1. DAWN MARIE RADY, RN., B.S.N.
580 Harborwood Lane ۰ Neenah, WI 54956 ۰ H - 920-969-0969 ۰ C- 920-740-8090
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Work Objective:
To use my skills, achievements, strategic thinking, and leadership abilities to lead a large patient
centered service group in a direction that provides high quality care to the members of the
community.
Summary of Skills:
A highly creative, goal oriented professional with demonstrated experience in supervisory and
management, training and development, and care management. Clinical pediatric, obstetric,
gynecological, and women’s’ health experience. Highly organized with the ability to manage
multiple projects and meet deadlines. Proven success in Lean projects. A strong work ethic
combined with a commitment to excellence in all projects undertaken. A team player, working
effectively with other departments and senior leadership in accomplishing objectives.
Exemplary communication and presentation skills. Computer literate. Mentor to developing
leaders.
Licensure:
Bachelors of Science, Nursing. License Number 78784-30, State of Wisconsin
Multi-State, Expiration Date: 2/28/2018
Education:
Marian College, Fond du Lac, WI 09/76 – 05/80
Bachelor of Science Degree – Nursing
Certifications and Additional Training:
➢ Fetal Monitoring Certification (no longer current)
➢ LEAN Training
➢ Quality Improvement Training
➢ Leadership Training
Relevant Experience:
Ministry Holdings Incorporated (MHI)/Network Health 09/98 – 11/16
Network Health
Quality Improvement Manager 07/12 – 11/16
➢ Leads and directs staff in process improvement activities that provide more efficient and
streamlined programs to ensure that services are implemented, coordinated, and
maintained at the highest standards for members.
➢ Oversees NCQA program. Activities for improvement include:
o Development of a position (Accreditation Coordinator) specifically responsible
for NCQA standard review to streamline the accreditation process.
o Identified nearly 500 individual business gaps – all of which were addressed with
the standard owners to improve the overall Accreditation score.
o Implemented an ongoing audit program to ensure continued standard compliance
and process improvements.
o Successfully completed NCQA survey for Commercial HMO/POS, Medicare
PPO, and Exchange products with an Excellent Status.
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o Built a QI team of 5 QI Coordinators, 3 were hired within the first 3 months of my
entering the department.
o Developed a high-functioning team that has effectively increased the STAR
measures from 3 to 4-5 STARs.
o Improved the Quality of Care Concern process, decreasing working time per case
by 75%.
o Sits on various planning and decision-making committees including:
▪ Quality Management Committee
▪ Operations Management Committee
▪ Medical Policy Committee
▪ Medicare Business Operations Committee
▪ STARs Committee
▪ Medicare Compliance Committee
▪ South-East Expansion Scalability Team
▪ Froedert Implementation Team
▪ Integrated Medical Management Work Team
Quality Improvement/Population Health Interim Director 07/14 – 12/15
➢ Establishes, maintains and coordinates the development of the plan-wide Quality
Improvement program to evaluate the quality and efficiency of services provided
➢ Ensures QI compliance with NCQA, HEDIS and CMS standards
➢ Works collaboratively with contracted providers and NHP/NHIC committees to develop
criteria, service and quality indicators, tracking mechanisms, reports, standards of care
that facilitate QI initiatives, and outcomes
➢ Maintains ongoing communication with NHP provider groups for the purpose of
integrating, coordinating and monitoring the effectiveness of QI and DM activities
➢ Performs QI studies. Identifies needs, analyzes data, and provides feedback in an
appropriate format. May assist with implementation of quality initiatives. Monitors
outcomes and quality of services provided.
➢ Collaborates with NHP/NHIC departments to complete various QI and DM initiatives as
required for NCQA, CMS and other regulatory bodies. Oversees the NCQA readiness
process and preparation team, and continually monitors standard updates to ensure
compliance.
➢ Collaborates with Health Management, Contracting, Marketing, and Risk Management
teams in the development of communication to practitioners and members, and the
coordination of those communications
➢ Prepares, monitors and controls the capital, supplies and personnel budget for the areas of
responsibility
➢ Represents and/or participates on NHP/NHIC committees including QMC, BOC, OMC,
and BOD.
➢ Reviews and manages contracts for HEDIS, CAHPS, and HOS vendors as well as
NCQA.
