Location: Columbus
in our communities. Job Description Summary: This position assists in development, implementation, and revision of the utilization management program. Monitors adherence to the hospital's utilization review plan to ensure effective and efficient use of hospital services and reviews the appropriateness of hospital admissions and extended hospitals stays.
Performs utilization review in accordance with all state and federal mandated regulations. Maintains compliancy with regulation changes affecting utilization management. Monitors adherence to the hospital's utilization review plan to ensure effective and efficient use of hospital services and reviews the appropriateness of hospital admissions
and extended hospitals stays. He/She works collaboratively with all interdisciplinary staff internal to Ohio Health and also external organizations to achieve timely, cost efficient and effective management of patient care.
Performs utilization review in accordance with all state and federal mandated regulations. Maintains compliancy with regulation changes affecting utilization management. Minimum Qualifications: Bachelor's Degree (Required)BLS - Basic Life Support - American Heart Association, CPI - Crisis Prevention Intervention - Crisis Prevention Intervention Graduate from an accredited Bachelor's of Nursing Program; current State of Ohio RN licensure. (If in the Behavioral Health
Department, must have Basic Life support (BLS) and Crisis Prevention Intervention (CPI) obtained with in the first 3 0 days of hire and must remain current.
) of discharge process, utilization management intensity of service, severity of illness criteria; Familiarity with computer technology, and ability to use database and spreadsheets; Excellent written/verbal communication and teaching/training skills; Demonstrated success in achieving or exceeding measurable performance criteria in a job setting. Three or more years of clinical Experience within hospital or payer setting. Case Management Certification within first year. BSN or 1 5 yrs of nursing Experience at Ohioh Health.
Work Shift: Day Scheduled Weekly Hours : 36 Department UM and Care Coordination Join us!. if your passion is to work in a caring environment. if you believe that learning is a life-long process. if you strive for excellence and want to be among the best in the healthcare industry Equal Employment Opportunity Ohio Health is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. Ohio Health does not discriminate against associates or applicants because of race, color, genetic information, religion, interaction, interactionual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law.
Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment For more details: jobs-search. org/advertising_columbus-c424845/rn-utilization-review-case-mgr-ii-days-riverside-columbus_i1964614694
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