Dana Dobson
New Albany,IN
Summary
Hands-on professional proudly offering more than 14 years of expertise in the nursing field. Well-rounded and personable Utilization Review Nurse talented in reporting, records oversight, and performance improvement.
Overview
13
13
years of professional experience
Work History
Utilization Management Nurse
Humana
02.2018 - Current
- Reduced hospital readmissions through effective discharge planning and coordination of post-discharge care.
- Streamlined utilization review processes by collaborating with interdisciplinary teams to develop individualized care plans.
- Increased efficiency in case management documentation by maintaining organized records and utilizing electronic medical record systems.
- Ensured compliance with regulatory guidelines by staying current on industry standards and participating in ongoing education opportunities.
- Participated in quality improvement initiatives to enhance overall standard of care within the organization.
- Conducted ongoing evaluations of patients'' progress toward established goals, adjusting care plans as needed for optimal results.
- Contributed to team success by consistently meeting productivity goals while maintaining high-quality standards in job performance.
- Performed prior authorization review of services requiring notification.
- Evaluated medical guidelines and benefit coverage to determine the appropriateness of services.
- Performed admission reviews for medical necessity based on MCG specifications.
- Supervised and maintained all utilization review documentation through CGX.
- Served as subject matter resource, providing information related to post-acute situations.
- Followed all personal and health data procedures to comply with HIPAA laws and prevent information breaches.
Nurse Manager
Clark Memorial Hospital
01.2011 - 01.2018
- Enhanced patient care by implementing evidence-based nursing practices and protocols.
- Improved patient satisfaction scores by fostering a team-oriented environment among nursing staff.
- Reduced hospital readmission rates with proactive discharge planning and thorough patient education.
- Developed comprehensive training programs for new hires, ensuring quality care and consistency in nursing practices.
- Conducted performance evaluations and provided constructive feedback to support professional growth of nursing staff members.
- Collaborated with interdisciplinary teams to develop individualized care plans for patients with complex needs.
- Managed budgets and controlled costs, achieving financial targets without compromising patient care quality.
- Implemented infection control measures, resulting in reduced incidence of hospital-acquired infections.
- Monitored clinical outcomes closely, identifying areas for improvement and implementing corrective actions.
- Established strong relationships with patients'' families, providing support and education throughout the treatment process.
- Championed continuous learning among staff members, organizing regular educational workshops and seminars.
- Ensured regulatory compliance by maintaining accurate records and staying up-to-date on industry standards.
- Promoted a culture of safety within the department, conducting regular risk assessments and addressing potential hazards promptly.
- Served as a key point of contact between nursing staff, physicians, administration, and other healthcare professionals.
- Advocated for patients'' rights and ethical considerations in all aspects of care delivery.
- Implemented best practices in pain management to optimize patient comfort during treatment processes.
- Coordinated staffing resources during times of high patient acuity or census fluctuations to maintain optimal nurse-to-patient ratios.
- Evaluated emerging healthcare technologies to determine their potential benefits for improving nursing practice.
- Fostered open communication among nurses through regular team meetings, promoting collaboration and shared decision-making.
- Supervised, directed, and motivated high-quality performance from nursing staff.
- Led staff meetings to keep teams informed of departmental changes and provide opportunities for nurses to share ideas and concerns.
- Investigated and independently resolved complaints from staff, physicians, and patients by leveraging clinical judgment and unit management expertise.
- Managed staff scheduling and time off to adequately staff nursing floors and allow nurses earned time off.
- Fostered improvement in staff development, personnel training, and standards of patient care.
- Established and continuously optimized unit schedules and individual work assignments.
- Promoted professional development opportunities to encourage nurses to pursue continuous training.
- Developed strategy to target nursing and patient satisfaction issues, improve response and patient care quality, and suggest actionable improvements to promote hospital-wide quality and safety initiatives.
- Streamlined nursing operations for increased efficiency by optimizing staff scheduling and resource allocation.
Education
Bachelor of Science - Nursing
Purdue Global Online
Lafayette, IN09.2025
Associate of Science - Registered Nurse
Ivy Tech
Sellersburg, In12.2010
Skills
- Critical Thinking
- Effective Communication
- Data Analysis
- Continuing Education
- Case Management
- Self-Motivated
- Performance Metrics
- Time Management
- Organizational Skills
- Insurance Knowledge
Timeline
Utilization Management Nurse
Humana
02.2018 - Current
Nurse Manager
Clark Memorial Hospital
01.2011 - 01.2018
Bachelor of Science - Nursing
Purdue Global Online
Associate of Science - Registered Nurse
Ivy Tech