➢ Oversees development of disease specific programs
➢ Directly supervises the DM manager and collaborates with QI leadership related to
hiring, recommending salary increases, disciplining, and terminating. Consults with the
Chief Medical Officer, Vice President of Health Management and Human Resources
relative to hiring, salary determination, discipline, and termination of individual staff.
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➢ Leads and directs staff
o Restructured QI department with development of Accreditation team, developed
and hired Accreditation supervisor, HEDIS Coordinator, Accreditation
Coordinator, and QI Analyst
o Added positions related to reconsiderations and quality of care concerns
o Developed and implemented streamlined processes and redeveloped quality work
plan for the organization
Care Management Manager (Case Management & Utilization Management) 10/05 – 07/12
➢ Managed and provided development for the CM staff. Provided program and project
coordination and integrate resources for case and utilization management for all
Commercial lines of business. Developed and implemented 5 new case management
programs including hiring and development of staff.
o Developed process improvements with utilization management and case
management.
o Transitioned inpatient team back to NHP and redeveloped inpatient utilization
programs.
o Successfully led Oncology Case Management Hoshin to completion ahead of
schedule.
▪ Realized a referral rate to Hospice at 37.5%, and Palliative Care referral
rate of 75%, Increased time between member hospice referral to death
rate, average length of time 34.6 days (National Average 26 days).
Instituted contract with external Oncology service to assist with case
reviews to achieve cost savings, saved $240,000 in 2 cases. Decreased ER
visits through managing side effects from chemo treatment.
o Project Leader on High Cost Pharmaceutical Hoshin.
▪ Developed and implemented process for self-injectable medications
(removing the service from outpatient facilities) to provide cost savings to
the Health Plan. Developed and implemented process for Home Infusion
therapy to members. Satisfier to members as well as cost savings to the
Health Plan.
o Successfully led Design Hoshin and move of Health Management Team to new
location. Completed Hoshin on schedule and under budget.
o Successfully completed 5 S project.
o Participated in Hoshin planning at NHP over past 2 years.
➢ Developed, coordinated and delegated processes to meet NCQA requirements.
o Successfully completed NCQA survey for Complex Case Management (new
standard) as well as Utilization Management.
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Breast Centers at Appleton and Oshkosh (MHI)
Manager of Breast Centers 02/04 – 10/05
➢ Responsible for combining clinical practice, education, community outreach and
administration to serve the needs of Affinity Health System’s Breast Centers. Duties
included providing system-wide responsibility for the leadership, direction, coordination
and administration of operations to ensure compliance with established objectives of
providing quality service in a cost-effective manner. Worked closely with the staff,
radiologists and surgeons that serviced the Breast centers to ensure continuity of care and
compliance with regulatory and accrediting agencies. Provided clinical breast exams as
needed.
o Successfully completed MQSA survey at both sites 2 years running.
o Improved film quality at Appleton Breast Center
o Improved patient access and scheduling
o Instituted a 2-day diagnosis-to-biopsy program for patients (the only Breast center
in the region to do so)
o Effectively built a successful team by fostering the values and behaviors of
Affinity.
o Began transition to Digital Mammography
o Organized and hosted "Evening for Women" event to promote breast cancer
awareness
Network Health
Manager of Training and Development 09/02 – 02/04
➢ Responsible for day-to-day operations of the Training and Development department.
Duties include Managing the Training and Development staff in the development of
plans, programs and procedures to meet specific training, leadership and staff
development needs for NHP departments and employees. Lead departments in their
efforts to standardize processes, and training methodologies for the purpose of
developing department operational guidelines. Develop and monitor Training and
Development department budget, develop department work plan and timeline, and
maintain department/plan wide policies.
o Served on AHS HIPAA Privacy Team. Organized and co-led HIPAA Privacy
Team at NHP. Instrumental in development and implementation of HIPAA
Privacy Standards for NHP. Developed training and achieved compliance of the
HIPAA standards.
o Served as an integral member of the management team at NHP
o Organized a team of trainers who are able to function with little direction
o Served on the IS Steering Committee and new system selection team.
o Served as leader of Team Facilitator for the System Implementation Team,
included training of team leaders and facilitators for process improvement,
meeting management, idea generation tools, planning and implementation.
