Nurse Case Manager

3 days ago


Columbus, Ohio, United States Mount Carmel Health System Full time
About the Role

As a Utilization Review Nurse at Mount Carmel Health System, you will play a critical role in ensuring that authorization requests and provider or member inquiries are handled appropriately within established timeframes. Your clinical expertise and strong communication skills will enable you to make informed decisions regarding medical appropriateness and effective utilization of healthcare resources.

Key Responsibilities
  • Perform timely clinical reviews and notify providers and members as necessary.
  • Collaborate with provider partners on Utilization Review processes.
  • Provide exceptional customer service to providers and members.
  • Work with management to promote improvements in work processes within the department and organization.
  • Stay up-to-date with professional development and maintain licensure.
Requirements

To be successful in this role, you should have:

  • A graduate degree in nursing.
  • A baccalaureate degree in nursing is preferred.
  • A current license to practice as a registered nurse in the State of Ohio.
  • Minimum 3-5 years of nursing experience and knowledge of the utilization review process.
What We Offer

At Mount Carmel Health System, we value our colleagues and offer a range of benefits, including:

  • Competitive compensation and benefits packages.
  • Retirement savings account with employer match.
  • Generous paid time off programs.
  • Tuition/professional development reimbursement.
  • Relocation assistance (geographic restrictions apply).
Columbus, Ohio

Columbus, Ohio, is a vibrant city with a blend of professional sports, world-class attractions, creative cuisines, and a thriving music and arts scene. As a resident of Columbus, you will enjoy a high quality of life and numerous opportunities for growth and development.

Mount Carmel Health System

We are a not-for-profit Catholic health system dedicated to providing excellent patient care and supporting the well-being of our colleagues. Our commitment to diversity, equity, and inclusion ensures that everyone has access to quality care and opportunities for growth and development.



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