Sarah Horn
O'Fallon,MO
Summary
Dedicated RN with 14 years experience. Excels in environments where client needs are the primary focus. Demonstrates stress tolerance, collaboration, and teamwork. Remained flexible and adaptive with added daily tasks. Strong work ethic and communication skills. Sound knowledge of medical terminology, nursing practices, and hospital regulations. Worked closely with physicians, nurses, and case management to ensure cohesive treatment. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Nurse Medical Management
Anthem
12.2020 - Current
- Perform initial acute and continued stay inpatient utilization reviews following MCG guidelines
- Assisted with DC planning and referred to CM as needed
- Maintain caseloads and comply with turn around times, and met productivity goals of 12-14 cases per day.
- Build external relationships with providers and facilities to support effective care management
- Collaborate with CM, physicians, and social workers to ensure quality of care.
- Maintained accuracy, completeness, and security for medical records and health information
Utilization Review Nurse
Aetna
10.2017 - 12.2020
- Performed initial and post acute utilization reviews and admission requests for managed care members per state and CMS guidelines
- Maintained and developed effective and professional relationships with facilities, clients, business partners, and medical providers on daily basis
- Completed weekly teleconference calls with utilization team, management team, and medical directors to discuss medically complex reviews, continued education, and new initiatives for accurate and appropriate level of care for members
- Continued adherence to accreditation, contractual, regulatory guidelines, and timeframes in performing utilization management review processes
- Continued daily screening for medical necessity and appropriate level of care and timeliness of delivery of care to members
- Continued monitoring of inpatient/rehabilitation progress, discharge/alternate discharge planning, possible alternate lower level of care, and needs for continued services after discharge.
Rn Clinical Liaison
Select Medical
11.2014 - 10.2017
- Coordinated safe transition of care through collaboration and communication with admission staff, clinical staff, and hospital personnel as appropriate
- Communicated special needs, equipment, or medication so it is readily available upon arrival of patient
- Supported Sales and Marketing through educational programs, tours, meetings, etc
- In assigned hospitals
- Developed strategies to grow market share in core business lines in assigned hospitals
- Created quarterly goals and objectives and submitted to supervisor
- Worked with Director Business Development to identify opportunities for expansion of strategic business initiatives
- Served as advocate and educated hospitals and communities on acute rehabilitation
- Consistently demonstrated commitment to patient-centered care and customer service excellence in all interactions with patients and patient families, internal and external customers by responding in timely, professional, and effective manner.
RN
Barnes Jewish St. Peters Hospital
05.2013 - 11.2014
- Performed comprehensive range of clinical functions in 12-bed intensive care/step down unit
- Assessed patients' conditions, administered medications, maintained patient charts, and responded to medical emergencies
- Built solid, trusting relationships with staff and patient families, generating positive attitude through extra efforts towards medical treatment and one-on-one communications
- Ensured and educated patients and families throughout entire hospital stay
- Collaborated with multidisciplinary team members, working closely with physicians, nurses, and therapists to formulate, implement, and modify individual care plans.
RN Staff Nurse
South Baldwin Regional Medical Center
08.2009 - 04.2013
- Provided care on 28 bed Medical-Surgical unit
- Responsible for delivery of patient care; assessment, diagnosis, planning, implementation, and evaluating, coordinating all nursing care based on established clinical nursing practices
- Collaborated with other professional disciplines to ensure effective and efficient patient care delivery and achievement of desired patient outcomes.
- Directed patient care by initiating and following through with plan of care, continuing care, and discharge instructions
- Precepted student nurses and oriented new hires, providing guidance and mentorship when teaching on hospital policies, emergency procedures, and nursing best practices
- Effectively prioritized assignments, executing care based on each patient's relative condition and delegating tasks to available personnel deliver safe and efficient care
Education
Bachelor of Science -
Chamberlain College of Nursing
Saint Louis, MO02.2008
Bachelor of Science -
Benedictine University
Lisle, IL01.2007
Skills
- RN
- Patient Evaluation
- Medical Terminology Expertise
- EMR Systems
- Patient Health Information Access
- Discharge Planning
- Utilization Management
Certification
Registered Nurse (RN), 04/01/17, 04/01/25
Timeline
Nurse Medical Management
Anthem
12.2020 - Current
Utilization Review Nurse
Aetna
10.2017 - 12.2020
Rn Clinical Liaison
Select Medical
11.2014 - 10.2017
RN
Barnes Jewish St. Peters Hospital
05.2013 - 11.2014
RN Staff Nurse
South Baldwin Regional Medical Center
08.2009 - 04.2013
Bachelor of Science -
Chamberlain College of Nursing
Bachelor of Science -
Benedictine University
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