RN Case Manager - Days
INTEGRIS Health, Oklahoma’s largest not-for-profit health system, is hiring a full‑time RN Case Manager in Oklahoma City, OK. In this role you will work with our Case Management team providing exceptional care to patients and partners. We offer competitive compensation, enhanced benefits such as front‑loaded PTO, 100% paid short‑term disability, increased retirement match, and paid family leave.
Responsibilities
Complete comprehensive assessments of patients’ clinical, psychological and financial needs using all available resources.
Recommend and coordinate timely transfers to appropriate levels of care based on clinical needs and utilization criteria.
Develop, implement and revise discharge plans, including referrals to other health care and community organizations.
Communicate discharge care plans and any changes to patients, families and healthcare professionals.
Assist physicians and hospital staff with resource utilization, applying utilization criteria and facilitating timely discharge planning.
Coordinate services between hospital departments to facilitate patient discharge.
Conduct concurrent reviews of patient records on admission and as clinically indicated.
Apply utilization criteria accurately to determine appropriate resource utilization.
Notify designated internal and external contacts of utilization issues that may affect patient care or reimbursement.
Facilitate patient transfers to other health care organizations in accordance with hospital policies and state/federal regulations.
Act as a resource/advisor to physicians regarding discharge planning, documentation, and resource utilization.
Integrate and manage established pathways to enhance clinical effectiveness and resource management.
Maintain knowledge of CMS regulations, Medicare/Medicaid, managed care, and payer regulations.
Provide education to patients, families and healthcare professionals about payer regulations and reimbursement.
Facilitate use of appropriate levels of care to conserve patient, hospital and payer resources.
Identify opportunities to reduce cost of patient care without compromising quality.
Collect and record data for utilization and quality improvement reporting.
Work collaboratively and professionally with patients, families, physicians, and staff.
Qualifications
Required:
5+ years of experience in a variety of clinical settings (home health, inpatient, physician office, clinic).
BLS certification issued by the American Red Cross or American Heart Association within 30 days of hire.
Current RN license in Oklahoma or a multistate license from a Nurse Licensure Compact member state.
Excellent interpersonal communication and collaboration skills.
Computer proficiency.
Valid Oklahoma State driver’s license and acceptable driving record.
Must be able to communicate effectively in English (verbal and written).
Incumbents may be required to operate an INTEGRIS‑owned vehicle or a personal vehicle.
Additional physical demands, on‑call requirements, and exposure to infectious diseases may apply. Refer to the Physical Demands Project SharePoint site or contact Risk Management/Employee Health for details.
Preferred Qualifications:
Experience with managed care and payer/provider requirements.
Bachelor’s of Science in Nursing.
Case Management Certification.
INTEGRIS is an Equal Opportunity/Affirmative Action Employer. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including veteran or disability status.