Part Time Utilization Review Jobs in Oklahoma (NOW HIRING)

Join our team as a day shift, part time, RN Case Manager, at INTEGRIS Health South Medical Center, in Oklahoma City, OK.

Get to Know Your Team:

• INTEGRIS Health, Oklahoma's largest not-for-profit health system, is seeking a dedicated caregiver to join us in our mission to partner with people to live healthier lives.  

• Benefits of being an INTEGRIS Health caregiver include front-loaded PTO, medical benefits through the extensive INTEGRIS Health network, financial assistance for continued education, 24/7 mental health support and more.  

• Take the first step toward growing your career by joining us.  

REQUIRED QUALIFICATIONS

EXPERIENCE:

• 5 years experience in a variety of clinical settings (i.e., home health, inpatient, physician office, clinic)

LICENSE/CERTIFICATIONS:

• RN (Registered Nurse) Current licensure as a Registered Nurse (RN) in the State of Oklahoma or current multistate license from a Nurse Licensure Compact (eNLC) member state
• BLS (Basic Life Support) Issued by American Red Cross or American Heart Association within 30 days of hire

SKILLS:

• Excellent interpersonal communication and collaboration skills
• Computer experience

PREFERRED QUALIFICATIONS

EXPERIENCE:

• Experience with managed care and payer/provider requirements
• Experience with Windows

EDUCATION:

Bachelor's of Science in Nursing 

INTEGRIS Health is an Equal Opportunity Employer. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.

The RN Case Manager responsibilities include, but are not limited to, the following:

• Assesses 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.

For INTEGRIS Decisions Only:

• Leads age and developmentally appropriate patient education groups to address the emotional, physical and environmental needs of Behavioral Health and/or Addiction Recovery patients.
• Participates in the writing of treatment plans with other program staff and physicians.
• Assist in utilization review process by contacting patients insurance companies to provide clinical information to authorize patient treatment.
• Serves as a patient advocate in the patients needs, as well as those individuals involved with patient.
• Completes or facilitates the completion of Emergency detention paperwork, as well as ensure its distribution and receipt by legally designated individuals.
• Processes orders/refills or laboratory for ordering physician.
• Monitors patients medications and provide education related to use and side effects.
• Monitors vital signs as indicated by physician orders or if deemed medically necessary.
• Provides referrals options for patients who are assessed, but do not enter the program.
• Completes a comprehensive Initial Mental Health Assessment of patients clinical, psychological and financial needs utilizing all available resources.
• Attends and participates in treatment team.

The Case Manager reports to the Director of the Case Management Services.

The Case Manager meets established deadlines, attends required inservices, 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. 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. Please consult the Physical Demands Project SharePoint site or contact Risk Management/Employee Health for additional information. All applicants will receive consideration regardless of membership in any protected status as defined by applicable state or federal law, including protected veteran or disability status.