2014 - 05.2014
Emergency Department RN (Full-time)
UNC Rex Healthcare
01.2014 - 01.2019
Bachelor of Science - Nursing
Western Carolina University
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