Job Details Utilization Management | Miamisburg | Part-time | Varied Shift Responsibilities & Requirements * Registered professional nurse with education, knowledge and experience. * Role focuses on ...
Job Details Utilization Management | Miamisburg | Part-time | Varied Shift Responsibilities & Requirements * Registered professional nurse with education, knowledge and experience. * Role focuses on ...
Incentives Utilization Management | Miamisburg | Part-time | Varied Shift Overview Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving ...
Incentives Utilization Management | Miamisburg | Part-time | Varied Shift Overview Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving ...
Job Details Utilization Management | Miamisburg | Part-time | Varied Shift Responsibilities & Requirements * Registered professional nurse with education, knowledge and experience. * Role focuses on ...
Job Details Utilization Management | Miamisburg | Part-time | Varied Shift Responsibilities & Requirements * Registered professional nurse with education, knowledge and experience. * Role focuses on ...
Utilization Management | Miamisburg | Part-time | Varied Shift * Registered professional nurse with education, knowledge and experience. * Role focuses on review of inpatient and observation ...
Utilization Management | Miamisburg | Part-time | Varied Shift * Registered professional nurse with education, knowledge and experience. * Role focuses on review of inpatient and observation ...
CASE MANAGER - Part Time
Dayton, OH · On-site
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 - Part Time
Dayton, OH · On-site
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 - Part Time
Dayton, OH · On-site
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 - Part Time
Dayton, OH · On-site
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 ...
Family Practice Physician Outpatient Only Practitioner - Physicians Only Apply - Perm
$215K - $344K/yr
Provides medical leadership of all for utilization management, cost containment, and medical ... Need 3-5 or more years in practice experience, prefer 2-4 years in FT/PT medical director or ...
Family Practice Physician Outpatient Only Practitioner - Physicians Only Apply - Perm
$215K - $344K/yr
Provides medical leadership of all for utilization management, cost containment, and medical ... Need 3-5 or more years in practice experience, prefer 2-4 years in FT/PT medical director or ...
Care Management Coord RN
Oxford, OH · On-site
Oxford, OH 45056 Schedule: Part Time Day Incentives & Benefits: We offer competitive shift ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...
Care Management Coord RN
Oxford, OH · On-site
Oxford, OH 45056 Schedule: Part Time Day Incentives & Benefits: We offer competitive shift ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...
Care Management Coord RN
Oxford, OH · On-site
Oxford, OH 45056 Schedule: Part Time Day Incentives & Benefits: We offer competitive shift ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...
Care Management Coord RN
Oxford, OH · On-site
Oxford, OH 45056 Schedule: Part Time Day Incentives & Benefits: We offer competitive shift ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...
Care Management Coord RN
Oxford, OH · On-site
Oxford, OH 45056 Schedule: Part Time Day Incentives & Benefits: We offer competitive shift ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...
Care Management Coord RN
Oxford, OH · On-site
Oxford, OH 45056 Schedule: Part Time Day Incentives & Benefits: We offer competitive shift ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...
Care Management Coord RN
Oxford, OH · On-site
Oxford, OH 45056 Schedule: Part Time Day Incentives & Benefits: We offer competitive shift ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...
Care Management Coord RN
Oxford, OH · On-site
Oxford, OH 45056 Schedule: Part Time Day Incentives & Benefits: We offer competitive shift ... Performs utilization review for patients served. Requires weekend, holiday, and off site commitment ...
... Part time/Per Diem positions are eligible for 401k based on reaching 1,000 hours within their ... patient-related utilization management criteria, and implementation of safe and appropriate ...
... Part time/Per Diem positions are eligible for 401k based on reaching 1,000 hours within their ... patient-related utilization management criteria, and implementation of safe and appropriate ...
RN Case Manager
Cleveland, OH · On-site
$40/hr
... Part time/Per Diem positions are eligible for 401k based on reaching 1,000 hours within their ... patient-related utilization management criteria, and implementation of safe and appropriate ...
RN Case Manager
Cleveland, OH · On-site
$40/hr
... Part time/Per Diem positions are eligible for 401k based on reaching 1,000 hours within their ... patient-related utilization management criteria, and implementation of safe and appropriate ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... We also offer our employee assistance program to part time employees. * Your Impact Matters: Join a ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... We also offer our employee assistance program to part time employees. * Your Impact Matters: Join a ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... We also offer our employee assistance program to part time employees. * Your Impact Matters: Join a ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... We also offer our employee assistance program to part time employees. * Your Impact Matters: Join a ...
