Nurse Case Manager - Internal

What You’ll Do Are you a compassionate and detail-oriented nurse looking to make a meaningful impact in the lives of children with special care needs? This role offers a dynamic blend of clinical decision-making, case management, community engagement, and administrative support—ideal for nurses who thrive in both independent and collaborative environments. Duties include: Clinical and Case Management Independently assess medical applications and determine eligibility for CMH services. Authorize or deny diagnostic, treatment, and service coordination based on medical data and program guidelines. Interpret medical plans for treatment and develop appropriate care strategies. Monitor ongoing service needs and effectiveness, ensuring compliance with HIPAA and CMH policies. Coordinate complex treatment plans with other state and federal programs. Evaluate diagnoses and determine appropriate services, including medical equipment, orthotics, prosthetics, and orthodontia. Manage case data and service authorizations. Community Engagement & Education Maintain contact with families, providers, and community partners through phone, written communication and site visits across Ohio. Provide technical assistance and orientation to providers on CMH policies, procedures and billing. Plan and participate in educational workshops, seminars, and nursing care conferences. Resolve service delivery issues and respond to sensitive inquiries professionally and confidentially. Collaborate with nurse case managers and other stakeholders to ensure timely and effective case processing. Administrative and Liaison Support Maintain accurate and confidential client records in accordance with national, state and CMH guidelines. Perform administrative tasks such as answering phone, managing documents and operating office equipment. Serve as a liaison to government agencies, private sector partners and other state programs. Unusual Working Conditions May require travel. Position Qualifications Current and valid license to practice professional nursing as Registered Nurse (R.N.) in Ohio, as issued by the Board of Nursing pursuant to Section 4723.03 of the Revised Code, and all of the following criteria: 24 months experience in pediatric nursing, including care of children with special health care needs (CSHCN) and/or case management of children with multiple health care needs. Completion of an undergraduate core program in nursing that includes at least one course in community health nursing or public health nursing and at least one course in research methodologies. One course or three months of experience in operation of a personal computer. Option 2: Current and valid license to practice professional nursing as Registered Nurse (R.N.) in Ohio, as issued by the Board of Nursing pursuant to Section 4723.03 of the Revised Code, and all of the following criteria: 24 months experience in pediatric nursing, including care of children with special health care needs (CSHCN) and/or case management of children with multiple health care needs. 24 months experience in nursing, which includes three months of training or three months of experience in community health or public health nursing and three months of training or three months of experience in data collection & analysis. One course or three months of experience in operation of a personal computer. Equivalent minimum class qualifications for employment may be substituted for the experience required, but not for the mandated licensure. Additional Qualifications Graduate or advanced degree in nursing. Experience in pediatric nursing and case management of children/young adults with special health care needs. Experience providing technical assistance/consultation services to a local health department or other provider of child/young adult health services (e.g., hospitals, pediatric clinics, physicians’ offices, other health‑care related professionals). Experience in public/community and/or home health nursing. Experience reviewing and authorizing medical plans of treatment/requests for services (may include durable medical equipment, orthotics, prosthetics, orthodontic services, therapies). Certified Nurse Case Manager / Discharge Planner or Certified Pediatric Nurse. Experience in analyzing health‑related data to prepare reports (e.g., quality assurance/technical reports, medical reports). Experience providing education or training to various groups (e.g., medical groups, nursing staff, parents, young adults). Experience with computer software (e.g., Microsoft Office: Word, PowerPoint). All Eligible Applications Will be reviewed considering the following criteria: qualifications, experience, education, active disciplinary record, and work record. Job Skills Nursing Technical Skills Health Administration, Medical Records, Nursing, Public Health, Public Relations Professional Skills Analyzations, Attention to Detail, Collaboration, Consultation, Verbal Communication, Written Communications Educational Transcript Requirements Official educational transcripts are required for all post‑high school educational accomplishments, coursework or degrees claimed on the application. Applicants must submit an official transcript within five (5) working days of request; failure to do so will result in elimination from further consideration. A transcript is considered "official" only if it is an original copy from the educational institution and includes an institutional watermark, ink stamp, or embossed stamp. Transcripts printed from the institution's website will not be accepted. ODH reserves the right to assess the academic credibility of an educational entity's award of a putative degree. If you use education or coursework to meet the minimum qualifications, an official transcript must be attached prior to submitting your application. Organization Health Agency Contact Gayla. A will contact you if selected for interview. Work Location Health Department Building Primary Location United States of America - Ohio - Franklin County - Columbus Compensation $34.96 Schedule Full‑time Work Hours Monday - Friday; 8 AM - 5 PM Classified Indicator Classified Union 1199 Primary Job Skill Nursing Agency Overview Nurse Case Manager- Internal (Medical Review Nurse) About Us Our mission at the Ohio Department of Health (ODH) is advancing the health and well‑being of all Ohioans. Our agency is committed to building a modern, vibrant public health system that creates the conditions where all Ohioans flourish. The Bureau of Maternal, Child, and Family Health (BMCFH)/ Complex Medical Help (CMH) is organized to support families by improving birth outcomes and the health status of women, infants, children, and youth, including children and youth with complex health care needs. Using data and proven practice, the bureau’s programs support the delivery of direct services, linkages and referrals, population‑based supports, program evaluation, education, monitoring and quality oversight, and policy and systems development. #J-18808-Ljbffr