RN Care Manager – Days
INTEGRIS Health
full-time
Posted on:
Location Type: Remote
Location: Oklahoma • United States
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About the role
- Assess patient from clinical, social, financial perspective and coordinates post-discharge needs with care team.
- Functions as a clinical and financial resource for patients and interdisciplinary team members.
- Assists in clinical data collection utilizing established criteria and the InterQual system.
- Proactively performs utilization review; communicates coverage; Information with third party payers, medical staff and clinical providers.
- The Case Manager reports to the Director of the Case Management Services.
- The Case Manager meets established deadlines, attends required in-services, maintains staff competencies and completes required documentation; collaborates and works as a team player with all disciplines; presents a professional image to all customers and patients.
- Required to be on call as scheduled by the department.
- Potential exposure to infectious diseases, potential physical danger from disturbed/irate patients and families.
- Emotional stress due to inability to control volume of timing of referrals and necessity to respond to a wide variety of demands and expectations from patients, families, physicians, and other health care professionals.
- Occupational exposure to bloodborne pathogens and other infectious materials as defined by OSHA.
- This position may have additional or varied physical demand and/or respiratory fit test requirements.
Requirements
- 5 years' experience in a variety of clinical settings (i.e., home health, inpatient, physician office, clinic) required.
- Experience with managed care and payer/provider requirements preferred.
- Current licensure as a Registered Nurse (RN) in the State of Oklahoma or current multistate license from a Nurse Licensure Compact (eNLC) member state. BSN preferred.
- Excellent interpersonal communication and collaboration skills.
- Computer experience required. Windows preferred.
Benefits
- front-loaded PTO
- 100% INTEGRIS Health paid short-term disability
- increased retirement match
- paid family leave
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical data collectionutilization reviewInterQual systemmanaged carepayer/provider requirements
Soft Skills
interpersonal communicationcollaborationteam playerprofessionalismstress management
Certifications
Registered Nurse (RN)BSN