RN Case Manager – Southwest Medical Center – Days
INTEGRIS Health Southwest Medical Center, Oklahoma's largest not‑for‑profit health system, offers an exciting opportunity for an RN Case Manager to work full‑time, days in Oklahoma City.
As an RN Case Manager you provide exceptional care, manage resources, and support patients through the continuum of care, ensuring clinical and financial outcomes.
Responsibilities
Complete comprehensive assessments of patients’ clinical, psychological, and financial needs.
Recommend and coordinate timely transfers to appropriate levels of care.
Develop, implement, evaluate, and revise discharge plans and referrals.
Communicate discharge care plans and changes to patients, families, and health‑care professionals.
Assist physicians and staff with resource utilization and timely discharge planning.
Coordinate services between departments to facilitate discharge.
Conduct concurrent reviews of patient records on admission and as clinically needed.
Apply utilization criteria accurately and notify contacts of any issues.
Facilitate patient transfers in accordance with policies and regulations.
Serve as resource/advisor for physicians on documentation and utilization.
Integrate established pathways to enhance clinical effectiveness.
Maintain knowledge of CMS regulations, Medicare/Medicaid, managed care, and payer limits.
Educate patients, families, and professionals on HCFA regulations and payer requirements.
Identify opportunities to reduce cost without impacting quality.
Participate in collecting and recording data for utilization and QI reporting.
Work collaboratively with patients, families, physicians, staff, and agencies.
Required Qualifications
5+ years of nursing experience in varied clinical settings (home health, inpatient, physician office, clinic).
BLS certification issued within 30 days of hire.
Registered Nurse (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.
Preferred Qualifications
Experience with managed care and payer/provider requirements.
Case Management certification.
Bachelor’s of Science in Nursing.
All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.
INTEGRIS Health is an Equal Opportunity/Affirmative Action Employer.