Registered Nurse Manager

Dawn Glahn R.N.

Objective: A quality review nurse position

Summary of Qualifications:

. Bachelors of Science in Nursing

. Case management experience includes patient education, discharge

planning and coordination of care

. Clinical experience includes cardiac, surgical and orthopedic patient population

. Quality review experience includes HEDIS, all measures

. Drug safety experience includes quality review and medical writing

. Utilization management experience with Interqual and Milliman

. Self motivated with proven ability to work autonomously

Summary of Career History:

2012-present United Health Group

Inpatient Case Manager/Utilization Review

Coordinate appropriate care for members from

admittance to discharge.

Perform medical records review to ensure quality

care for members. Work

remotely from home office.

2012 Medical Review Group, Brighton, MI

Quality Review Nurse Consultant

Performed medical record reviews and chart

abstraction for HEDIS. Also

performed over reads of reviews completed by co-

workers. Performed

reviews for several insurance companies in multiple

databases. Scanned

medical records and up/downloaded assignments.

2011 Chelsea Community Hospital, Chelsea, MI

Case Manager/Utilization Manager

Performed utilization management duties including

applying Interqual criteria to ensure that medical care is clinically appropriate and complies with

established criteria. Presented utilization management

orientation to new physicians.

2007-2011 i3 Drug Safety, Ann Arbor, MI

Pharmacovigilance Coordinator

Performed medical record review and chart abstraction of

information related to adverse drug events. Processed and

reported findings per sponsor and regulatory agency guidelines.

Other responsibilities included mentoring new employees and

performing peer reviews.

2006-2007 Medical Review Group, Brighton, MI

Quality Review Nurse Consultant

Performed medical record reviews and chart abstraction for

HEDIS. Performed reviews for several insurance companies in

multiple databases.

1998-2000 Forest Health Medical Center, Ypsilanti, MI.

Case Manager/Registered Nurse

Managed patient case from intake to surgery. Reviewed medical

records and coordinated with insurance companies to obtain pre-

authorization for surgery. Submitted appeals to insurance

companies. Provided comprehensive nursing care to post-surgical

patient population.

1998. CNA Insurance, Nashville, TN. (Dearborn, MI.)

Insurance Underwriter

Established the company's first off-site underwriter position.

Reviewed applicant's medical records to determine insurance risk

related to obtaining long term care insurance coverage.

1997 University of Michigan Medical Center, Ann Arbor, MI.

Registered Nurse

Provided comprehensive nursing care to cardiac, orthopedic

and trauma patient population.

Education: Madonna University, Livonia, MI.

Bachelors of Science in Nursing GPA 3.6

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