Utilization Care Manager, RN
United States
Full Time
3 weeks ago
No Visa Sponsorship
About this role
Role Overview
- Contributes to the hospital's Utilization Management Program Plan by using medical necessity guidelines to determine appropriateness for inpatient level of care or observation services.
- Requires in-depth knowledge and ability to apply various payer rules, regulations and MCG guidelines.
- Maintains an awareness of State and National health care trends, TJC, CMS and third party payor Utilization Management guidelines.
Requirements
- Bachelor's degree in Nursing required with RN licensure.
- Two years of Care 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.