Ohio Licensed Utilization Care Manager - job 1 of 2

Job Summary

A company is looking for a Utilization Care Manager - RN.

Key Responsibilities

• Determine appropriateness for inpatient level of care or observation services using medical necessity guidelines
• Apply various payer rules, regulations, and MCG guidelines for Utilization Management
• Maintain awareness of State and National health care trends and compliance with Utilization Management guidelines

Required Qualifications

• Bachelor's degree in Nursing preferred, or in public health, allied health, or a clinically related field
• Two years of Care Management and/or Utilization Management experience required