Case Management Nurse
Western and Southern Financial Group is in search of an experienced Registered Nurse to join the team in Cincinnati, Ohio!
To be considered for an interview, please make sure your application is full in line with the job specs as found below.
Position:
Manage Care RN (Case Management)
Location:
400 Broadway, Cincinnati, Ohio 45202
Shift:
8am “ 5pm
Pay:
Starting at $83,000 and increases with experience
Job Description:
- clinical experience and appropriate clinical criteria and guidelines, along with Plan provisions, in monitoring, evaluating, and coordinating both inpatient and outpatient medical care to promote quality outcomes at reasonable costs.
- prospective and concurrent utilization reviews to determine medical necessity for inpatient admission, inpatient continued stay and selected outpatient services to ensure medically appropriate, high quality and cost-effective care and for most efficient utilization of third-party services.
- members (associates, retirees, and dependents) in navigating the healthcare landscape and optimizing benefit plan utilization by identifying opportunities to promote quality healthcare.
- potential high-cost claims for early intervention with case management and retrospective reviews to assure appropriate and cost effectiveness.
Please submit your resume for immediate consideration!
#DP
Estimated Salary: $20 to $28 per hour based on qualifications.
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