Summary
Overview
Work History
Education
Skills
Degree
Professional Development
Accomplishments
Timeline
Generic

ROBIN SAMBUCO, BSN, RN

Springfield,PA

Summary

Healthcare leader, patient advocate, and registered nurse with 25+ years of experience partnering with healthcare providers, health systems, patient advocacy organizations, and multidisciplinary stakeholders to improve patient outcomes and healthcare access. Proven success educating providers, supporting patients and caregivers through complex healthcare journeys, and collaborating across the healthcare continuum to enhance care coordination, engagement, and access to appropriate treatment. Experienced in supporting individuals and families navigating complex, chronic, and rare medical conditions through advocacy, education, care coordination, and healthcare system navigation.

Overview

29
29
years of professional experience

Work History

Cost Optimization Manager

Crumdale Specialty
09.2024 - Current
  • Clinical leader supporting patient advocacy, care management collaboration, medication access, and healthcare engagement initiatives across self-funded health plan populations.
  • Lead high-cost claimant identification, monitoring, and intervention strategies.
  • Partner with underwriting, pharmacy, care management, account management, TPAs, brokers, and vendors to improve outcomes and reduce healthcare costs.
  • Oversee oncology initiatives, including member identification, care coordination, referral management, engagement tracking, and outcome reporting for individuals navigating complex treatment journeys.
  • Serve as a clinical subject matter expert for utilization management, complex claims review, and care management collaboration.
  • Provided clinical oversight of precertification processes and complex clinical reviews for more than 200 self-funded employer and union health plan groups.
  • Collaborate with pharmacy partners and specialty vendors to support medication access, specialty pharmacy coordination, high-cost medication oversight, and patient support initiatives.
  • Maintain working knowledge of manufacturer Patient Assistance Programs (PAPs), copay assistance resources, and medication access programs to help address treatment affordability and access barriers.

Practical Nursing Instructor / Nurse Educator

Delaware County Intermediate Unit (DCIU)
04.2023 - 09.2024
  • Educated and mentored practical nursing students in classroom, simulation, and clinical settings.
  • Developed curriculum and evaluated student competencies.
  • Collaborated with healthcare partners to support clinical education experiences.
  • Prepared future nurses for successful transition into professional practice.

Vice President of Operations

Guardian Nurses Healthcare Advocates
07.2018 - 03.2023
  • Executive oversight of healthcare advocacy, care navigation, and member support programs serving self-funded employer groups and union health plans.
  • Directed a multidisciplinary team including 5 direct reports and approximately 50 nurses supporting employer and union health plan populations.
  • Directed healthcare advocacy, care navigation, and case management programs serving self-funded employers and union health plans.
  • Built collaborative relationships with providers, hospitals, health systems, community organizations, and healthcare stakeholders to improve patient experiences and outcomes.
  • Collaborated with patient advocacy organizations, community resources, and healthcare stakeholders to support member education, healthcare access, and patient-centered outcomes.
  • Served as a public-facing representative of the organization, delivering educational presentations and speaking at employer, union, broker, and community events to promote healthcare advocacy services, member engagement, and organizational growth.
  • Represented the organization at benefit fairs, health education events, and member outreach programs to promote healthcare advocacy services and member engagement.
  • Supported members and families navigating complex diagnoses, treatment decisions, healthcare access challenges, and transitions of care while collaborating with employers, brokers, consultants, and community resources to improve engagement and outcomes.
  • Led multidisciplinary clinical teams and promoted patient-centered care through education, advocacy, and healthcare system navigation.
  • Supported healthcare cost-management strategies through advocacy, care coordination, and early intervention programs.

Clinical Manager

Guardian Nurses Healthcare Advocates
01.2017 - 07.2018
  • Supervised nursing and advocacy staff while overseeing case management operations and complex member cases.
  • Supported cost-containment initiatives through advocacy, care coordination, provider collaboration, and early intervention strategies for self-funded employer and union health plan populations.
  • Established and managed a collaborative referral partnership with Penn Medicine, enabling Guardian Nurses staff to facilitate timely access to specialty and primary care services for union health plan members, often within 48 hours.
  • Developed and implemented organizational playbooks, onboarding materials, and orientation programs to support training, consistency, and successful integration of new hires.
  • Provided clinical guidance and mentorship to nursing and advocacy staff supporting self-funded employer and union health plan populations.
  • Collaborated with providers, hospitals, employers, and community resources to address complex member needs and improve care coordination.
  • Supported members and families navigating healthcare access challenges, treatment decisions, and transitions of care.

