Clinical Financial Case Manager

3 days ago


Columbus, Ohio, United States Ohio State University Wexner Medical Center Full time
Job Title: Clinical Financial Case Management Specialist 2

Job Summary:

The Clinical Financial Case Management Specialist 2 will utilize clinical knowledge to manage complex ambulatory medical necessity denials through the appeals process. This role will provide scientific evidence to support cutting-edge therapies and diagnostic services, as well as clinical education to payers regarding current standard of care treatment and frequently denied services.

Key Responsibilities:

  • Identify trends and areas for needed clinical education to decrease denials
  • Submit pre-determination requests to support clinicians in identifying areas where loss of revenue is at risk
  • Provide clinical support for the review of clinical data to access current policies and processes impacting revenue
  • Facilitate education as needed to ensure compliance and support strong business practices for clinical areas

Requirements:

  • Associate Degree in Nursing preferred
  • Minimum of 3 years oncology experience preferred
  • Experience with Windows, Excel, Access, and Intranet/internet navigation tools
  • Strong knowledge of ICD-9-CM, HCPCs, and CPT coding preferred
  • Excellent verbal and written skills required

Working Relationships:

The Clinical Financial Case Management Specialist 2 will foster effective working relationships with Nurse Managers, clinical staff, and CBO departments to provide education and clinical support as appropriate.

Ohio State University Wexner Medical Center is a leader in patient care, medical research, and education, and we are committed to providing a work environment that is inclusive, equitable, and supportive of all employees.



  • 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 InsideHigherEd Full time

    Job Title: Clinical Financial Case ManagerWe 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...


  • 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...

  • Clinical Case Manager

    2 weeks ago


    Columbus, Ohio, United States Select Medical Full time

    Job Title: Clinical Case ManagerAt Select Medical, we are seeking a highly skilled and compassionate Clinical Case Manager to join our team. As a Clinical Case Manager, you will play a vital role in ensuring the seamless transition of patients from acute care to post-acute care settings.Key Responsibilities:Conduct thorough assessments of patients' medical...


  • 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 AdministrationJob Summary: The Clinical Case Manager facilitates an assigned group of patients through the healthcare system with the primary focus of efficient, effective, and compassionate inpatient care and a safe transition to the outpatient...


  • 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 Ohio State University Wexner Medical Center Full time

    Job SummaryThis role 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 and...

  • Clinical Case Manager

    3 weeks ago


    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...

  • Clinical Case Manager

    3 weeks ago


    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 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

    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...

  • Financial Manager

    2 days ago


    Columbus, Ohio, United States Creative Financial Staffing Full time

    Financial Manager OpportunityWe are seeking a highly skilled Financial Manager to join our team at Creative Financial Staffing. The ideal candidate will have experience in accounting and finance, with a strong background in financial management.The Financial Manager will be responsible for:Managing financial statements and reportsCoordinating with outside...


  • 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

    4 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...


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

    Job DetailsTotalMed Case Management Staffing is seeking a skilled travel nurse RN case manager to join their team.Specialty: Case ManagementDiscipline: RNAssignment Length: 8 weeksTotal Hours Per Week: 40Shift Breakdown: 5x8 hoursAs a travel nurse case manager, you will be responsible for providing high-quality patient care and management services to...

  • Financial Manager

    3 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

    4 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

    3 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...