Utilization Case Manager, RN

The Ohio State University, Main Campus

Utilization Case Manager (RN) overseeing inpatient care decisions at Ohio State University Wexner Medical Center. Implementing care standards and managing compliance with healthcare guidelines.

Posted 6/23/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSeniorWebsite

About the role

Key responsibilities & impact

Implements and supports the philosophy, mission, values, standards, policies and procedures of The Ohio State University Wexner Medical Center.
Contributes to the hospitals Utilization Management Program Plan by using medical necessity guidelines to determine appropriateness for inpatient level of care or observation services based on documented clinical information in compliance with CMS guidelines and other payer requirements regarding appropriate level of care.
Maintains an awareness of State and National health care trends, JCAHO, CMS and third party payor Utilization Management guidelines.

Requirements

What you’ll need

Bachelor’s degree, Masters preferred.
RN licensure required.
Three years of Case Management and/or Utilization Management experience required.

Benefits

Comp & perks

Medical, dental and vision coverage, with Ohio State paying a significant portion of the cost.
Paid time off, including sick and vacation time and 11 holidays.
State retirement plan or an alternative retirement plan, both with generous employer contributions.

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Certifications

RN licensure