Position Summary:Provide comprehensive healthcare management services to facilitate appropriate healthcare treatment, effectively manage healthcare costs and improve healthcare program/operational efficiency involving clinical issuesDuties:Determines medical necessity/ appropriatenessFacilitates optimal outcomesIdentifies and follow through with continuous quality/ compliance opportunities .Educates/ empowers customers to ensure compliance, satisfaction and promote patient advocacyOptimize total costsImplementation and evaluation of policy based on usage and program directivesEducate/empower colleagues at all levels to enable decision making at most appropriate levelComplete transition of care protocol and follow up which includes a post discharge assessment and care plan updatesExperience:Minimum 2 years of clinical experienceEffective communication skills, both verbal and writtenAbility to multitask, prioritize and effectively adapt to a fast paced changing environmentEducation:Minimum of an associated degree in nursingRN license that is active and unrestricted in Ohio or compact stateNotes:Monday - Friday 8am- 5pm ESTFully remote (never coming onsite)
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