Work Preference
Summary
Overview
Work History
Education
Skills
Affiliations
Additional Information
Timeline
Registered Nurse
Open To Work

Sandra Sherman

HUMANA
Springhill,FL

Work Preference

Desired Job Title

Telephonic Nurse Case Manager IITelephonic RN Case ManagerHome Health RNTriage NurseInstructor

Work Type

Part Time

Location Preference

Remote

Important To Me

Paid time offFlexible work hours401k matchWork-life balanceWork from home option

Summary

Compassionate Nurse Case Manager offering 19 years of experience working with patients in multiple Acute Care facility roles, Telephonic Nursing, Home Health, and long term facility. Committed to working collaboratively with health plan, leadership and department coordinators to achieve highest quality of patient satisfaction. Well-versed in developing individualized care plans and advocating patient welfare.

Triage RN in Remote Call Center environment

Certificate in Managed Care

Utilized EMR for abstracting patient information to develop care plan and meet NCQA requirements.

Experience with claims procedure codes and ICD coding.

Skilled in creating and implementing processes to improve patient care and cultivate support teams. Seasoned nursing professional offering proven clinical knowledge, natural interpersonal strengths and technical abilities. Knowledgeable about EMR charting, medication administration and interdisciplinary collaboration focused on optimizing patient care and support. Quality-focused and efficiency-driven leader.

22
Years of experience

Work History

Telephonic Nurse Case Manager II

2 Years 11 Months
Elevance Health | 12.2019 - 11.2022
  • Certificate of Continuing Nursing Education for Managed Care Course - "A Comprehensive Introduction to Managed Care Nursing"
  • Clinical experience as remote Telehealth Nurse Case Manager for a health plan in call center style with automatic dialer for outbound Case Management calls and accepted inbound calls also.
  • Utilizing many computer applications simultaneously to outreach members for enrollment and follow up in case management.
  • Provide guidance and support to members to manage their health related concerns or goals using motivational interviewing and provide resources, education and referrals to available health team as needed.
  • Experience in Nurse line Triage and guided member's to proper cost effective care.
  • Close any Care Gaps (HEDIS)

Telephonic RN Case Manager

1 Year 1 Month
Access Healthcare | Springhill, FL | 10.2018 - 11.2019
  • Case Management for Physician Group and Medicare patients.
  • Utilized EMR's to abstract patient information
  • Collaborated with other health care professionals regarding plan of care and variances in plan implementation to achieve outcomes.
  • Screened medical records and information for necessity and appropriateness and referred for physician review cases not meeting medical criteria.
  • Evaluated patients referred for case management to determine physical, mental, financial and psychosocial status by utilizing comprehensive, standardized criteria to identify existing and potential needs.
  • Assessed current treatment plan to identify barriers, clarify or determine realistic goals and objectives and seek potential alternatives.

Clinical RN Supervisor

2 Years 5 Months
CARES Home Health | 05.2016 - 10.2018
  • Home Health Case Manager RN duties and responsibilities to support patients in their home.
  • Clinical Supervisor of Home Health Case Managers
  • Performed Medicare OASIS documentation.
  • Supervisor of Home health RN's, Quality assurance, ICD 10 experience, Medicare OASIS documentation, scheduling, coordinating care with Providers and insurance companies.

Home Health RN

3 Months
Family Home Health Services | 02.2016 - 05.2016
  • Home Health Duties and Responsibilities
  • Performed OASIS Medicare documentation.
  • Performed Assessment, Care plan, clinical interventions, collaborate with ancillary staff as needed.

Real Estate Sales Associate

2 Years 8 Months
Florida Luxury Realty, with Brokerage | 03.2014 - 11.2016

Self Employed Real Estate Sales agent

Registered Nurse

8 Months
NorthBay Hospital, Float Pool-RN, Pinnacle Home | 03.2014 - 11.2014

Float Pool Registered Nurse in an Acute Care Facility.

