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Part Time Utilization Management Bcba Jobs in Ohio

Case Manager (RN) Dept: Integrated Care Management Program Shift: Part Time -0830-1700 / 48 Hours ... analysis, utilization management, transition planning and process, resource allocation, team ...

Case Manager (RN) Dept: Integrated Care Management Program Shift: Part Time -0830-1700 / 48 Hours ... analysis, utilization management, transition planning and process, resource allocation, team ...

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Part Time Utilization Management Bcba information

What is the difference between Part Time Utilization Management Bcba vs Part Time Behavior Analyst?

AspectPart Time Utilization Management BcbaPart Time Behavior Analyst
CertificationsBCBA or BCaBA, plus utilization management trainingBCBA or BCaBA
Work EnvironmentHealthcare, insurance, or managed care settingsClinical, educational, or behavioral therapy settings
Job FocusReviewing service necessity, authorizations, and resource allocationDeveloping and implementing behavior intervention plans
Employer UsageHealth plans, insurance companies, healthcare providersSchools, clinics, private practices

While both roles require BCBA credentials, the Part Time Utilization Management Bcba focuses on managing healthcare resources and authorizations, whereas the Part Time Behavior Analyst concentrates on direct behavioral assessment and intervention. Understanding these differences helps professionals choose the role that aligns with their skills and career goals.

What are the most commonly searched types of Utilization Management Bcba jobs in Ohio? The most popular types of Utilization Management Bcba jobs in Ohio are:
What cities in Ohio are hiring for Part Time Utilization Management Bcba jobs? Cities in Ohio with the most Part Time Utilization Management Bcba job openings:

RN Utilization Rvw Spclst - Utilization Management

Kettering Health

Miamisburg, OH • On-site

Part-time

Posted 27 days ago


Kettering Health rating

7.3

Company rating: 7.3 out of 10

Based on 188 frontline employees who took The Breakroom Quiz

305th of 887 rated healthcare providers


Job description

Job Details

Utilization Management | Miamisburg | Part-time | Varied Shift

Responsibilities & Requirements
  • Registered professional nurse with education, knowledge and experience.
  • Role focuses on review of inpatient and observation admissions to ensure correct assignment of Admit status.  
  • Communicates concurrently and resolves medical necessity discrepancies with physicians and other hospital leadership as needed.
  • Responsible for completing clinical review on all assigned patients and communicates these reviews to payers.
  • Identifies potential or actual denials for admission or ongoing stay both during the patient's hospital stay and post discharge.
  • Review and decide the validity of medical necessity payer denials.  Submits payer denial appeals.
  • Participates in design of work flows and procedure to reduce incidence of denials.
  • Current unrestricted Ohio RN licensure, BSN required.
  • Experience with computers required.
Preferred Qualifications
  • 5 years clinical experience with 2 years case management
  • Case Management certification
  • Works independently
  • Familiar with MCG Care guidelines
  • Ability to adapt quickly to changing priorities and regulations
  • Experience with Microsoft applications and EPIC software

                                                                            ! WEEKEND ONLY!

Overview

Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving southwest Ohio. Our mission is to live God's love by promoting and restoring health. Our commitment to our patients is to help individuals be their best. With that context, safety is our top priority. We provide an integrated system of healthcare experts committed to providing exceptional care.

Employment Type: PART_TIME

What Kettering Health employees say

Pay

Benefits

Hours and flexibility

Workplace

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