Occupational Health Case Manager Job

1 OR 2 QUALIFIED OCCUPATIONAL HEALTH CASE MANAGER'S needed for a CONTRACT JOB opportunity with Yoh's client located in Columbus, OH.

THE BIG PICTURE - TOP SKILLS YOU SHOULD POSSESS: Occupational Health Case Management
- Provide medical justification for hospitalization and severity
- Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review

What You'll Be Doing:
- Best qualified candidate will be responsible for inpatient medical necessity/utilization review and other utilization management activities, ensuring plan members have proper care
- Also, be able to assist with concurrent review and prior authorizations

What You Need to Bring to the Table:
- Best qualified candidate will have two to four (2 - 4) years of experience dealing with reviewing appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures
- Should have two to four (2 - 4) years of clinical practice, preferably hospital nursing, utilization management, and/or case management
- Broad background of acute medical care
- Chart of Medical Review experience necessary

Bonus Points! Otherwise Known As Preferred Qualifications:
- Registered Nurse License in good standing
- In depth knowledge of Interqual and other references for length of stay and medical necessity determinations
- Experience with NCQA
- Proficient with various computer programs
- Proficient with meeting daily goals and be a team player
- CPR Certified

What's In It For You?
- This role will definitely add more overall nursing experience, working in an environment where you will gain the valuable experience dealing with a client who is well known and offers a terrific work atmosphere. There will be a High degree of respect and value placed on the individual who will be selected for this role.

OPPORTUNITY IS CALLING, APPLY NOW!

RECRUITER: Daniel Kelly

Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V.

J2W: HC

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SFSF: HC