IRA LOGAN
Summary
Successful 30 years' experience as a nursing professional, providing safe and effective healthcare for patients, using patient-centered and innovative healthcare strategies to improve patient care and administrative processes.
Healthcare professional prepared for role with strong background in managing prior authorizations and fostering positive relationships with healthcare providers and insurance companies. Known for collaborative approach and consistently achieving results despite changing needs. Proficient in medical coding, insurance guidelines, and effective communication.
Experienced with navigating healthcare insurance systems to secure treatment approvals. Utilizes keen attention to detail and extensive knowledge of medical coding to streamline processes. Strong understanding of insurance guidelines and patient advocacy to ensure optimal outcomes.
Overview
29
29
years of professional experience
1
1
Certification
Work History
Oncology Medication Prior Authorization
UAMS Hospital
09.2024 - Current
- Communicated authorization requirements for smooth collaboration with medical staff and insurance representatives.
- Conducted follow-up calls to ensure timely processing of authorization requests, minimizing delays in patient care.
- Addressed concerns regarding authorization denials with thorough investigations and clear communication with stakeholders.
- Prepared comprehensive reports on authorization trends to assist in identifying areas for improvement.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Maintained accurate records of authorization requests by organizing documentation and tracking status updates.
- Reached out to insurance carriers to obtain prior authorization for testing and procedures.
- Analyzed medical records and other documents to determine approval of requests for authorization.
- Verified eligibility and compliance with authorization requirements for service providers.
Charge Nurse/Clinic Nurse
Youth Home, Inc.
07.2007 - Current
- Assess patients and develop high-quality nursing care plans for long-term care patient, while maintaining updates in the medical charting system
- Knowledgeable of medical terminology and disease control standards
- Supervise, train and mentor new clinical staff nurses on EMR to ensure they have 100% adherence to provide adequate and safe patient care
- Provide patient progress updates and feedback to nurses to provide supportive patient care using learned professional skills
- Prior Authorizations for Behavioral Health Services Clinics
Nurse Care Advocate/Case Manager
HealthScope, UMR
07.2017 - 01.2022
- Use clinical knowledge, review various reports, include risk assessment reports, and And coverage gaps
- Conduct assessments to offer clinical advice in the development of individual plans for complex care and transplant patients
- Provide clinical knowledge for clients benefit to refer to Centers of Excellence
- Support specific chronic condition care related initiatives to improve outcomes
- Serve as stakeholder liaison between COE facilities and Care Managers
Nurse Manager
Centers for Youth and Families
08.1998 - 07.2014
- Executed healthcare checks for clients, including ambulation, daily personal care, medicine administration for residential programs
- Supervised, trained and mentored new clinical nursing staff and mental health technicians to ensure they have 100% adherence for adequate and safe patient care
- Provided both in-person and phone support for emergency nursing care for patients
- Lead, developed and coordinated daily clinical care as a daily nurse for Day Treatment Systems
- Coordinated and managed the medication clinic, training nursing staff to ensure 100% compliance with regulatory and quality program requirements
- Served as social worker (case coordinator) liaison for Centers with LRSD
Public Health Nurse
Arkansas Department of Health
12.1996 - 03.1999
- Initiated and terminated outpatient care for tuberculosis patients
- Manage and maintain patient medical records, including accurate data management
- Maintained excellent patient care through nursing process and provided ongoing evaluations of ambulatory clinical goals & created action plans to meet patient needs
Weekend Coordinator
University of Arkansas for Medical Sciences
07.1996 - 12.1996
- Developed and maintained digital medical chart for each client from admission to discharge and ensured 100% HIPAA compliance
- Maintained and assessed care plans and gave feedback for nursing staff
- Provided physician and patient support on rounds
Education
Master of Science - Social Work
University of Arkansas at Little Rock
Little Rock, ARBachelor of Science - Nursing
University of Arkansas for Medical Sciences
Little Rock, ARAssociates - Nursing
Phillips County Community College
Helena, ARSkills
- Medical Care Management
- Patient Counseling
- Treatment Identification
- Patient Record Maintenance
- Administration Management
- Strategic Process Developer
- Organizational Process Management
- Compliance Coordinator
- Cohesive & Effective Communicator
- Training & Development
- Community Educator
- Crisis Resolution
- Prior Authorizations
- Psychosocial Assessment
- Program Evaluations & Enhancement
- Project Management
- Persuasive & Effective Leader
- Prior authorization process
- Insurance procedures
- Records maintenance
- Patient confidentiality compliance
- Pharmacy benefit management
- Provider relations
- Utilization review experience
- Prescription coordination
- Critical thinking
- CPT coding
- Eligibility determination
- Referral coordination
- Problem-solving
- Documentation and paperwork
Certification
- State Certification, R045188
- Master Social Work License, 1415-M
- Basic Life Support Certification
- Advanced Cardiovascular Life Support Certification
- Adult & Child First Aid/CPR/AED Certified American Red Cross
Training
- Crisis Prevention Intervention, 01/01/24
- Best Practices In Trauma Specific Treatment, 01/01/24
- Best Practices Behavior Support & Intervention, 01/01/24
- Community-Based Suicide Prevention, 01/01/23
- Cultural Competence & HIPAA, 01/01/24
- Opioid Treatment & Prevention, 01/01/19
- Substance Abuse Prevention Effort, 01/01/19
- Social Media & Substances, 01/01/19
- Peer Support In Recovery Oriented Systems of Care, 01/01/19
- Internet Addiction, 01/01/19
- NARCAN Training, 01/01/19
- Ethical Issues for Counselors, 01/01/24
- Understanding the Family Inside Addiction, 01/01/19
- Addressing Trauma Beneath Addiction, 01/01/19
- Strategies for Engaging Clients in Substance Abuse & Mental Health, 01/01/21
Timeline
Oncology Medication Prior Authorization
UAMS Hospital
09.2024 - Current
Nurse Care Advocate/Case Manager
HealthScope, UMR
07.2017 - 01.2022
Charge Nurse/Clinic Nurse
Youth Home, Inc.
07.2007 - Current
Nurse Manager
Centers for Youth and Families
08.1998 - 07.2014
Public Health Nurse
Arkansas Department of Health
12.1996 - 03.1999
Weekend Coordinator
University of Arkansas for Medical Sciences
07.1996 - 12.1996
Bachelor of Science - Nursing
University of Arkansas for Medical Sciences
Associates - Nursing
Phillips County Community College
Master of Science - Social Work
University of Arkansas at Little Rock
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