Nurse Advocate / Mobile Care Coordinator

Guardian Nurses Healthcare Advocates
09.2015 - 01.2017
  • Provided mobile care coordination and advocacy services for members of self-funded union health plans, supporting individuals during provider appointments and helping navigate complex healthcare needs, treatment decisions, and access-to-care challenges.
  • Collaborated with providers, hospitals, case managers, and community resources to improve care coordination and outcomes.
  • Advocated for members and families while helping them navigate healthcare resources, treatment options, and access-to-care challenges.

Bed Management Coordinator

Children's Hospital of Philadelphia (CHOP)
Philadelphia, Pennsylvania
12.2004 - 09.2015
  • Coordinated patient flow and hospital capacity management across a nationally recognized pediatric healthcare system.
  • Collaborated with physicians, nursing leadership, and hospital administration to optimize admissions, transfers, and patient placement.
  • Facilitated communication among clinical teams to ensure timely access to care and efficient coordination of patient services.
  • Served as a member of the hospital's Emergency Preparedness Team, participating in emergency response planning, disaster preparedness exercises, and hospital capacity coordination to support organizational readiness during critical events.

Inpatient Homecare Liaison

Children's Hospital of Philadelphia (CHOP)
Philadelphia, Pennsylvania
11.2000 - 12.2004
  • Coordinated discharge planning and transition-of-care services for pediatric patients and families.
  • Facilitated home care, palliative care, infusion services, and durable medical equipment to support safe transitions from hospital to home.
  • Collaborated with physicians, nurses, homecare agencies, and community resources to ensure continuity of care and family education.
  • Educated patients and caregivers on treatment plans, homecare services, and available healthcare resources.
  • Served as a liaison between families, healthcare providers, and community-based services to support care coordination and access to needed services.

Staff Nurse - Surgical/Trauma Unit

Children's Hospital of Philadelphia (CHOP)
Philadelphia, Pennsylvania
12.1997 - 11.2000
  • Provided nursing care for pediatric surgical and trauma patients within a high-acuity environment.
  • Collaborated with multidisciplinary healthcare teams to support patient-centered care and positive clinical outcomes.
  • Educated patients and families regarding treatment plans, recovery expectations, and ongoing healthcare needs.

Education

Bachelor of Science - Nursing

Neumann University

Registered Nurse (RN) -

Skills

  • Patient advocacy and engagement
  • Care navigation and management
  • Provider and community collaboration
  • Population health strategies
  • Clinical education and outreach
  • Account management and stakeholder relations
  • Medication access solutions
  • Specialty pharmacy partnerships
  • Healthcare analytics and insights
  • Team leadership

Degree

BSN, RN

Professional Development

Healthcare Leadership Development Program

Accomplishments

  • Finalist Pennsylvania Nightingale Award
  • Wildwood New Jersey Honoree

Timeline

Cost Optimization Manager

Crumdale Specialty
09.2024 - Current

Practical Nursing Instructor / Nurse Educator

Delaware County Intermediate Unit (DCIU)
04.2023 - 09.2024

Vice President of Operations

Guardian Nurses Healthcare Advocates
07.2018 - 03.2023

Clinical Manager

Guardian Nurses Healthcare Advocates
01.2017 - 07.2018

Nurse Advocate / Mobile Care Coordinator

Guardian Nurses Healthcare Advocates
09.2015 - 01.2017

Bed Management Coordinator

Children's Hospital of Philadelphia (CHOP)
12.2004 - 09.2015

Inpatient Homecare Liaison

Children's Hospital of Philadelphia (CHOP)
11.2000 - 12.2004

Staff Nurse - Surgical/Trauma Unit

Children's Hospital of Philadelphia (CHOP)
12.1997 - 11.2000

Bachelor of Science - Nursing

Neumann University

Registered Nurse (RN) -

ROBIN SAMBUCO, BSN, RN