What are the responsibilities and job description for the Managed Care Nurse position at Western & Southern Financial Group?
Join Western & Southern Financial Group — Somewhere to Grow, Lead, Win and Do Good for Others
Western & Southern Financial Group (Western & Southern) is one of the strongest financial services groups in the world, with a 138-year history built on trust, compassion and a commitment to our customers and our community. We help provide financial security and peace of mind to millions of families across the country through insurance, investments and retirement solutions.
What You’ll Do: A Day in the Life of a Managed Care Nurse in our Benefits department
A Managed Care Nurse provides concurrent and retrospective utilization reviews, large case management, disability case management and other programs to improve the quality of medical care and control costs. Communicate regularly with members, physicians, physician office staff, pharmacists and hospital utilization personnel.
Your Qualifications, Skills and Experience
- Utilizes clinical experience and appropriate clinical criteria and guidelines, along with Plan provisions, in monitoring, evaluating and coordinating both inpatient and outpatient medical care to promote quality outcomes at reasonable costs.
- Performs prospective and concurrent utilization reviews to determine medical necessity for inpatient admission, inpatient continued stay and selected outpatient services to ensure medically appropriate, high quality and cost effective care and for most efficient utilization of third-party services.
- Assists members (associates, retirees and dependents) in navigating the healthcare landscape and optimizing benefit plan utilization by identifying opportunities to promote quality healthcare.
- Monitors potential high-cost claims for early intervention with case management and retrospectively reviews to assure appropriate and cost effectiveness.
Required:
- Bachelors degree in Nursing
Preferred:
- Case/claim management system experience. - Preferred
Why Work for Us
We know people do their best work when they feel valued and are supported. That’s why we offer a comprehensive benefits package designed to help you succeed both at work and at home, including:
- Paid time off increasing with tenure.
- Tuition reimbursement and individualized career development plans.
- Medical, dental, vision, and life insurance.
- 401(k) savings plan with pension options.
- Parental leave and maternity leave with a 4-week transition back to work.
- Access to on-site amenities like a fitness center, cafeteria and more.
- Extensive employee discount program.
Headquartered in Cincinnati, Ohio, Western & Southern is a Fortune 500® company recognized as one of America’s Best Midsize Employers by Forbes1. We invest in our associates through meaningful skill development, leadership opportunities and career coaching.
Our commitment to career growth and employee development earned us national recognition, including two gold badges from Where You Work Matters and Top 10 Military Friendly Employer and Top Spouse Employer designations. We take pride in helping associates build meaningful careers through award-winning development programs and leadership opportunities. Hear what our associates say about their experience at W&S!
We also recognize that talent comes from many different backgrounds and experiences. If you're excited about this opportunity but don't meet every qualification, we encourage you to apply.
Our Culture
Western & Southern is built on a culture driven by integrity, top-notch performance, teamwork and collaboration. We’re committed to hiring and developing professionals who strive for excellence, demonstrate strong ethics and make fact-based decisions. Our associates are empowered to chase their career dreams while being supported every step of the way.
Western & Southern is not just a place to work — it’s somewhere to grow, lead, win and make a difference in your career and community.
Learn more at www.westernsouthern.com/careers.
From Fortune ©2026 Fortune Media IP Limited.All rights reserved. Used under license. Fortune and Fortune 500 are registered trademarks of Fortune Media IP Limited and are used under license. Fortune Magazine and Fortune Media (USA) Corporation are not affiliated with, and do not endorse products or services of, Western & Southern Financial Group.
1 https://www.forbes.com/lists/best-midsize-employers/