Remote RN Case Manager — Utilization Review (PRN)

OU Medicine, Inc.; Oklahoma; Hybrid; USD 90,000 - 110,000; Part time

Benefits offered by this job

PTO

401(k)

Medical and dental plans

Job summary

OU Health in Oklahoma is seeking a Case Manager, RN - Utilization Review, for PRN coverage. The RN CM evaluates medical necessity, secures authorizations, and collaborates with payors, patients, and interdisciplinary teams to ensure appropriate hospital stays and care.

This remote role allows work from approved states. Requirements include a Bachelor's in Nursing, a minimum of 3 years of nursing experience (care management preferred), and an active RN license in OK or a compact license.

Qualifications

• Bachelor's Degree in Nursing required.
• At least 3 years of nursing experience; care management preferred.
• Current RN license (OK or multi-state compact) required.

Responsibilities

• Conduct comprehensive assessments using evidence-based criteria.
• Coordinate with payors, patients, and families to ensure appropriate status and reimbursement.
• Educate patients and families about the hospitalization and status in compliance with regulations.
• Facilitate communication among patients, providers, and payors for timely authorizations.
• Lead care management meetings and participate in quality improvement initiatives.

Skills

Regulatory knowledge

Communication skills

Leadership

Problem-solving

HIPAA compliance

Education

Bachelor's Degree in Nursing

Tools

EHR software

Job description

OU Health in Oklahoma is seeking a Case Manager, RN - Utilization Review, for PRN coverage. The RN CM evaluates medical necessity, secures authorizations, and collaborates with payors, patients, and interdisciplinary teams to ensure appropriate hospital stays and care.

This remote role allows work from approved states. Requirements include a Bachelor's in Nursing, a minimum of 3 years of nursing experience (care management preferred), and an active RN license in OK or a compact license.