License Practical Nurse

Integrated Resources Inc.; Columbus (OH); On-site; USD 45,000 - 60,000; Full time

Job summary

A leading healthcare solutions company seeks an LPN Case Manager to join its Utilization Management team in Columbus, OH. This role involves performing utilization review activities and conducting member visits to ensure they receive appropriate care while adhering to regulations. Candidates must hold an active LPN license in Ohio and have substantial nursing experience, particularly in home care.

Qualifications

• Active, unrestricted State Nursing License (Practical Nurse) in Ohio.
• 5+ years of LPN experience, including home care.
• Willingness to drive within the Columbus area.

Responsibilities

• Conduct face-to-face visits with members and educate them on benefits.
• Perform inpatient medical necessity/utilization review.
• Assess services to ensure optimal outcomes and compliance.

Skills

Self-starter

Communication

Documentation

Education

Completion of an accredited Registered Nursing program

Job description

Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.

We’ve stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.

Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients’ success.

Job Description

Works with the Utilization Management team, primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing healthcare members with the right care at the right place and time. Provides daily review and evaluation of members requiring hospitalization and/or procedures, including prior authorizations and/or concurrent review. Assesses services for members to ensure optimal outcomes, cost-effectiveness, and compliance with all state and federal regulations and guidelines.

Duties:

Complete face-to-face visits with members in case management and as directed by the case manager. This role requires driving to multiple locations in a given day and covering multiple counties. The case manager will provide a series of questions to ask. The goal is to educate members on their benefits and advise them on how to utilize them fully. This involves observing and documenting through computer, with minimal hands-on care. Candidate must be a self-starter.

Qualifications

Must Haves:

• Active, unrestricted State Nursing License (Practical Nurse), in good standing for Ohio.
• 5+ years of LPN experience, including home care.
• Willingness to drive within the Columbus, OH area.

Required Education:

Completion of an accredited Registered Nursing program. A combination of experience and education may be considered in lieu of a Registered Nursing degree.

Required Experience:

0-2 years of clinical practice, preferably hospital nursing or utilization review.

Required Licensure/Certification: Active, unrestricted State Nursing (LPN) license in good standing.

Additional Information

All your information will be kept confidential according to EEO guidelines.