Registered Nurse Case Management

AccessHealth; Catoosa (OK); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Health insurance

Retirement plans

Paid time off

Professional development

Emotional support resources

Family support

Additional perks

Job summary

AccessHealth is hiring a registered nurse for a full-time case management role in a hospital setting. You will validate medical necessity, advocate for benefits, and coordinate safe transitions to reduce readmissions.

The role emphasizes maximizing organizational revenue through claims management, preventing denials, and ensuring compliance with clinical standards and regulations. A valid RN license and CCMC/ACM preferred are required or encouraged, with 5+ years RN and 3+ years in case

Qualifications

• Active RN license in good standing.
• Certification as CCMC or ACM preferred but not required.
• Minimum 5+ years as an RN and 3+ years in case management.

Responsibilities

• Validate medical necessity and coordinate patient-centered care.
• Advocate for benefits and manage appeals to maximize revenue.
• Coordinate safe transitions and reduce readmissions.
• Streamline hospital workflows and coordinate multidisciplinary teams.
• Ensure compliance with clinical standards and regulations.

Skills

Communication

Advocacy

Organization

Healthcare regulations

Education

RN license

CCMC/ACM certification preferred

Tools

EHR systems

Discharge planning software

Job description

Role Overview

This position is for a registered nurse in a full-time case management role within a hospital setting.

Responsibilities include ensuring patient-centered care by validating medical necessity, advocating for benefits, and coordinating safe transitions to reduce readmissions.

It involves maximizing organizational revenue through claims management, preventing denials, and managing appeals.

The role also focuses on streamlining hospital workflows, coordinating multidisciplinary teams, and ensuring compliance with clinical standards and regulations to mitigate risks.

Qualifications include a valid nursing license and a preferred certification as a Certified Case Manager (CCMC or ACM).

Minimum experience required is 5+ years as an RN and 3+ years in case management, with hospital discharge planning experience preferred.

Key skills involve strong communication, advocacy, and organizational abilities, along with knowledge of healthcare regulations.

Benefits encompass comprehensive health coverage, retirement plans, paid time off, professional development, emotional support resources, family support, and additional perks.

Equal opportunity employment policies are in place, and applicants are advised to be aware of fraud prevention measures during the hiring process.