RN UM Discharge, Planning

apartment Summa Health location_onCleveland, OH, US

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$34 - $50.99 / HOUR

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SummaCare - 1200 E Market St, Akron, OH

Full-Time / 40 Hours / Days

Remote after training

As a regional, provider-owned health plan, SummaCare values the relationship between the members and their doctors. SummaCare is a part of Summa Health, an integrated healthcare delivery system that includes Summa Health System hospitals, its community-based health centers, dedicated clinicians and SummaCare. Based in Akron, Ohio, SummaCare provides Medicare Advantage, individual and family and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2025 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits.

Summary

Collaborates with other health care providers to evaluate medical necessity of care, for elective and emergency admissions, surgeries, diagnostic procedures and treatments. Coordinate the delivery of services in the most appropriate setting, and provide support for transitions between settings for plan members that meets organizational goals related to quality outcomes, member experience, and cost-efficiency, using approved medical criteria and regulatory guidelines.

Formal Education Required

Bachelor Degree or may substitute with 4 years of like experience.

Experience & Training Required

3+ years performing same or similar responsibilities. Relevant experience includes: previous industry, utilization management/utilization review experience and care coordination.

Other Skills, Competencies And Qualifications

Registered Nurse (RN) state license in good standing. CCM/ACM certification or equivalent helpful.
Basic typing/computer skills needed to collect, assess, and enter data.
Demonstrate knowledge and skills necessary to provide care appropriate to the age of the members serviced. Takes ownership in identifying and obtaining education and training needed to meet needs of the members.
Work cooperatively with team members to accomplish HSM mission and goals.
Organize and manage time to accurately complete tasks within designated time frames in fast paced environment.
Maintain current knowledge of and comply with regulatory and company policies & procedures.
Maintain confidentiality of member health and business information.
Flexible: Ability to adjust work hours to meet business demands.
Ability to effectively interact with populations of patients/customers with an understanding of their needs for self-respect and dignity

Level Of Physical Demands

Sit and/or stand for prolonged periods of time.
Bend, stoop, and stretch.
Lift up to 20 pounds.
Manual dexterity to operate computer, phone, and standard office machines.

Equal Opportunity Employer/Veterans/Disabled

$34.00/hr - $50.99/hr

The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.

Summa Health offers a competitive and comprehensive benefits program to include medical, dental, vision, life, paid time off as well as many other benefits.

Basic Life and Accidental Death & Dismemberment (AD&D)
Supplemental Life and AD&D
Dependent Life Insurance
Short-Term and Long-Term Disability
Accident Insurance, Hospital Indemnity, and Critical Illness
Retirement Savings Plan
Flexible Spending Accounts – Healthcare and Dependent Care
Employee Assistance Program (EAP)
Identity Theft Protection
Pet Insurance
Education Assistance
Daily Pay

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