Home Health Registered Nurse Case Manager

8 Months
Mobile Personal Services | 07.2013 - 03.2014

Performed Home Health Nurse duties with assessment, care plan, interventions, overcome barriers, education as needed.

Trained and Orientation for Nurse Aids

Float Pool RN

9 Years 2 Months
Robert Packer Hospital | 05.2004 - 07.2013

* Acute Care Facility Float pool in ICU/CCU, Med/Surg, Telemetry, Ambulatory Surgery.

· Monitoring patients’ recovery and compiling reports for the relevant doctors and other stakeholders.

· Manage patients from intake to discharge to ensure patients are getting the proper care they need.

· Administer medications based on patient needs utilizing safety measures.

· Developed nursing plan of care based on nursing diagnosis and interventions utilizing EMR

· Performing wound inspections, changing dressings, and monitoring the patients’ overall wellbeing.

· Ensuring that all equipment and medical supplies are kept sterile and well organized.

*ACLS Certification

6 Years 2 Months
Memorial Hosp | 01.2006 - 03.2012
  • Travel
  • RN for Winter Med/Sur/Tele/ED Overflow.-Fish

16 Years 7 Months
01.2010undefined
  • 11-4/6/11 Travel RN position for the
  • Winter Med

PACU RN

2 Years 10 Months
Wilson Memorial Hospital | 10.2007 - 08.2010

Post Anesthesia nursing including critical care services.

Travel Nurse

6 Months
Fawcet Memorial Hosp | 06.2004 - 12.2004

Float Pool Nursing duties

RN Case Manager

3 Years 6 Months
HUMANA | 999 Work at home, Tampa, FL 33610 | 02.2023 - Current
  • Coordinated patient care plans with interdisciplinary teams to enhance quality of service delivery.
  • Assessed patients' needs and developed individualized care strategies to improve health outcomes.
  • Monitored patient progress and adjusted care plans based on clinical assessments and feedback.
  • Ensured compliance with regulatory standards while maintaining high-quality care for diverse patient populations.

Education

Associate of Applied Science - Certificate in Managed Care Nursing

American Association of Managed Care Nurses | Glen Allen, Virginia | 12.2019

Associate of Science - Nursing

Corning Community College | Corning, NY | 06.2004

Skills

Educated on Managed Care Nursing with Certificate.
Motivational Interviewing
Multitasking with multiple computer screens and programs
Strong clinical judgment
Preventive health
Chronic disease management
Home care
Patient and family advocacy
Acute care expertise
Patient consultation
EMR / EHR use for documentation and information extraction
Excellent Communication Skills
History of coding Claims and course in ICD-10 codes and CMS requirements.

Affiliations

  • Previous Certification in ACLS

Additional Information

  • Compact RN License with home state of Florida
  • PA RN license
  • NY RN license
  • Certificate in Managed Care

Timeline

RN Case Manager
HUMANA
02.2023 - Current
Telephonic Nurse Case Manager II
Elevance Health
12.2019 - 11.2022
Telephonic RN Case Manager
Access Healthcare
10.2018 - 11.2019
Clinical RN Supervisor
CARES Home Health
05.2016 - 10.2018
Home Health RN
Family Home Health Services
02.2016 - 05.2016
Real Estate Sales Associate
Florida Luxury Realty, with Brokerage
03.2014 - 11.2016
Registered Nurse
NorthBay Hospital, Float Pool-RN, Pinnacle Home
03.2014 - 11.2014
Home Health Registered Nurse Case Manager
Mobile Personal Services
07.2013 - 03.2014
01.2010
PACU RN
Wilson Memorial Hospital
10.2007 - 08.2010
Memorial Hosp
01.2006 - 03.2012
Travel Nurse
Fawcet Memorial Hosp
06.2004 - 12.2004
Float Pool RN
Robert Packer Hospital
05.2004 - 07.2013
Corning Community College
Associate of Science from Nursing
American Association of Managed Care Nurses
Associate of Applied Science from Certificate in Managed Care Nursing
Sandra ShermanRegistered Nurse