Utilization Case Manager, RN

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🔥 3 hours ago

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The Ohio State University, Main Campus

WebsiteLinkedInAll Job Openings

1 - 10 employees

Founded 1870

📚 Education

Education

The Ohio State University, Main Campus is a public research university located in Columbus, Ohio. It offers a comprehensive education with a wide array of undergraduate, graduate, and professional programs. The university is engaged in numerous research initiatives and partnerships, providing opportunities for students, faculty, and industry partners to collaborate. Ohio State promotes a vibrant student life with various academic, recreational, and wellness services to support student needs. It also emphasizes community involvement and leadership development, fostering an inclusive environment on its multiple campuses across Ohio.

📋 Description

• Implements and supports the philosophy, mission, values, standards, policies and procedures of The Ohio State University Wexner Medical Center. • Contributes to the hospitals Utilization Management Program Plan by using medical necessity guidelines to determine appropriateness for inpatient level of care or observation services based on documented clinical information in compliance with CMS guidelines and other payer requirements regarding appropriate level of care. • Maintains an awareness of State and National health care trends, JCAHO, CMS and third party payor Utilization Management guidelines.

🎯 Requirements

• Bachelor’s degree, Masters preferred. • RN licensure required. • Three years of Case Management and/or Utilization Management experience required.

🏖️ Benefits

• Medical, dental and vision coverage, with Ohio State paying a significant portion of the cost. • Paid time off, including sick and vacation time and 11 holidays. • State retirement plan or an alternative retirement plan, both with generous employer contributions.