Full time
The Ohio State University Wexner Medical Center
Columbus, OH, USA
Current Employees and Students: Please log in to Workday to use the internal job search and application process. Scope of Position This position serves as a Patient Care Resource Manager (PCRM) – Senior Specialist for health plan utilization management programs and reports to the Utilization Manager. The PCRM – Senior Specialist is responsible for delivering superior customer service and achieving clinical and operational excellence as it relates to the implementation and execution of OSU Health Plan medical/pharmacy benefits and utilization management. The position is tasked with ensuring highly personalized and cost-effective care for all OSU Health Plan members. The PCRM – Senior Specialist is responsible for resolving escalated member/provider concerns and working with the Utilization Manager and team clinicians to provide quality assurance for our top-quality clinical programs. The PCRM – Senior Specialist provides informal guidance to other care management program staff...
