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

Contact this candidate