RN Case Manager - Days

INTEGRIS Health; Oklahoma City (OK); On-site; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking a dedicated RN Case Manager to join their Case Management team in Oklahoma City. This full-time role involves providing exceptional care and managing patient outcomes through effective resource utilization and coordination. The ideal candidate will have extensive clinical experience, strong communication skills, and a passion for patient advocacy. Join a forward-thinking organization committed to enhancing the health and well-being of the community, offering competitive compensation and a comprehensive benefits package designed to support their caregivers. If you are ready to make a difference in patients' lives, this opportunity is for you.

Benefits

Front-loaded PTO

100% Paid Short-term Disability

Increased Retirement Match

Paid Family Leave

Qualifications

• 5+ years of experience in various clinical settings required.
• Current RN licensure in Oklahoma or multistate license preferred.

Responsibilities

• Completing comprehensive assessments of patients’ needs.
• Coordinating timely transfers to appropriate levels of care.
• Educating patients and families on discharge care plans.

Skills

Interpersonal Communication

Collaboration Skills

Clinical Assessment

Resource Utilization

Patient Advocacy

Education

Registered Nurse Licensure in Oklahoma

BSN

Current Case Management Certification

Tools

Windows

Job description

INTEGRIS Health Southwest Medical Center, Oklahoma’s largest not-for-profit health system, has a great opportunity for a RN Case Manager in Oklahoma City, OK. In this position, you’ll work 8a-5p, full-time, with our Case Management team providing exceptional care to those who have entrusted INTEGRIS Health with their healthcare needs. If our mission of partnering with people to live healthier lives speaks to you, apply today to learn more about our increased compensation plans and recently enhanced benefits package for all eligible caregivers, including front-loaded PTO, 100% INTEGRIS Health paid short-term disability, increased retirement match, and paid family leave. We invite you to join us as we strive to be The Most Trusted Partner for Health.

The Case Manager is responsible for the clinical and financial outcomes for an assigned caseload of patients. The role involves facilitating patient care during hospitalization, managing, coordinating, and monitoring resource utilization to achieve optimal clinical outcomes and financial goals. The Case Manager proactively plans, coordinates, and negotiates efficient patient movement throughout the continuum of care, functioning as a clinician, educator, researcher, manager, and advocate to serve the best interests of the system and patient. Adherence to National Patient Safety Goals is required based on patient contact level.

Qualifications

• 5 years experience in various clinical settings (e.g., home health, inpatient, physician office, clinic) required.
• Experience with managed care and payer/provider requirements preferred.
• Current licensure as a Registered Nurse (RN) in Oklahoma or a multistate license from a Nurse Licensure Compact (eNLC) member state.
• BSN preferred.
• Excellent interpersonal communication and collaboration skills.
• Computer experience required; Windows preferred.
• Current Case Management Certification preferred, attained within one year of hire (INTEGRIS Certified Case Management only).
• Current Driver's License issued by Oklahoma.

Responsibilities

The RN Case Manager's responsibilities include, but are not limited to:

• Completing comprehensive assessments of patients’ clinical, psychological, and financial needs using all available resources.
• Recommending and coordinating timely transfers to appropriate levels of care based on clinical needs and utilization criteria.
• Developing, implementing, evaluating, and revising discharge plans, including referrals to other healthcare and community organizations.
• Communicating discharge care plans and changes to patients, families, and healthcare professionals.
• Assisting physicians and hospital staff in resource utilization and facilitating timely discharge planning.
• Coordinating services between hospital departments for timely patient discharge.
• Conducting concurrent reviews of patient records and applying utilization criteria to determine resource use.
• Notifying relevant contacts of utilization issues affecting patient care or reimbursement.
• Facilitating patient transfers in accordance with policies and regulations.
• Advising physicians on discharge planning, documentation, and resource utilization.
• Managing pathways to enhance clinical effectiveness and resource management.
• Maintaining knowledge of CMS regulations, Medicare/Medicaid, managed care, and payer regulations.
• Educating patients, families, and healthcare professionals on relevant regulations and benefits.
• Identifying opportunities to reduce costs without impacting quality.
• Participating in data collection for utilization and quality improvement.

Mental Health Specific Responsibilities

• Leading age-appropriate patient education and recreational groups for mental health and chemically dependent patients.
• Documenting daily group activities and facilitating discharge planning.
• Participating in treatment team meetings and developing patient care plans.
• Assisting in utilization review and advocating for patients’ needs.
• Developing and executing marketing strategies for program services.
• Handling emergency detention paperwork and providing therapy and medication education.
• Monitoring vital signs and assessing admission appropriateness.

INTEGRIS Certified Case Management Specific Responsibilities

• Timely documentation and communication of patient progress.
• Managing evolving schedules for patient care.
• Acting as a liaison between patients, providers, and the organization.

Additional Notes

Other responsibilities include leading patient education groups, participating in treatment planning, assisting with utilization review, and ensuring compliance with regulations. The position reports to various managers depending on the department and requires the ability to assist with physical restraints, handle physical and emotional demands, and be on call as scheduled. All applicants will receive consideration regardless of protected status.