RN Case Manager

4 weeks ago

Oklahoma City, Oklahoma, United States OU Health Full time
Job Title: RN Case Manager

OU Health is seeking a skilled RN Case Manager to join our team. As a RN Case Manager, you will play a critical role in ensuring that patients receive the highest quality care while minimizing unnecessary hospital stays and costs.

Key Responsibilities:
  • Conduct timely medical necessity reviews for patients using nationally accepted criteria to determine appropriateness of admission and level of care.
  • Communicate with insurance companies and members of the care team as needed using critical thinking skills, clinical expertise, and sound medical judgment.
  • Ensure that healthcare services administered to patients are of the highest quality, cost-efficient, and in compliance with current regulations.
  • Complete continuous review and audit of patients' treatment records to prevent unnecessary procedures, ineffective treatment, and unnecessary extensive hospital stays.
  • Use critical thinking skills, clinical expertise, and judgment along with established medical criteria to provide a recommendation of level of care to physicians.
  • Follow HIPAA guidelines for patient privacy.
  • Review charts to ensure documentation and medical necessity meet Medicare regulations.
  • Review insurance denials and attempt to get them overturned.
  • Communicate with members of the healthcare team.
  • Create reports out of system as needed.
  • Utilize various computer applications.
  • Attend meetings online or in person as required.
Requirements:
  • Graduate from an accredited school of nursing required.
  • Bachelor of Science (or higher) in Nursing Board Approved Program preferred.
  • Three (3) years clinical nursing experience in an acute care facility.
  • Experience with utilization review or case management preferred.
  • MCG experience preferred.
  • Current RN License issued by the Oklahoma State Board of Nursing, or a current multistate Compact RN License (eNLC).
  • Case management certification preferred.
Preferred Qualifications:
  • Knowledge of nursing practices and procedures.
  • Strong clinical assessment skills and critical thinking skills.
  • Requires knowledge of third-party payer issues concerning reimbursement and regulatory perimeters.
  • Must be proficient with basic computer skills (Microsoft Office products).
  • Knowledge of insurance terminology and Medicare guidelines.
  • Excellent typing skills.
  • Ability to work independently, manage time, and prioritize patient needs.
  • Ability to work under minimal supervision in a remote environment.
  • Able to work some weekends and holidays.
  • Able to adapt to frequent changes in direction.
  • Excellent interpersonal and communications skills with nursing staff, physicians, nurse practitioners, and other healthcare workers.
  • Ability to meet deadlines and manage multiple priorities, and effectively adapt and respond to complex, fast-paced, rapidly growing, and results-oriented environments.
  • Able to work in a dynamic, fast-paced team environment and to promote team concepts.

OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.

  • RN Case Manager

    4 weeks ago

    Oklahoma City, Oklahoma, United States Integris LLC Full time

    Job Title: RN Case ManagerINTEGRIS Health Baptist Medical Center, Oklahoma's largest not-for-profit health system, is seeking a skilled RN Case Manager to join our team. As a key member of our Case Management team, you will work closely with patients, families, and healthcare providers to ensure seamless care transitions and optimal clinical outcomes.Key...

  • RN Case Manager

    4 weeks ago

    Oklahoma City, Oklahoma, United States Spectrum Healthcare Resources Full time

    Job Title: Registered Nurse Case ManagerSpectrum Healthcare Resources is seeking a Registered Nurse Case Manager to provide nursing services to injured Federal workers in Oklahoma City and surrounding areas.Job Summary:The successful candidate will manage cases from 3 to 6 months, providing nursing services to injured workers who have not returned to work...

  • Case Manager RN

    4 weeks ago

    Oklahoma City, Oklahoma, United States GLOBALHEALTH HOLDINGS LLC Full time

    Job Title: Case Manager RNGlobalHealth Holdings LLC is seeking a skilled Case Manager RN to join our team. As a Case Manager RN, you will play a critical role in improving the long-term wellness of our members by coordinating care and advocating on their behalf.Job Summary:The Case Manager RN will conduct telephonic case management for complex, high-risk...

