Giane Logan

Experience

• 

  Gottlieb Memorial Hospital

  May 1995 - Jan 1998

  Registered Nurse Ortho/Neuro

  Staff registered nurse on a medical surgical floor. Float responsibilities to oncology and Progressive Care Unit. Collaborated with Social Worker to ensure safe discharge.

• 

  Family First Healthcare

  Dec 1997 - Feb 1999

  Manager Medical Review

  Managed UM / CM RN and support coordinators. Developed policy and procedures for medical review for start up organization. Provided after hours triage to Medicaid enrollees. Prepared UM data and appeals for monthly Medical Directors meetings. Conducted monthly onsite visits with contracted physicians

• 

  UNIVERSITY OF CHICAGO PHYSICIANS GROUP

  Feb 1999 - Jun 2001

  Case Manager/UM Team Lead

  Collaborated with hospital case managers and discharge planners to assist with timely transition to a lower level of care. Coordinated services for individual members with complex discharge needs. Conducted onsite Physician office audits for HEDIS and STARS. Reviewed referral authorization request and redirected as appropriate

• 

  Adventist Hinsdale Hospital

  Jul 2001 - Nov 2010

  Supervised in house resource pool approximately 70 full time RN, Techs, and Unit Secretaries. Managed House Supervisors providing administrative assistance on off hours. Oversaw Bed Central staff and all patient placement concerns for 275 bed facility and contracted staff. Completed initial reviews using InterQual or MCG criteria for patients admitted from the ED. Supervised ER Registration staff. Coordinated return to Nursing Home or ALF when medically appropriate. Completed discharge screenings with patient families.

  • Manager Nursing Resource/House Supervisors

    May 2008 - Nov 2010

  • ER Case Manager /Patient Flow

    Jul 2001 - May 2008
• 

  Loyola University Medical Center

  Jan 2011 - Nov 2013

  RN Case Manager

  Conducted face-to-face assessments with patients and family to identify discharge needs. Liaised with faculty and assist with discharge planning to ensure appropriate level of care. Completed UM reviews resulting in 1 million in revenue for facility

• 

  Humana Inc.

  Nov 2013 - Jan 2020

  Sr. Care Manager

  Managed high volume of cases. Assessed patients for gaps in discharge plans or new medical needs. Referred appropriate cases to 3rd party programs such as Behavioral Health, Palliative Care and Home Health. Provided post discharge teaching ,resources, and community teaching resulting in lower readmission rates.

• 

  UT Health

  Apr 2020 - now

  Clinical Case Manager