Seasoned nursing professional offering proven clinical knowledge, natural interpersonal strengths and technical abilities. Experience with managed care, NCQA guidelines, and interdisciplinary collaboration focused on optimizing patient care and support. Quality-focused and efficiency-driven leader.
Hi, I’m
Sandra Carlin
MSN, RN, CCM
Toms River,NJ
Summary
Overview
27
years of professional experience
10
years of post-secondary education
4
Certifications
Work History
Horizon Blue Cross Blue Shield Of NJNewark, NJ
Registered Nurse Case Manager
01.2017 - Current
Job overview
- Advocated for patients by communicating care preferences to practitioners, verifying interventions met treatment goals and identifying insurance coverage limitations.
- Evaluated healthcare needs, goals for treatment, and available resources of each patient and connected to optimal providers and care.
- Effectively communicated with physicians regarding patient needs, performance, medications and changes.
- Worked with suppliers and vendors on provision of medical equipment, items and services.
- Created individualized care plans based on nursing diagnosis and incorporated appropriate nursing methods to achieve positive outcomes.
- Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
- Performed prior authorization review of services requiring notification.
Monmouth County Vocational School DistrictMiddletown, NJ
Health Occupations Teacher
09.2010 - 10.2016
Job overview
- Contributed educational and clinical expertise to help optimize training courses and boost student learning.
- Supported student educational and vocational planning to help each optimize learning strategies and reap long-term career benefits.
- Assessed student knowledge levels and abilities with detailed assessments.
- Monitored progress of each student and provided formal evaluation upon completion of clinical placements.
- Identified and assigned appropriate activities and projects to enhance student learning.
- Prepared course materials such as syllabi, homework assignments and handouts for distribution or use within classroom.
Education
Kean UniversityUnion, NJ
Master of Science from Clinical Management
01.2014 - 05.2016
University Overview
Kean UniversityUnion, NJ
Bachelor of Science from Nursing
09.2006 - 05.2008
University Overview
Ocean County CollegeToms River, NJ
Associate of Science from Nursing
09.1990 - 12.1996
University Overview
Skills
Insurance plan expert
undefinedCertification
Certified Case Manager
Timeline
Registered Nurse Case Manager
Horizon Blue Cross Blue Shield Of NJ
01.2017 - Current
Kean University
Master of Science from Clinical Management
01.2014 - 05.2016
Health Occupations Teacher
Monmouth County Vocational School District
09.2010 - 10.2016
Kean University
Bachelor of Science from Nursing
09.2006 - 05.2008
Ocean County College
Associate of Science from Nursing
09.1990 - 12.1996
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