  • RN Case Manager

    3 weeks ago

    Oklahoma City, Oklahoma, United States Integris LLC Full time

    Integris Health Baptist Medical Center is seeking a skilled RN Case Manager to join our team in Oklahoma City, OK.This part-time position offers a unique opportunity to work with our Case Management team, providing exceptional care to patients and their families.Key Responsibilities:Manage and coordinate patient care during hospitalization to achieve optimal...

  • RN - Case Manager

    4 weeks ago

    Oklahoma City, Oklahoma, United States Spectrum Healthcare Resources Full time

    Spectrum Healthcare Resources is seeking a Registered Nurse Case Manager to provide nursing services to injured Federal workers in Oklahoma City and surrounding areas. The ideal candidate will have a minimum of two years of adult medical/surgical nursing experience and two years of case management experience in the workers' compensation...

  • RN - Case Manager Position

    3 weeks ago

    Oklahoma City, Oklahoma, United States Spectrum Healthcare Resources Full time

    Job Title: RN - Case Manager PositionWe are seeking a skilled Registered Nurse to fill a Case Manager position in our team.Job Summary:As a Case Manager RN, you will be responsible for providing nursing services to injured Federal workers in Oklahoma City and surrounding areas.Key Responsibilities:* Provide nursing services to injured Federal workers* Manage...

  • RN Case Manager

    4 weeks ago

    Oklahoma City, Oklahoma, United States INTEGRIS Health Full time

    Job SummaryWe are seeking a skilled RN Case Manager to join our team at INTEGRIS Health Baptist Medical Center. As a RN Case Manager, you will be responsible for coordinating patient care and ensuring optimal clinical outcomes.Key Responsibilities:Conduct comprehensive assessments of patients' clinical, psychological, and financial needsDevelop and implement...

  • RN Case Manager

    3 weeks ago

    Oklahoma City, Oklahoma, United States Integris Health Full time

    Job DescriptionIntegris Health is seeking a skilled RN Case Manager to join our team. As a key member of our Case Management Services, you will play a vital role in ensuring the best possible outcomes for our patients.Key ResponsibilitiesConduct comprehensive assessments of patients' clinical, psychological, and financial needsDevelop and implement...

  • Case Management RN Position

    4 weeks ago

    Oklahoma City, Oklahoma, United States MedPro Healthcare Staffing Full time

    Job Summary: MedPro Healthcare Staffing is seeking a skilled Case Management Registered Nurse (RN) for a 13-week travel nursing assignment. The RN will work 36 hours per week on day shifts, coordinating continuity of care for patients and promoting self-managed care.Responsibilities:Coordinate continuity of care for patientsPromote self-managed careEnsure...

  • RN - Case Manager Position

    3 weeks ago

    Oklahoma City, Oklahoma, United States Spectrum Healthcare Resources Full time

    Job Summary:Spectrum Healthcare Resources is seeking a skilled Registered Nurse Case Manager to provide nursing services to injured Federal workers in Oklahoma City and surrounding areas.Key Responsibilities:Provide nursing services to injured Federal workers who have immediate time loss and have not returned to work within a specified number of days.Manage...

  • Travel Nurse RN Case Manager

    4 weeks ago

    Oklahoma City, Oklahoma, United States MedPro Healthcare Staffing Full time

    Job Description & RequirementsMedPro Healthcare Staffing is seeking a travel nurse RN Case Management for a travel nursing job in a top healthcare facility.Specialty: Case ManagementDiscipline: RNDuration: 13 weeks36 hours per weekShift: 12 hours, nightsEmployment Type: TravelAs a Case Manager Registered Nurse, you will coordinate continuity of care for...