Case Manager / PRN ( RN / RT / SW / LPN )
Cleveland, OH · On-site
$40/hr
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... We also offer our employee assistance program to part time employees. * Your Impact Matters: Join a ...
Case Manager / PRN ( RN / RT / SW / LPN )
Cleveland, OH · On-site
$40/hr
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... We also offer our employee assistance program to part time employees. * Your Impact Matters: Join a ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... We also offer our employee assistance program to part time employees. * Your Impact Matters: Join a ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... We also offer our employee assistance program to part time employees. * Your Impact Matters: Join a ...
... utilization, managing costs, and building strong trust with local hockey and community stakeholders ... Financial management * Own the facility operating budget and profit-and-loss performance, including ...
... utilization, managing costs, and building strong trust with local hockey and community stakeholders ... Financial management * Own the facility operating budget and profit-and-loss performance, including ...
THERAPIST-BSW/LSW-YCATS
Dayton, OH · On-site
Part-time, full-time, and associate therapist positions are available. Full time positions include ... utilization management of clinical care. Demonstrate knowledge of other regulatory standards.
THERAPIST-BSW/LSW-YCATS
Dayton, OH · On-site
Part-time, full-time, and associate therapist positions are available. Full time positions include ... utilization management of clinical care. Demonstrate knowledge of other regulatory standards.
THERAPIST-BSW/LSW-YCATS
Dayton, OH · On-site
Part-time, full-time, and associate therapist positions are available. Full time positions include ... utilization management of clinical care. Demonstrate knowledge of other regulatory standards.
THERAPIST-BSW/LSW-YCATS
Dayton, OH · On-site
Part-time, full-time, and associate therapist positions are available. Full time positions include ... utilization management of clinical care. Demonstrate knowledge of other regulatory standards.
Part Time Utilization Management information
What is a part time utilization management?
A part-time utilization management job involves reviewing and evaluating the medical necessity, appropriateness, and efficiency of healthcare services, procedures, and facilities on a part-time basis. These professionals help ensure that patients receive the right care at the right time while controlling healthcare costs and complying with insurance policies. Part-time roles may be suitable for nurses, social workers, or other healthcare professionals who want flexible hours while contributing to quality patient care and resource management.
What are the key skills and qualifications needed to thrive as a part time utilization management professional?
To thrive as a Part Time Utilization Management professional, you need a background in nursing or healthcare, critical thinking skills, and knowledge of medical necessity criteria, often supported by RN or LPN licensure. Familiarity with utilization review software, electronic health records (EHRs), and systems like InterQual or Milliman is typically required. Strong communication, attention to detail, and organizational skills help you effectively coordinate with providers and ensure accurate documentation. These abilities are essential for making informed coverage determinations, optimizing resource use, and maintaining compliance with healthcare regulations.
What is the difference between Part Time Utilization Management vs Part Time Care Coordinator?
| Aspect | Part Time Utilization Management | Part Time Care Coordinator |
|---|---|---|
| Primary Role | Reviewing and approving healthcare services to ensure appropriate utilization | Coordinating patient care plans and services across providers |
| Certifications | Typically requires healthcare or insurance-related certifications | Often requires healthcare or case management certifications |
| Work Environment | Office-based, insurance companies, healthcare organizations | Healthcare facilities, clinics, or community health settings |
| Employer & Industry Usage | Insurance companies, managed care organizations | Hospitals, clinics, healthcare providers |
While both roles involve healthcare coordination, Part Time Utilization Management focuses on reviewing and authorizing services, whereas Part Time Care Coordinators actively manage patient care plans. Understanding these differences helps in choosing the right career path or job search focus.
What are the most commonly searched types of Utilization Management jobs in Ohio?
The most popular types of Utilization Management jobs in Ohio are:
What cities in Ohio are hiring for Part Time Utilization Management jobs?
Cities in Ohio with the most Part Time Utilization Management job openings:
RN Utilization Rvw Spclst - Utilization Management
Miamisburg, OH • On-site
Kettering Health
7.3
Based on 190 frontline employees who took The Breakroom Quiz
304th of 893 rated healthcare providers
People enjoy working here
Good employer
Recommended by students
Recommended by parents
Respectful managers
Part-time
Re-posted 13 days ago
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.
- 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!
OverviewKettering 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_TIMEWhat Kettering Health employees say
Pay
Benefits
Hours and flexibility
Workplace
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