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Job description
Performs utilization and resource management activities to promote quality, clinical and cost-effective outcomes. Assesses patients' treatment plans, communicates with third-party payers, and collaborates with healthcare team members.
Conducts chart reviews, admission reviews, and continued stay utilization reviews. Identifies strategies to reduce length of stay and resource consumption. Confers with admitting physicians and keeps current on regulatory changes.
Requires 5 years of clinical nursing experience and 3 years of quality management, utilization review, or discharge planning experience. Preferred certifications include CPHQ, CCM, or CPUR.
Company
Healthcare
Capital Health Care Network is a senior‑focused healthcare system operating in Ohio and West Virginia. It delivers a continuum of services—including skilled nursing, assisted and independent living, outpatient rehabilitation, home health, and hospice—through a network of facilities staffed by more than 1,500 skilled professionals. By leveraging advanced technology and evidence‑based practices, the organization ensures high‑quality, patient‑centered care across all settings. The network’s core offerings encompass rehospitalization risk reduction, in‑ and out‑patient therapy, post‑surgical orthopedic care, respite and long‑term care, medication management, wound and Alzheimer’s care, as well as personal safety monitoring and driving simulation programs. Capital Health Care Network’s integrated approach enables seniors to age independently while providing meaningful career opportunities for healthcare talent committed to improving quality of life.
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Capital Health Care Network
Capital Health Care Network
Capital Health Care Network
Capital Health Care Network
Capital Health Care Network
Capital Health Care Network