Dawn M. Email and Phone Number
As a registered nurse complex case manager at Optum, I manage the care of Medicare patients with complex and chronic conditions. I have a CCM certification and over 14 years of experience in the healthcare industry. I am an expert in care management, utilization review, data abstraction, and health information. I use MS Office, MCG, NCQA, CMS, and HEDIS standards and guidelines to ensure quality and compliance.Besides my nursing career, I am also a successful entrepreneur and a community leader. I founded and own the first coffee shop and bakery in Wellsville, KS, where I employ and train local residents as baristas. I have a strong background in computer aided drafting and design, and I have a high level of computer and tech skills. I opened this business in 2018 to create a positive impact on my community and provide employment opportunities. I am proud to say that we survived COVID-19 and continue to serve our loyal customers with quality products and services. I am driven by my passion for community health, wellness, and social responsibility.
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Clinical Appeals RnUnitedhealthcare Aug 2024 - Present -
Small Business OwnerAurora Coffee Co Llc May 2018 - PresentWellsville, Kansas- Opened the first coffee shop and bakery in Wellsville, KS- Built a brick-and-mortar business from the ground up that would benefit the community- Employer of 4-9 employees, trained as Baristas- We survived COVID-19!
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Business OwnerSno Shack In The Back May 2018 - PresentWellsville, Kansas
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Registered Nurse Complex Case ManagerOptum Nov 2022 - Aug 2024Kansas City Metropolitan Area- Complex case management of Medicare population- Post-hospital management of patient's healthcare activities- Discover and connect patients with health resources -
Rn Clinical Case ManagerAmerican Health Holding Jun 2022 - Sep 2022Remote -
Rn Clinical Case ManagerAetna, A Cvs Health Company Oct 2019 - Dec 2020- Assessment of member's health risk, medical history, behavioral health history, medication history and care needs using motivational interviewing techniques- Appropriate referrals for services and special programs as deemed necessary- Extensive review of claims data to determine a complete medical history and treatment path- Consult with other team members to overcome barriers of care- Maintain contact with clients as directed by state Medicaid guidelines- Complete and maintain plans of care in accordance with Medicaid guidelines, HEDIS measures, NCQA standards and case management goals- Thorough documentation of all relevant information per state and company guidelines, in accordance with quality measures -
Rn Community Transitions Case ManagerUnitedhealth Group Oct 2012 - Oct 2019Overland Park, KansasWorking with KanCare and the HCBS program, I help people achieve their dream of leaving the nursing home and getting back into the community, enjoying greater independence and dignity while supporting their safety and well-being.- Assess Medicaid/KanCare clients for HCBS waiver services- Extensive knowledge of available waiver programs (FE, PD, TBI, IDD, etc)- Complete and maintain plans of care in accordance with Medicaid guidelines, HEDIS measures and NCQA standards- Client contact every 90 days (telephonic or in-person) and update for changes in condition- In between telephonic and home visits, assist clients as needed- Assist clients in crisis with available community services- Facilitate a safe transition of nursing home clients back into the community- Coordinate with multiple agencies to support client wellbeing- Training of new employees, mentoring, training document creation- Thorough documentation of all relevant information per state and company guidelines, in accordance with quality measures -
Resident Care DirectorVintage Park At Gardner Jun 2012 - Nov 2012Director of Nursing
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Registered NurseMeadowbrook Rehabilitation Hospital Sep 2011 - Jun 2012Registered Nurse / Charge Nurse - Post-Acute Rehab, SNF, LTC, TBI
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Registered NurseCorrect Care Solutions Sep 2007 - Sep 2011Correct Care Solutions / Johnson County Corrections & Juvenile Detention CenterRegistered Nurse / Charge Nurse
Dawn M. Education Details
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Registered Nursing/Registered Nurse -
Computer Aided Drafting And Design
Frequently Asked Questions about Dawn M.
What company does Dawn M. work for?
Dawn M. works for Unitedhealthcare
What is Dawn M.'s role at the current company?
Dawn M.'s current role is Clinical Appeals RN - Clinical Advancement - UHC Clinical Services.
What schools did Dawn M. attend?
Dawn M. attended Neosho County Community College, Universal Technical Institute Of Arizona Inc.
Who are Dawn M.'s colleagues?
Dawn M.'s colleagues are Eric Huska, Gabriela Isabel S., Hayleigh Hood, Luz Lopez, Doris Myles, Kiersten Vincent, Mph, Michele Naccarato.
Not the Dawn M. you were looking for?
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Dawn Brunn “Bliss,” M.Ed., CPC.
Minneapolis, Mn -
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