  • Travel Nurse RN Case Manager

    4 weeks ago

    Oklahoma City, Oklahoma, United States MedPro Healthcare Staffing Full time

    Job Title: Case Manager Registered NurseMedPro Healthcare Staffing is seeking a qualified Case Manager Registered Nurse (RN) for a travel assignment with one of our top healthcare clients.Job Summary:The role of the case management nurse (RN) is to coordinate continuity of care for patients often as a liaison between the patient's family and healthcare...

  • RN Case Manager

    4 weeks ago

    Oklahoma City, Oklahoma, United States Amedisys Full time

    OverviewAmedisys is a leading provider of home health, hospice, and high-acuity care, dedicated to helping patients and families navigate the complex healthcare system. We are seeking a highly skilled and compassionate Registered Nurse (RN) to join our team as a Case Manager.ResponsibilitiesPerform patient assessments and collaborate with the care team to...

  • RN Case Manager Hospice

    3 weeks ago

    Oklahoma City, Oklahoma, United States Della Infotech Full time

    Job Summary:Good Shepherd Hospice is seeking a RN Case Manager to provide nursing assessment, planning, and care to maximize the comfort and health of patients and families in Choctaw, OK and surrounding communities.Responsibilities include responding to phone calls promptly, making patient visits as necessary, and completing after hour admissions and deaths...

  • Nurse Case Manager

    4 weeks ago

    Oklahoma City, Oklahoma, United States Enhabit Home Health & Hospice Full time

    OverviewAt Enhabit Home Health & Hospice, we're committed to delivering exceptional patient care in the comfort of their own homes. As a Registered Nurse (RN) Case Manager, you'll play a vital role in coordinating care and ensuring our patients receive the highest level of service.We're seeking a skilled and compassionate RN to join our team. If you're...

  • RN Case Manager

    4 weeks ago

    Oklahoma City, Oklahoma, United States Integris LLC Full time

    Job Summary: We are seeking a skilled RN Case Manager to join our team at INTEGRIS Health Baptist Medical Center. As a RN Case Manager, you will be responsible for managing the clinical and financial outcomes for an assigned caseload of patients. This is a part-time position working 8a-430p.Key Responsibilities:Facilitate patient care during hospitalization...

  • Travel Nurse Case Manager

    4 weeks ago

    Oklahoma City, Oklahoma, United States MedPro Healthcare Staffing Full time

    Job Title: Travel Nurse Case ManagerMedPro Healthcare Staffing is seeking a skilled Case Manager Registered Nurse (RN) for a travel assignment with one of our top healthcare clients.Job Requirements:Eighteen months of recent experience in an Acute Care Case Manager settingActive RN LicenseBLS CertificationsDegree from accredited nursing...

  • Travel Nurse RN Case Manager

    4 weeks ago

    Oklahoma City, Oklahoma, United States Prokatchers Full time

    Job Description & RequirementsProKatchers is seeking a travel nurse RN Case Management for a travel nursing job in Oklahoma City, Oklahoma.Specialty: Case ManagementDiscipline: RNDuration: 13 weeks36 hours per weekShift: 12 hours, daysEmployment Type: TravelSalary: $2,400.60/weekMedical Specialty: RN Case ManagerStandard shift: DaysWeekly schedule:...

  • Nurse Case Manager

    4 weeks ago

    Oklahoma City, Oklahoma, United States Enhabit Home Health & Hospice Full time

    OverviewAt Enhabit Home Health & Hospice, we're committed to delivering exceptional patient care in the comfort of their own homes. As a Registered Nurse (RN) Case Manager, you'll play a vital role in coordinating care and ensuring our patients receive the highest level of service.As a national leader in home-based care, we're dedicated to fostering a...

  • Travel Nurse RN Case Manager Position

    3 weeks ago

    Oklahoma City, Oklahoma, United States MedPro Healthcare Staffing Full time

    MedPro Healthcare Staffing is seeking a travel nurse RN Case Management professional for a travel nursing assignment in a top healthcare facility.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNShift: 12 hours, daysEmployment Type: TravelAs a travel nurse RN Case Manager, you will be responsible for coordinating continuity of care for...