Ohio Health Columbus , OH 43216
This position assists in development, implementation, and revision of the utilization management program. Monitors adherence to the hospitals 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 hospitals 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 OhioHealth 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 Education, Certification, Registration, LicenseBachelor's of NursingBLS - Basic Life SupportCPI - Crisis Prevention InterventionField of Study: NursingField of Study: Graduate from an accredited Bachelors of Nursing Program or 15 yrs of nursing
Years of Experience: 3SPECIALIZED KNOWLEDGE 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 30 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 15 yrs of nursing experience at Ohiohealth.
Additional Job Information
Equal Employment Opportunity
OhioHealth is an equal opportunity employer and fully supports and maintainscompliance with all state, federal, and local regulations. OhioHealth does not discriminateagainst associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age,ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or othercharacteristics protected by law. Equal employment opportunity is extended to all persons in allaspects of the associate-employer relationship including recruitment, hiring, training, promotion,transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and anyother term or condition of employment.