Clinical Financial Case Manager

1 week ago


Columbus, Ohio, United States InsideHigherEd Full time
Job Title: Clinical Financial Case Manager

We are seeking a highly skilled Clinical Financial Case Manager to join our team. As a Clinical Financial Case Manager, you will be responsible for managing the complex process of coordinating insurance verification and prior authorization of outpatient medications.

Key Responsibilities:
  • Utilize clinical knowledge to identify trends and areas for needed clinical education to decrease denials.
  • Provide evidence to support cutting-edge therapies and provide clinical education to payers regarding current standard of care treatment.
  • Submit test claims proactively to support clinicians in efforts to identify areas where risk of denial is high to mitigate that risk.
  • Understand and verify benefits and obtain prior authorization for outpatient medications.
  • Communicate with patients/families to ascertain additional demographic, financial, and insurance information essential to the authorization processes.
  • Evaluate and solve complex customer problems and communicate with the clinical team.
Requirements:
  • Bachelor's Degree in Nursing, Pharmaceutical Sciences, or a similar clinical healthcare field.
  • At least 1 year of clinical experience, preferably in the field of oncology and/or pharmacy.
  • Experience in physician practice and/or utilization review is a plus.
  • Knowledge of Medicare and commercial insurance reimbursement is desired.
  • Strong knowledge of medical and pharmaceutical terminology is highly desired.
  • Proficient in the use of computer-based research and medical record documentation.
What We Offer:
  • A dynamic and supportive work environment.
  • Opportunities for professional growth and development.
  • A competitive salary and benefits package.

We are an equal opportunity employer and welcome applications from diverse candidates. If you are a motivated and detail-oriented individual with a passion for clinical finance, we encourage you to apply for this exciting opportunity.



  • Columbus, Ohio, United States InsideHigherEd Full time

    Job Title:Clinical Financial Case ManagerDepartment:James | Pharmacy Medication AccessScope of Position:The Clinical Financial Case Manager plays a critical role in ensuring the financial integrity of our clinical operations. This position is responsible for establishing and implementing financial controls, executing financial operations, and preparing and...


  • Columbus, Ohio, United States InsideHigherEd Full time

    Job Title:Clinical Financial Case ManagerDepartment:James | Pharmacy Medication AccessScope of Position:The Clinical Financial Case Manager will be responsible for establishing financial controls and policies, ensuring their implementation and effectiveness, executing financial operations, preparing and interpreting financial and operational reports, and...


  • Columbus, Ohio, United States Ohio State University Wexner Medical Center Full time

    Job SummaryThis position utilizes clinical knowledge to manage the complex process of coordinating insurance verification and prior authorization of outpatient medications. The successful candidate will provide evidence to support cutting-edge therapies, provide clinical education to payers regarding current standard of care treatment, and identify trends...


  • Columbus, Ohio, United States The Ohio State University Full time

    Job Title: IRP-Clinical Case Manager (RN)Department: University Hospital | Social Work and Case Management AdministrationScope of Position/Position Summary:The Clinical Case Manager plays a vital role in facilitating the healthcare journey of patients, ensuring efficient and effective care throughout the inpatient process. This involves collaborating with...


  • Columbus, Ohio, United States The Ohio State University Full time

    Job Title: IRP-Clinical Case ManagerThe Ohio State University is seeking a skilled Clinical Case Manager to join our team. As a Clinical Case Manager, you will be responsible for facilitating an assigned group of patients through the healthcare system, ensuring efficient and effective inpatient care and a safe transition to the outpatient setting.Key...


  • Columbus, Ohio, United States InsideHigherEd Full time

    Job Title: Clinical Case Manager - RNAt The Ohio State University, we are seeking a highly skilled Clinical Case Manager - RN to join our team. As a key member of our healthcare team, you will play a vital role in ensuring the efficient and effective delivery of patient care.Scope of Position:The Clinical Case Manager - RN will be responsible for...


  • Columbus, Ohio, United States InsideHigherEd Full time

    Job Title: IRP-Clinical Case ManagerAt The Ohio State University, we are seeking a skilled Clinical Case Manager to join our team. As a Clinical Case Manager, you will play a critical role in facilitating the care of patients through the healthcare system, ensuring efficient and effective inpatient care and a safe transition to the outpatient setting.Key...


  • Columbus, Ohio, United States InsideHigherEd Full time

    Clinical Case Manager Job SummaryWe are seeking a skilled Clinical Case Manager to join our team at The Ohio State University. As a Clinical Case Manager, you will play a critical role in facilitating the care of patients through the healthcare system, ensuring efficient and effective care and a safe transition to the outpatient setting.Key...


