Current Career Opportunities at Oaklawn

Thank you for your interest in employment opportunities with Oaklawn, a nationally recognized healthcare employer by Modern Healthcare magazine. As Marshall’s largest employer, we have a team of over 1,000 dedicated full-time, part-time and casual employees, and our outstanding patient satisfaction scores have landed us in the top 2% of Michigan hospitals and top 5% nationwide. If you’re looking to join a team of exemplary employees, you’re committed to providing exceptional patient care, and you personify our core values, then we encourage you to explore our current openings.

It is Oaklawn’s policy, as an equal opportunity employer, to provide for a diverse, non-discrimatory work environment. Oaklawn is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, national origin, sex, sexual orientation, gender identity, age, religion, disability, veteran status or any other characteristic protected by law.

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Specialist , Utilization Review

Job Summary: Reviews and screens the appropriateness of services, the utilization of hospital resources and the quality of patient care rendered. 

Essential Functions:

  • Consistently uses an outward mindset and puts forth exemplary effort in accomplishing his/her goals and objectives in a manner that helps others to achieve their goals and objectives.
  • Conducts concurrent or extended stay reviews on appropriate day and/or specified time
  • Combines clinical, business and regulatory knowledge and skill to reduce significant financial risk and exposure caused by concurrent and retrospective denial of payments for services provided
  • Prepares and submits appeals to payors, effectively coordinating collection of all pertinent data to support the hospital and patient’s position
  • Maintains and updates reviews in the electronic medical record (EMR) and maintains other appropriate records as needed
  • Communicates pertinent payor issues to physician and other caregivers
  • Understands and communicates insurance information to team members, including benefits and levels of care
  • Prepares any reports assigned or requested by the Manager of Case Management or his/her supervisor

Minimum Qualifications: Licensed in the State of Michigan as a Registered Nurse. Three (3) years of clinical experience. 

Knowledge, Skills & Abilities:   Bachelor’s degree preferred. Previous utilization management or case management experience preferred. Demonstrated competence with basic Microsoft Office tools. Knowledge of outside regulatory agencies inter-face with the institution.  The ability to communicate with individuals from various backgrounds regarding a variety of hospital-wide practices.  Strong critical thinking skills necessary to assess documentation of care provided in EMR.  Excellent prioritization and organizational skills emphasized. 

Working Conditions/Physical Requirements: Work is generally sedentary in nature, but may require standing and walking for up to 10% of the time. Work is generally performed within an office environment, with standard office equipment available.

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