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Click here or scroll down to respond to this candidateCandidate's Name , APRN, FNP-CStreet Address Capitol PlaceFrontenac, MO. Street Address
Phone: PHONE NUMBER AVAILABLEEmail: EMAIL AVAILABLEObjective: I am a dedicated Nurse who is a hardworking, reliable, and ethical. I am a team player that builds positive relationships with patients, family members, physicians, and other medical professionals to ensure positive health outcomes. I am a patient advocate that strongly believes in empowering patients by delivering health education and nursing care that enhances wellness and quality of life.Education:Master of Science in Family Nurse Practice 2015Saint Louis UniversityInternship completed at:oWalgreensoPeoples Health ClinicoBarnes Jewish Outpatient Womens Health ClinicoCenter for Preoperative Assessment and PlanningoSt. Louis Childrens Outpatient SurgeryBachelor of Science in Nursing 2009Goldfarb School of Nursing, Barnes-Jewish CollegeBachelor of Arts, University of Southern California 1999Major: Communication Minor: FrenchCertifications:American Academy of Nurse PractitionersBLSACLSLeft Ventricle Assist Device (LVAD)Cigna Care CoachingProfessional ExperienceClinical Supervisor Case Management Specialist, Premium Solutions 7/21- presentCigna- Plano, TX.Manage 30 Case Managers on teamCollaborate with the Quality Team for improvement opportunities and appropriate outcomesPartners with matrix partners for escalated cases; provides contact with customer to resolve service delivery problems, responds to customer requests, communicates any special customer instructions or procedures that are followed by the Case Management TeamMaintains clinical knowledge and provides precepting to staffAdvises policy changes in customer, service delivery, or business functionsSupports needs for current and prospective customer visits, presentations, and auditsReviews reporting for performance guarantees and provides feedback to staffParticipates in projects involving case managers and reports progress or barriers to direct supervisorBuilds solid working relationships with staff, customers, providers, and other matrix partnersEnsures personal development of staff through different learning styles and feedbackCreated and implemented guides/templates for delivery systems (Legacy and HMCM) for better quality improvements and positive audit outcomesCreated and implemented calendar cohesion throughout Premium Case ManagementMonitors team performance metrics for quality compliance and positive client outcomesCost Savings Subject Matter Expert to help with Total Medical CostsEnsures Online Account Manual (OLAM) up-to-date with client information by collaborating directly with the Client Service ExecutiveDeskside reviews of telephonic outreaches performed by the Case Manager to offer successes and opportunitiesCollaborated on Medical Management standard operating procedure (SOP)Collaborated on Medical Director consult documentation standard operating procedure (SOP) in TruCare systemFacilitate Medical Ground RoundsClinical Team Lead Case Management Specialist, Premium SolutionsCigna- Plano, TX. 3/21- 7/21Re-educates on process and procedures for documentation, TruCare System,MD consults, Cost Savings, Audit Gap Metric and Inventory MetricsClinical Team Lead Case Management Specialist, Premium SolutionsCigna St. Louis, MO 3/19 3/21Manages 20 Case Managers for compliance with URAC standardsCollaborate with the Quality Team for improvement opportunities and appropriate outcomesPartners with matrix partners for escalated cases; provides contact with customer to resolve service delivery problems, responds to customer requests, communicates any special customer instructions or procedures that are followed by the Case Management TeamMaintains clinical knowledge and provides precepting to staffAdvises policy changes in customer, service delivery, or business functionsSupports needs for current and prospective customer visits, presentations, and auditsReviews reporting for performance guarantees and provides feedback to staffParticipates in projects involving case managers and reports progress or barriers to direct supervisorBuilds solid working relationships with staff, customers, providers, and other matrix partnersEnsures personal development of staff through different learning styles and feedbackCreated and implemented guides/templates for delivery systems (Legacy and HMCM) for better quality improvements and positive audit outcomesCreated and implemented calendar cohesion throughout Premium Case ManagementMonitors team performance metrics for quality compliance and positive client outcomesCost Savings Subject Matter Expert to help with Total Medical CostsEnsures Online Account Manual (OLAM) up-to-date with client information by collaborating directly with the Client Service ExecutiveDeskside reviews of telephonic outreaches performed by the Case Manager to offer successes and opportunitiesCollaborated on Medical Management standard operating procedure (SOP)Collaborated on Medical Director consult documentation standard operating procedure (SOP) in TruCare systemFacilitate Medical Ground RoundsCase Management Specialist, Premium SolutionsCigna St. Louis, MO 11/16 3/19Work with physicians to create treatment plans for high-risk patients to ensure no gaps in care or barriers to healthcareCoordinate medical services for customer based on treatment planResponsible for lowering total medical costs by steering customer towards in network providers and servicesFacilitate home health services and durable medical equipment attainment for post-discharge customersStrong leadership, decision-making, and oral and written communication skills applied dailyDevelopment of multifaceted, effective and teaching relationshipsProvide leadership and mentorship to peers to achieve positive health outcomes and savingsAbility to prioritize with application of time management and organizational skillsPatient care/education delivered per Evidence Based StandardsRegistered Nurse Advisor, Your Health First 4/11 11/16Cigna - St. Louis, MOUse Cigna Care Coaching to conduct telephonic coaching calls with customers with chronic health conditions to educate on medical conditions, medication, and lifestyle modification for improved health outcomesPromote and facilitate integration between various matrix partners and business units to provide a customer-centric approach to managing customer health status and needsDedicated to reducing Total Medical Cost (TMC) for customers through education and follow up for customers facing hospitalizations through Pre-Hospitalization/Post-Operative education, Treatment Decision Support coaching, Short-Term Case Management, and RN consult teamServe as site subject matter expert through participation with Medical Director and Matrix Partners in various projects including TheraCare standards of procedures, Gaps in Care Pilot, CAD Tool, and NCQAInteracted with various clients and Sales staff to promote the health coaching program and integration between Cigna ProductsCommitted to improving program quality, efficiency, and customer experience throughrecommendations of improvements to processes and proceduresRegistered Nurse/Charge Nurse Telemetry/Step-down Unit 11/09-4/11Des Peres Hospital - St. Louis, MOIn charge of staffing, assigning patients to nursesPerformed daily assessments of patients using nursing processPulled pacer wires from patients status post CABGPulled arterial/venous sheaths from patients status post cardiac catheterizationCalculated medications, gave medications, administered blood transfusionsAdministered medications through IV drips, IM, SQStarted IV's, performed blood draws, wound dressing changes, EKGDaily communication with health teamRegistered Nurse, Cardiac Rapid Evaluation Unit 4/07-9/09Barnes-Jewish Hospital - St. Louis, MOPerformed daily assessments of patients using nursing processCalculated medications, gave medications, administered blood transfusionsStarted IV's, performed blood draws, wound dressing changes, EKGAdministered medications through IV drips, IM, SQSkills:Microsoft Office SuiteConversational French language |
