Hybrid Remote Case Manager- Utilization Review Coordinator (RN) – Oklahoma

Job Overview

  • Clinical License RN
  • State(s) OK

Full job description

Overview:

ONE TEAM. ALL HEART. At Oklahoma Heart Hospital (OHH), patient care is at the heart of everything we do. This physician owned hospital was designed by cardiologists to ensure that patients receive expert, individualized care with utmost comfort. OHH offers a competitive benefits program to all team members from the first day of employment.

Top Tier Benefit Packages:
  • Medical, Dental, and Vision
  • 401 (k) plan
  • Paid Time Off (PTO)
  • Extended Medical Benefit (EMB)
Location: North Campus- 4050 W. Memorial Road, OKC OK 73120
Shift: Full-Time, Days
Hybrid/ Remote 90% of time, probability of coming in 1-2 times per month.

Responsibilities:

Responsible for comprehensive coordination of care and service of individual patients and/or patient populations, promoting effective utilization of resources, and assuming a leadership role on the multidisciplinary team to achieve patient and physician satisfaction and optimal outcomes. Responsible for all activities associated with the clinical documentation improvement program and Utilization Review process. Must be able to work with all disciplines to meet patients’ needs from admission through discharge. Will perform duties and responsibilities in a manner consistent with the mission and values of the Oklahoma Heart Hospital.
Performs admission review to assure patient is placed in correct level of care and concurrent or focused reviews using Medicare and payer specific criteria.
Demonstrates an ability to identify cases where admission criteria not met. Contacts physicians for additional information and suggests alternatives if admission/continued stay is not appropriate
Knowledgeable on inpatient, observation and outpatient criteria
Knowledgeable of billing, payer contracts, agreements and reimbursement issues for services provided to OHH patients.

Qualifications:

Education: Graduate of an accredited school of nursing. Bachelors or Master’s degree a plus.

Experience:
 Minimum of three (3) years hospital based nursing practice with experience in utilization/case management. Willing to pursue certification in Case Management (CCM) or CCDS (Certified Clinical Documentation Specialist). Proficient in computer usage.

Licensure/Certification:
 Registered Nurse with current Oklahoma licensure.

Every team member at OHH plays an integral role in our patients’ experience. They are the reason OHH continues to serve the state and lead the nation. Be part of the future of cardiac care.

Learn more
 about diversity at Oklahoma Heart Hospital.

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