Pediatric Complex Care RN Case Manager

Oklahoma Children's Hospital; United States; On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

PTO

401(k)

Medical plan

Dental plan

Relocation assistance

Job summary

OU Health is seeking a Case Manager RN for the Pediatric Complex Care team in Downtown Oklahoma City. The role focuses on coordinating care for high-need pediatric patients, conducting EMR reviews and patient interviews, and closing gaps in care to improve outcomes.

The ideal candidate has strong clinical judgment, care coordination expertise, and a patient-centered approach, with duties spanning collaboration with physicians, nurses, and other teams to reduce unnecessary utilization.

Qualifications

• BSN required for nurses.
• LMSW or LCSW under supervision for social work role or LMSW/LCSW licensure.
• Basic Life Support (BLS) required.

Responsibilities

• Conducts EMR reviews and patient interviews to close care gaps.
• Performs readmission reviews to reduce avoidable hospitalizations.
• Reviews medical necessity in denial cases with physicians and payers.
• Facilitates complex discharge planning and transitions of care.
• Analyzes utilization, processes, and outcomes metrics for improvement.

Skills

EMR reviews

Care coordination

CMS guidelines

Communication skills

Teamwork

Problem solving

EHR proficiency

Education

BSN required

LMSW/LCSW (supervised)

Tools

Care management software

EHR systems

Job description

OU Health is seeking a Case Manager RN for the Pediatric Complex Care team in Downtown Oklahoma City. The role focuses on coordinating care for high-need pediatric patients, conducting EMR reviews and patient interviews, and closing gaps in care to improve outcomes.

The ideal candidate has strong clinical judgment, care coordination expertise, and a patient-centered approach, with duties spanning collaboration with physicians, nurses, and other teams to reduce unnecessary utilization.