Ohio RN Clinical Financial Case Manager

Job Summary

A company is looking for a Clinical Financial Case Management - RN Specialist 2.

Key Responsibilities

• Implement and support clinical pre-certification, case reviews, and denial management
• Utilize clinical knowledge to interpret medical necessity guidelines and determine appropriate levels of care
• Become a Subject Matter Expert for assigned payers and maintain awareness of healthcare trends and guidelines

Required Qualifications

• Bachelor's degree in nursing with a current license
• Minimum of 3 years of clinical care experience
• Experience collaborating with physicians and understanding their plans of care
• Extensive knowledge of clinical operations and patient flow
• Proficient in Microsoft Office and various technology applications