Position Desired: Management Location Desired: Rochester, NY Area of Expertise: Administration-Management
Compensation Desired: Salary Travel Desired: No Travel
Joseph P. Lo Tempio, RN, BSN, MS
638 Crows Nest Lane Cell: (585) 474-4556 Macedon, NY 14502 Residence: (315) 986-4509
Senior Clinical Analyst MVP HealthCare
Highly focused and successful consultant to the Vice-president of Medical Affairs advising senior management on matters concerning operational and decision support, policy utilization and integration, medical technology evaluation, development and implementation of cost-saving initiatives, intervention effectiveness and risks, and medical policy assessment.
Acknowledged for the ability to build trust, instill confidence and demonstrate integrity and leadership. Applied team building to drive business solutions and develop staff in achieving short and long term corporate goals, provide critical analysis of utilization and cost effective data, and write policy to address the needs of membership in compliance with federal, state and local regulatory agencies.
Professional Highlights 2003-2014
Managed medical policies and guidelines to provide the most cost effective, safe and proven healthcare procedures and devices for members in accordance with federal, state and local regulations across the enterprise.
Directed, coordinated and managed staff in the completion of corporate projects to ensure they were performed on time, on-budget and that met or exceeded corporate goals.
Presented detailed analysis to senior staff concerning long-term safety, efficacy and cost-effectiveness of novel evidence-based medical technologies, interventions and procedures.
Identified high-risk medical devices, pharmaceuticals, diagnostics, biologics and procedures that may potentially have a negative impact on the health of our members.
Consulted with community medical experts to determine best practice, safe, proven and cost-effective peer-reviewed medical treatments and procedures that have been recognized as providing the highest probability of positive outcomes for our member's health.
Provided detailed analysis of the personal mobility market including marketing tactics, utilization and cost analysis, UM concerns, potential provider abuse, CMS criteria, problems with DME billing, and discrepancies within Case Management and UM departments.
Developed a Decision Support Tool (DST) to facilitate communications of financial data, risk-avoidance, corporate incentives, new technology reviews and operational metrics.
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Recommended changes to medical policy review criteria and implementation of an integrated training initiative to educate staff in order to maintain consistency and reliability in the review process between Case Management, UM Outpatient and Medical Director review functions.
Recommended revisions to medical policy criteria in compliance with FDA, CMS, Medicaid, and New York State, New Hampshire and Vermont regulations. Achieved millions of dollars in cost- savings by streamlining programs requiring both short-term and strategic initiatives to control utilization and costs for ASO, IPA, HMO, PPO, commercial and Medicare/Medicaid members.
Worked closely with corporate legal department, product managers, project managers and stake holders ensuring that medical policies are developed and executed in compliance with the rules and regulations of the FDA, Medicare, Medicaid and the NYS Department of Health.
Recommended program changes targeting specific areas of specialization that demonstrated utilization variance compared to national trends.
Participated in Professional Advisory Teams composed of internal senior medical staff and community medical specialists from across the enterprise who reviewed medical policies, provider and member needs, new technology requests, compensation issues, concerns of the medical community, practice guidelines, regulatory compliance and credentialing issues.
Served as a strategic partner working closely with senior management in the planning, development, implementation, and management of policies and processes that impact membership, utilization, costs, and quality of care across the enterprise.
Provided ad hoc technical and regulatory support to senior management, medical directors, product managers and review staff to ensure accurate and timely resolution of member-related issues.
Cardiac Case Manager 2000-2003 Visiting Nurse Service (VNS)
Managed the care of post-surgical cardiac patients recently discharged from the hospital. Responsible for assessment, medication administration and compliance, wound care and patient education.
Interpreted patient status and made critical decisions about patient needs both physically and psychologically.
Discussed patients’ plan-of-care, response to medications, wound care treatments and mental status with physicians to provide optimally safe and effective treatment for quick recovery.
Directed and supervised care delivery by other healthcare personnel (RNs, LPNs, home health aides) .
Provided clinical support in the delivery of advanced care throughout Rochester for patients requiring intravenous medications and/or fluid therapy, advanced wound care, central line maintenance and management of severe extracellular fluid volume (edema).
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Senior Staff Nurse – Level I Trauma Unit (8-1400) 1994-2000 University of Rochester Medical Center
Provided care for acutely traumatized burn patients and patients who experienced severe morbidity due to accidents, surgical interventions, gunshot wounds or assault. Patient population included pediatric, adult and geriatric age groups.
Assumed the Charge Nurse role managing nine nurses in the delivery of care in the Level I Trauma Unit. This entailed the coordination of surgical resources and tertiary personnel, as well as interfacing with multiple disciplines in determining the level of care required for individual patients. I also served as a hemodynamic specialist and instructor as well as a clinical preceptor for trainees.
Discussed plan-of-care for patients facing life-threatening injury and co-morbidities with surgeons and multiple medical specialists to provide the highest level of care including medication administration, fluid management, wound care protocols, radiographic diagnostic testing, lab work, nutritional and electrolyte therapy and scheduling of surgical and interventional procedures.
Counseled and comforted family members, explaining the course of treatment for their family member(s) ensuring them that the highest level of care is being provided for their loved one(s).
Education MS Organizational Management – Rochester Institute of Technology Cum Laude BS Nursing – SUNY College at Brockport Magna Cum Laude
Profession Member of Sigma Theta Tau, Omicron Beta Chapter – International Nursing Organizations Honor Society Member of Alpha Chi National Honor Society