Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Heather Dahmen

Senecaville

Summary

Compassionate and detail-oriented Registered Nurse with over 16 years of clinical experience, including a strong background in Labor and Delivery and current expertise in Utilization Management. Adept at conducting comprehensive medical necessity reviews, applying MCG guidelines, and collaborating with multidisciplinary teams to ensure quality, cost-effective care. Skilled in clinical documentation review and regulatory compliance. Brings a patient-centered mindset from the bedside care into the managed care environment, with a strong commitment to evidence-based decision making and healthcare quality improvement.

Overview

16
16
years of professional experience
1
1
Certification

Work History

UM Clinical Consultant, Aetna Better Health

ABH Virginia
01.2022 - Current

- Conduct comprehensive clinical reviews of medical records to determine medical necessity, appropriateness, and efficiency of healthcare services based on established guidelines and evidence based criteria (e.g. MCG).

-Collaborate with physicians, healthcare providers, and interdisciplinary teams to ensure high-quality while managing healthcare costs.

-Utilize clinical expertise to evaluate inpatient services and concurrent review cases.

-Maintain up-to-date knowledge of health plan policies, regulatory compliance standards and clinical best practices to ensure accurate decision making.


UM Clinical Consultant

Aetna Better Health- ABH PA
08.2021 - 01.2022
  • Collected and analyzed key data to make accurate assessments.
  • Evaluated medical guidelines and benefit coverage to determine appropriateness of services.
  • Evaluated patient histories, complaints and current symptoms.

Registered Nurse

Genesis Healthcare System
01.2021 - 08.2021
  • Provide comprehensive, patient-centered care to mothers and newborns throughout all stages of labor, delivery, and immediate postpartum recovery.
  • Monitor fetal heart tones, maternal vital signs, and labor progression, utilizing electronic fetal monitoring and clinical assessment to ensure safety and well-being.
  • Assist physicians during vaginal deliveries, cesarean sections, and emergency obstetric procedures.
  • Maintain accurate and timely documentation in electronic medical records (EMR) to ensure quality and continuity of care.

Registered Nurse, Childbirth Center

Southeastern Ohio Regional Medical Center
06.2011 - 01.2021
  • Was also employed as a PRN staff member August 2021- May 2022
  • Collaborated with physicians to quickly assess patients and deliver appropriate treatment while managing rapidly changing conditions.
  • Became and maintained competency in labor and delivery, postpartum and nursery care.
  • Multitasked on a daily basis by triaging new patients during regular patient assignments.
  • Monitored patient condition, including interpreting and tracking fetal monitor readings, identifying irregular fetal monitor readings and updating team members and physicians on changes in stability or acuity with both the patient and fetus.

Registered Nurse, Med-Surg, Mother-Baby, Nursery

Licking Memorial Hospital
12.2008 - 05.2011
  • Chronic patient care in a medical-surgical unit. Adeptly handling all aspects of treatment from medication, wound care, and ekg monitoring. I have six months of medical-surgical experience before transferring to a postpartum/special care nursery position.
  • Equipped patients with tools and knowledge needed for speedy and sustained recovery.
  • Provided care to new mothers and their newborns immediately following delivery.
  • Became competent in taking care of premature infants in the special care nursery.

Education

Associate of Science - Nursing

Ohio University
Zanesville, OH
10.2008

Bachelor of Science - BSN

Ohio University
Zanesville, Ohio
04.2016

Skills

  • Utilization Review & Management
  • Medical Necessity Determinations
  • MCG Criteria Proficiency
  • Clinical Documentation Review
  • Regulatory compliance (eg NCQA)
  • Electronic Medical Record (EMR) Systems
  • Multidisciplinary Team Collaboration
  • Strong clinical Judgement and Critical Thinking
  • Communication and interpersonal skills
  • HIPAA and Confidentiality Compliance

Certification

  • Licensed Registered Nurse
  • RN certification in Electronic Fetal Monitoring

Timeline

UM Clinical Consultant, Aetna Better Health

ABH Virginia
01.2022 - Current

UM Clinical Consultant

Aetna Better Health- ABH PA
08.2021 - 01.2022

Registered Nurse

Genesis Healthcare System
01.2021 - 08.2021

Registered Nurse, Childbirth Center

Southeastern Ohio Regional Medical Center
06.2011 - 01.2021

Registered Nurse, Med-Surg, Mother-Baby, Nursery

Licking Memorial Hospital
12.2008 - 05.2011

Associate of Science - Nursing

Ohio University

Bachelor of Science - BSN

Ohio University