  • Columbus, Ohio, United States InsideHigherEd Full time

    Job Title: IRP-Clinical Case Manager (RN)Job Summary:The Clinical Case Manager RN is responsible for facilitating an assigned group of patients through the healthcare system, ensuring efficient and effective inpatient care and a safe transition to the outpatient setting. This role involves monitoring patient care processes, documenting and communicating data...


  • Columbus, Ohio, United States The Ohio State University Full time

    Job Title: IRP-Clinical Case ManagerAbout the Role:The Ohio State University is seeking a skilled Clinical Case Manager to join our team. As a Clinical Case Manager, you will play a critical role in facilitating the care of patients through the healthcare system, ensuring efficient and effective care, and a safe transition to the outpatient setting.Key...

  • Financial Manager

    2 weeks ago


    Columbus, Ohio, United States Creative Financial Staffing Full time

    Controller PositionCreative Financial Staffing is seeking a highly skilled Controller to join their team. The ideal candidate will have a strong background in accounting and finance, with experience in managing financial operations and leading a team.Key Responsibilities:Manage financial planning, budgeting, and forecastingOversee financial reporting and...

  • Financial Manager

    6 days ago


    Columbus, Ohio, United States Creative Financial Staffing Full time

    Controller PositionCreative Financial Staffing is seeking a highly skilled Controller to join their team. The ideal candidate will have a strong background in accounting and finance, with experience in managing financial operations and leading a team.Key Responsibilities:Manage financial planning, budgeting, and forecastingOversee financial reporting and...

  • Financial Manager

    2 weeks ago


    Columbus, Ohio, United States Creative Financial Staffing Full time

    Accounting ManagerAt Creative Financial Staffing, we are seeking an experienced Accounting Manager to join our team. As a key member of our financial team, you will be responsible for managing and recording new loans, refinances, and construction draws, as well as coordinating with lenders to provide financial statements and review debt service ratios.Key...

  • Financial Manager

    2 weeks ago


    Columbus, Ohio, United States Creative Financial Staffing Full time

    Accounting ManagerCreative Financial Staffing is seeking an experienced Accounting Manager to join our team in Columbus, OH. As a key member of our financial operations team, you will be responsible for managing and recording new loans, refinances, and construction draws, as well as coordinating with lenders to provide financial statements and review debt...

  • Financial Manager

    5 days ago


    Columbus, Ohio, United States Creative Financial Staffing Full time

    Accounting ManagerCreative Financial Staffing is seeking an experienced Accounting Manager to join our team in Columbus, OH. As a key member of our financial team, you will be responsible for managing and recording new loans, refinances, and construction draws, as well as coordinating with lenders to provide financial statements and review debt service...


  • Columbus, Ohio, United States TotalMed Case Management Staffing Full time

    Job Title: Travel Nurse RN Case ManagerTotalMed Case Management Staffing is seeking a skilled travel nurse RN case manager to join our team in Columbus, Ohio.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNEmployment Type: TravelShift: 8 hours, daysDuration: 13 weeksHours per week: 40We are looking for a dedicated and experienced case...

  • Financial Manager

    1 week ago


    Columbus, Ohio, United States Creative Financial Staffing Full time

    Accounting ManagerCreative Financial Staffing is seeking a highly skilled and experienced Accounting Manager to join their team in Columbus, OH. This is a fantastic opportunity for a dedicated and ambitious professional to take the next step in their career.Key Responsibilities:Team Management:Supervise and mentor a team of accounting professionals to ensure...

  • Financial Manager

    1 week ago


    Columbus, Ohio, United States Creative Financial Staffing Full time

    Controller PositionCreative Financial Staffing is seeking a highly skilled Controller to join their team. The ideal candidate will have a strong background in accounting and finance, with experience in managing financial operations, preparing financial statements, and analyzing financial data.Key Responsibilities:Billing and accounts payable/receivable...


  • Columbus, Ohio, United States TotalMed Case Management Staffing Full time

    Job Title: Travel Nurse RN Case ManagerTotalMed Case Management Staffing is seeking a skilled Travel Nurse RN Case Manager to join our team.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNDuration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelWe are looking for a dedicated Case Manager-Registered Nurse to work...


  • Columbus, Ohio, United States TotalMed Case Management Staffing Full time

    Job Title: Travel Nurse RN Case ManagerTotalMed Case Management Staffing is seeking a travel nurse RN Case Management for a travel nursing job in Columbus, Ohio.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNDuration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelWe are seeking a Case Manager-Registered Nurse for...