Sandra Tempelhoff, APRN, FNP-C
Frontenac, MO. 63131
Phone: 314-***-****
Email: ad42ng@r.postjobfree.com
Objective: 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 2015
Saint Louis University
Internship completed at:
oWalgreens
oPeople’s Health Clinic
oBarnes Jewish Outpatient Women’s Health Clinic
oCenter for Preoperative Assessment and Planning
oSt. Louis Children’s Outpatient Surgery
Bachelor of Science in Nursing 2009
Goldfarb School of Nursing, Barnes-Jewish College
Bachelor of Arts, University of Southern California 1999
Major: Communication Minor: French
Certifications:
American Academy of Nurse Practitioners
BLS
ACLS
Left Ventricle Assist Device (LVAD)
Cigna Care Coaching
Professional Experience
Clinical Supervisor Case Management Specialist, Premium Solutions 7/21- present
Cigna- Plano, TX.
Manage 30 Case Managers on team
Collaborate with the Quality Team for improvement opportunities and appropriate outcomes
Partners 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 Team
Maintains clinical knowledge and provides precepting to staff
Advises policy changes in customer, service delivery, or business functions
Supports needs for current and prospective customer visits, presentations, and audits
Reviews reporting for performance guarantees and provides feedback to staff
Participates in projects involving case managers and reports progress or barriers to direct supervisor
Builds solid working relationships with staff, customers, providers, and other matrix partners
Ensures personal development of staff through different learning styles and feedback
Created and implemented guides/templates for delivery systems (Legacy and HMCM) for better quality improvements and positive audit outcomes
Created and implemented calendar cohesion throughout Premium Case Management
Monitors team performance metrics for quality compliance and positive client outcomes
Cost Savings Subject Matter Expert to help with Total Medical Costs
Ensures Online Account Manual (OLAM) up-to-date with client information by collaborating directly with the Client Service Executive
Deskside reviews of telephonic outreaches performed by the Case Manager to offer successes and opportunities
Collaborated on Medical Management standard operating procedure (SOP)
Collaborated on Medical Director consult documentation standard operating procedure (SOP) in TruCare system
Facilitate Medical Ground Rounds
Clinical Team Lead Case Management Specialist, Premium Solutions
Cigna- Plano, TX. 3/21- 7/21
Re-educates on process and procedures for documentation, TruCare System,
MD consults, Cost Savings, Audit Gap Metric and Inventory Metrics
Clinical Team Lead Case Management Specialist, Premium Solutions
Cigna – St. Louis, MO 3/19 – 3/21
Manages 20 Case Managers for compliance with URAC standards
Collaborate with the Quality Team for improvement opportunities and appropriate outcomes
Partners 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 Team
Maintains clinical knowledge and provides precepting to staff
Advises policy changes in customer, service delivery, or business functions
Supports needs for current and prospective customer visits, presentations, and audits
Reviews reporting for performance guarantees and provides feedback to staff
Participates in projects involving case managers and reports progress or barriers to direct supervisor
Builds solid working relationships with staff, customers, providers, and other matrix partners
Ensures personal development of staff through different learning styles and feedback
Created and implemented guides/templates for delivery systems (Legacy and HMCM) for better quality improvements and positive audit outcomes
Created and implemented calendar cohesion throughout Premium Case Management
Monitors team performance metrics for quality compliance and positive client outcomes
Cost Savings Subject Matter Expert to help with Total Medical Costs
Ensures Online Account Manual (OLAM) up-to-date with client information by collaborating directly with the Client Service Executive
Deskside reviews of telephonic outreaches performed by the Case Manager to offer successes and opportunities
Collaborated on Medical Management standard operating procedure (SOP)
Collaborated on Medical Director consult documentation standard operating procedure (SOP) in TruCare system
Facilitate Medical Ground Rounds
Case Management Specialist, Premium Solutions
Cigna – St. Louis, MO 11/16 – 3/19
Work with physicians to create treatment plans for high-risk patients to ensure no gaps in care or barriers to healthcare
Coordinate medical services for customer based on treatment plan
Responsible for lowering total medical costs by steering customer towards in network providers and services
Facilitate home health services and durable medical equipment attainment for post-discharge customers
Strong leadership, decision-making, and oral and written communication skills applied daily
Development of multifaceted, effective and teaching relationships
Provide leadership and mentorship to peers to achieve positive health outcomes and savings
Ability to prioritize with application of time management and organizational skills
Patient care/education delivered per Evidence Based Standards
Registered Nurse Advisor, Your Health First 4/11 – 11/16
Cigna - St. Louis, MO
Use 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 outcomes
Promote and facilitate integration between various matrix partners and business units to provide a customer-centric approach to managing customer health status and needs
Dedicated 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 team
Serve 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 NCQA
Interacted with various clients and Sales staff to promote the health coaching program and integration between Cigna Products
Committed to improving program quality, efficiency, and customer experience through
recommendations of improvements to processes and procedures
Registered Nurse/Charge Nurse Telemetry/Step-down Unit 11/09-4/11
Des Peres Hospital - St. Louis, MO
In charge of staffing, assigning patients to nurses
Performed daily assessments of patients using nursing process
Pulled pacer wires from patients status post CABG
Pulled arterial/venous sheaths from patients status post cardiac catheterization
Calculated medications, gave medications, administered blood transfusions
Administered medications through IV drips, IM, SQ
Started IV's, performed blood draws, wound dressing changes, EKG
Daily communication with health team
Registered Nurse, Cardiac Rapid Evaluation Unit 4/07-9/09
Barnes-Jewish Hospital - St. Louis, MO
Performed daily assessments of patients using nursing process
Calculated medications, gave medications, administered blood transfusions
Started IV's, performed blood draws, wound dressing changes, EKG
Administered medications through IV drips, IM, SQ
Skills:
Microsoft Office Suite
Conversational French language