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Health Management Trainer 11/00 – 09/02
➢ Responsible for development and administration of Plan Wide skill based training
programs. Identify Plan Wide training needs, develop curriculum and assure the
effectiveness of the training, methods and materials. Serve as a liaison between
departments in support of a structured process that continuously evaluates monitors and
shares information/procedural guidelines among departments. Develop and maintain new
employee training. Participate on department product implementation and process
improvement teams. Develop and implement training/job aids for new or existing
operational guidelines.
o Developed Desk Procedure manuals for Care Managers, Referral techs, Provider
Relations representatives, Credentialing Assistant, Health Management
Technicians
o Developed and implemented a training program for new care managers and
referral techs
o Developed and implemented resource manuals for several different software
programs
o Implemented medical terminology course
o Developed and presented soft skill programs such as Communication Workshops,
Working Effectively with People Workshop, FISH, Meeting Dynamics
Mercy Medical Center (MHI)
Manager of Women and Families 10/99 – 11/00
➢ Responsible for facilitating and evaluating staffing needs and prepare monthly schedule.
Assist with development of policies and procedures for the OB, Pediatrics and Women’s
services department to comply with JCAHO Standards. Provided 24 hour a day
responsibility for coordinating, directing, and evaluating the overall operations of a
BirthPlace, Pediatrics and Women’s Surgical Services and facilitating the provision of
quality patient/family care. Responsible for completion of department quality assurance
development, compliance, accountability, and documentation.
o Coordinated and assisted with construction, development and moving to a new
unit in a new hospital
o Facilitated the merging of two departments into one.
St. Elizabeth Hospital (MHI)
Nurse Clinician 09/98 – 10/99
➢ Responsible for providing clinical expertise as a professional practitioner and consultant.
Accountable for establishing and monitoring quality of care for BirthPlace department.
Provided advanced management of nursing care, consultation and educational services.
Acted as mentor to staff in new areas of development. Identified educational needs of
patients and staff. Developed and presented educational programs and conferences.
Coordinated staff orientation and participated in development of competency based
orientation program. Maintained staff competencies. Participated in QA/QI program
monitoring and evaluation studies. Development and implementation of standards and
policies and procedures.
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o Development and implementation of orientation program for nursing and support
staff for BirthPlace
o Coordinated and assisted with implementation of educational programs for
physicians, RNs, LPNs, and scrub techs
o Served as chair of Education Committee
o Served as chair of Practice Standards Committee
o Member of Women and Families Team
o Standardized policies and procedures across Women and Families.
St. Agnes Hospital, Fond du Lac, WI 11/81 – 09/98
Assistant Director of Perinatal Services 09/95 – 09/98
➢ Facilitating and evaluating staffing needs. Develop policies and procedures. Plan and
participate in department education. Assist in planning and conducting monthly
department meetings. Served as chair of a variety of committees within the department
as well as physician committees. Promoted continuous quality through the QI process
o Active in design and planning for a new OB unit including the budget of this unit
o Solicited the Foundation Committee to support the OB unit as their project for
fundraising.
o Worked as representative for the unit and helped raise through the Foundation
$700,000.
o Worked with the Love Light Committee to raise $22,000 for a new infant security
system for the unit
o Instrumental in marketing research pertinent to the institution and their
competitors through data analysis, written reports and formal presentations
o Trained in TQM/CQI as Leader and Facilitator. Successfully developed and
facilitated Diabetes QI team.
Instructor, Educational Services 08/91 – 09/95
➢ Responsible for organizing, implanting and evaluating specific in-service programs for
the Nursing Division and assisted in the development of philosophy, objectives, policies
and procedures of the Educational Services Department. Maintained records of quality
assurance for departmental activities. Conducted orientation program for new and
returning nursing personnel. Taught CPR certification and recertification programs as
well as other portions of Annual Skills Day. Composed articles for bi-monthly
newsletter.
o Developed and coordinated a Pain Management Course, Competency Program,
Nursing in the Nineties and a Diabetic Competency Program
o Served as a member of: Nurse Practice Committee, Skin Care Committee, Policy
and Procedure Committee and chaired the Patient Education Committee
Awards/Recognition:
➢ Identified as one of the top leaders at Affinity through the new Succession Planning
Program
➢ Nominated for President’s Award for the Value of Service
➢ Recognized as top performer each year since 2005