Ohio Licensed Case Manager

Job Summary

Managing complex healthcare cases remotely, the full-time Ohio Licensed Case Manager will evaluate member needs, facilitate communication among healthcare teams, and implement treatment plans while maintaining documentation in compliance with company policies.

Key responsibilities

• Independently manage complex healthcare cases through various communication methods, verifying eligibility and assessing patient needs
• Facilitate and implement interventions based on care treatment plans developed with the healthcare team
• Maintain appropriate documentation in accordance with company and regulatory guidelines

Required qualifications

• Graduate of a registered nursing program approved by the Ohio State Nursing Board
• 3 years of experience as a Registered Nurse with clinical and case management experience, preferably in health insurance
• Current State of Ohio or Multistate unrestricted Registered Nurse license
• Certified Case Manager (CCM) or other industry-recognized certification preferred
• Intermediate proficiency with Windows and web-based systems, along with basic Microsoft Office skills