Avita Health System
Promote efficient utilization of health services and appropriate level of care for hospitalized patients. Responsible for acquiring all clinical documentation to support the medical necessity for hospitalization to process the service request to insurance companies. Perform clinical reviews utilizing the organizations adopted clinical review criteria.
Current Registered Nurse licensure in State of Ohio.
Minimum of 3 years experience in an acute care hospital with previous experience in a Case Management program or related job preferred.
Working knowledge of criteria for Medicare, Medicaid, HMO and private insurance coverage.
Is knowledgeable of basic statistical methods, patient care assessment and evaluation methodology.
Is a motivated, independent individual who can organize workload so that all functions are appropriately completed.
Hours per pay
Days of week