This document provides a summary of Dean Hamby's professional experience and qualifications. He has over 16 years of nursing experience in various clinical settings including emergency rooms, critical care, flight nursing, HIV/AIDS research, and case management. His most recent roles involved utilization review, case management for commercial insurance plans, and coordinating care as an RN case manager for low-income patients. He has extensive training in guidelines and software systems, and experience working with diverse patient populations.

1. Dean Hamby RN BSN PHN 619.840.2730
San Diego, California deanhamby@hotmail.com
Professional Profile
Registered Nurse with 16 years of diverse nursing experience. Areas of experience
include ER, Critical Care, Flight Nursing, Critical Care Transport, HIV/AIDS Research,
Occupational Health and Immunization. Recent experience in Case Management,
Utilization Review and the Affordable Care Act
 Extensive training and use of
Milliman Care Guidelines
 Worked with Epic computerized
patient data documentation system
 Experienced in use of Excel
spreadsheet and Word
 Extensive knowledge of NCQI
 Preparing for CCM certification
 Excellent customer service skills
 Ability to communicate clearly and
concisely
 Ability to remain flexible and handle
multiple tasks
 Experienced in providing care to
homeless clients
 Experienced in working with the LGBT
and Latino community
 Working knowledge of Medi-Cal,
Ryan White, ADAP and Oregon
Health Plan
 Experienced in telephonic care and
providing home visits in a competent
manner
ProfessionalExperience
Moda Healthcare / Portland, Oregon
11/2014 – 03/2015
RN CASE MANAGER / Commercial Insurance
Responsibilites:
• Coordinated care by managing inpatient concurrent review and outpatient
pre-authorizations utilizing Milliman Care Guidelines
• Worked with multiple commercial insurance plans to ensure appropriate
utilization of benefits
• Worked closely with medical director in managing authorizations
and denials
• Responsible for making outgoing calls to members and providers to
assist in care coordination of outpatient procedures
• Provided inpatient concurrent review utilizing Milliman Care
Guidelines
• Provided pre-auths for DME, home health and SNF/LTACH admits

2. Dean Hamby RN BSN PHN
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United Healthcare / San Diego, California
08/2011 – 01/2013
RN CASE MANAGER / Low Income Health Program
Responsibilities:
 Daily telephonic follow up with clients after discharge from the ER and
ensure clients had appropriate follow up primary care physician
 Reported abnormal findings to clients primary care physician, ensured
clients had appropriate medical equipment and supplies and provided
vigilance over clients throughout the entire outpatient continuum
 Visited clients in their home with social worker for assessment of health
needs and worked to prevent bad healthcare outcomes
 Provided comprehensive education to clients regarding their disease
process and ensured clients had an understanding of their medications
 Worked with numerous complex software programs to document client
data
Pacific Ambulance / San Diego, California
09/2009 – 09/2010
Critical Care Transport Nurse
Responsibilities:
 Maintained IV infusions and ventilator during intra-facility patient
transport
 Provided advanced cardiac life support and cardiac monitoring
University of California San Diego / HIV Neurobehavioral Research Center
02/2004 – 08/2008
HIV Research Nurse III
Responsibilities:
 Performed comprehensive neurological exams and lumbar punctures
Followed participants after lumbar puncture to assess for post-lumbar
puncture complications and reported to neurologist
 Provided HIV/AIDS and STD education to study participants
 Reported abnormal lab values to primary HIV physician
 Recorded all exam findings in computerized documentation system
 Gave frequent power point presentations on various aspects of
HIV/AIDS to physicians, nurses, and public
Schaeffer Air Ambulance / Los Angeles, California 01/2000 – 01/2004
Flight Nurse
Responsibilities:
• Worked as flight nurse responsible for critical care while in flight
Cedars-Sinai Medical Center / Los Angeles, California 08/1997 – 12/1999
Emergency Room Nurse II
Responsibilities:
• Responsible for emergency care of neonates, children, and adults
• Areas include triage, trauma, urgent care, and MICN

3. Dean Hamby RN BSN PHN
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Education
Dominican University / San Rafael, California
Bachelor of Science in Nursing
May 1997
Licenses
Registered Nurse CA # 532086
Public Health Nurse CA
Registered Nurse Oregon
Certifications
Cardiopulmonary resuscitation certified