Epic (EMR), Cerner, Meditech, Allscripts, eClinicalWorks, PointClickCare, McKesson, Pyxis/Omnicell
Kimberly Horton
Cranberry Township,PA
Work Preference
Summary
Registered Nurse with 34 years of progressive experience across specialty pharmacy, chronic disease management, behavioral health, and substance abuse disorder treatment. Experienced in telephonic care management, comprehensive member assessments, individualized care planning, medication adherence support, and multidisciplinary coordination. Proven ability to engage complex populations, identify barriers to care, and improve quality outcomes while supporting quality metrics, and utilization goals. Prior to Accredo, clinical leader with deep understanding of integrated specialty pharmacy and payer-aligned care models within Evernorth Health Services and The Cigna Group.
Overview
34
34
years of professional experience
Work History
Personal In-Home Caregiver
Private Citizen
Valencia, PA
04.2025 - 12.2025
- Provided compassionate personal care to client, ensuring comfort and dignity in daily activities.
- Assisted client with medication management, promoting adherence to prescribed treatment plans.
- Served as an advocate for the client when communicating with family members or healthcare providers regarding their needs or concerns.
- Implemented creative solutions to overcome obstacles faced by client due to physical limitations or cognitive decline.
- Supported family through difficult times by offering emotional support and education on important care tasks.
Registered Nurse Manager
Gateway Rehabilitation Center
Aliquippa, PA
03.2020 - 12.2024
- Conducted comprehensive assessments and follow-up outreach for substance abuse disorder populations
- Support Medication-Assisted treatment (MAT) including monitoring, eduction, and adherence
- Developed and adjusted individualized care plans based on evolving member need
- Collaborated with physicians, therapists, and care teams to ensure continuity of care
- Identified barriers to care and coordinated appropriate referrals
- Maintained accurate, timely documentation in EHR systems aligned with quality standards
Personal Health Leave
Personal Health Leave
Cranberry Township
2018 - 2019
Director of Nursing
St Barnabas Health System
Gibsonia, PA
10.2009 - 09.2018
- Led nursing operations with accountability for quality outcomes and regulatory compliance, along with QAPI and infection control programs
- Oversaw admissions, care coordination, and transitions of care
- Analyzed quality metrics and implemented performance improvement initiatives
- Managed staffing models, department budgets, and resource allocation
- Recruited, trained, and mentored nursing staff consisting of 18 nurses and 26 nursing assistants
- Served as escalation point for complex clinical and operational issues
Medical Science Liaison Consultant
Gilead Sciences
San Francisco, CA
09.2004 - 08.2009
- Developed and delivered evidence-based education on specialty therapies for Pulmonary Arterial Hypertension
- Communicated complex clinical data to physicians, pharmacists, and key stakeholders
- Supported clinical research initiatives and treatment optimization
- Built collaborative relationships across healthcare networks
National Clinical Manger
Accredo Health, Inc, A Medco
Memphis, TN
06.1998 - 09.2004
- Managed national team of 27 cardiopulmonary nurse specialists
- Developed specialty clinical programs for complex and rare disease states
- Provided telephonic clinical support and education to patients and providers
- Supported medication access, adherence, and continuity of care
- Developed clinical guidelines using utilization and outcomes data
- Partnered across pharmacy, clinical, and sales teams to support integrated care
Education
Bachelor of Science - Nursing Science
University of Phoenix
Tempe, AZ07.2015
Skills
- Telephonic Care Management
- Health Risk Assessments (HRA)
- Care plan development & transitions of care
- Medication Reconciliation & Adherence
- MAT support and Behavioral Health support
- Member engagement & Motivational Interviewing
- EMR/EHR Documentation
- Quality Metrics & Utilization Reduction
- Multidisciplinary Collaboration
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
swipe to browse
Case Management & Specialty Pharmacy Focus
- High-cost specialty medication support
- Behavioral health and chronic condition overlap
- Integrated medical/pharmacy benefit coordination
- Value-based and outcomes-driven care models
Software
Microsoft Word, Excel, PowerPoint, Outlook, Google Docs, Adobe Acrobat
ShiftWizard, Workday
Incident Reporting Systems, Risk Management Software
Microsoft Teams, Zoom
Quote
Success is often achieved by those who don’t know that failure is inevitable.
Coco Chanel
Languages
English
Full Professional
Timeline
Personal In-Home Caregiver
Private Citizen
04.2025 - 12.2025
Registered Nurse Manager
Gateway Rehabilitation Center
03.2020 - 12.2024
Director of Nursing
St Barnabas Health System
10.2009 - 09.2018
Medical Science Liaison Consultant
Gilead Sciences
09.2004 - 08.2009
National Clinical Manger
Accredo Health, Inc, A Medco
06.1998 - 09.2004
Bachelor of Science - Nursing Science
University of Phoenix
Personal Health Leave
Personal Health Leave
2018 - 2019