ZipRecruiter

Log In

1

Utilization Case Manager Jobs in Oklahoma (NOW HIRING)

Encompass Health

Case Manager

Broken Arrow, OK · On-site

$17.50 - $22.50/hr

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...

Encompass Health Corporation

Case Manager

Broken Arrow, OK · On-site

$17.50 - $22.50/hr

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...

Encompass Health

Case Manager

Broken Arrow, OK · On-site

$17.50 - $22.50/hr

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...

Healthcare Scouts

Hospital Case Manager

Tulsa, OK · On-site

Responsible for all case management activities assignedm, including case management and utilization management * The Case Manager provides concise management of patients hospitalization from pre ...

Dulyhealthandcare

The Case Manager is responsible for increasing efficient utilization of health care services; identifying chronic or catastrophic cases through the case management process and initiating intensive ...

next page

Showing results 1-20

All JobsUtilization Case JobsUtilization Case Manager JobsUtilization Case Manager Jobs in Oklahoma

Utilization Case Manager information

What is a utilization case manager?

A Utilization Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient cases, coordinate with healthcare providers, and ensure that treatments are in line with established guidelines and insurance requirements. Their goal is to optimize patient outcomes while managing costs and ensuring compliance with regulations. Utilization Case Managers often work in hospitals, insurance companies, or managed care organizations.

What are the key skills and qualifications needed to thrive as a utilization case manager?

To thrive as a Utilization Case Manager, you need a background in nursing or social work, strong analytical skills, and a solid understanding of healthcare regulations and insurance processes, often supported by RN licensure or certification in case management (e.g., CCM). Familiarity with utilization management software, electronic health records (EHRs), and payer authorization systems is essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration among patients, providers, and payers. These skills ensure appropriate care delivery, cost management, and compliance with healthcare standards.

How does a utilization case manager typically collaborate with healthcare providers and insurance companies?

Utilization Case Managers play a key role in coordinating care between healthcare providers and insurance companies. They review patient cases to ensure that the recommended treatments are medically necessary and align with insurance policies. This often involves regular communication with doctors, nurses, and insurance representatives to gather information, clarify treatment plans, and advocate for appropriate patient care. Strong collaboration skills are essential, as Utilization Case Managers must balance the needs of patients with organizational guidelines while maintaining positive professional relationships.

What is the difference between Utilization Case Manager vs Utilization Review Nurse?

AspectUtilization Case ManagerUtilization Review Nurse
CredentialsRN license, case management certificationRN license, certification in utilization review
Work EnvironmentCase management teams, hospitals, insurance companiesUtilization review departments, hospitals, insurance providers
Primary FocusCoordinating patient care, discharge planning, resource allocationAssessing medical necessity, reviewing patient records for appropriateness
Common UsageBroader case management roles, patient advocacySpecific review of medical necessity and insurance claims

While both roles require RN licensure and focus on patient care, the Utilization Case Manager primarily coordinates overall patient services and discharge planning, whereas the Utilization Review Nurse concentrates on evaluating the medical necessity of treatments for insurance purposes. Understanding these distinctions helps in choosing the right career path or job search focus.

What degree do I need for utilization case manager?

Utilization case managers typically need at least a bachelor's degree in healthcare, social work, nursing, or a related field. Some positions may prefer or require a master's degree or relevant certifications, such as Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ).

What are popular job titles related to Utilization Case Manager jobs in Oklahoma?

For Utilization Case Manager jobs in Oklahoma, the most frequently searched job titles are:

What job categories do people searching Utilization Case Manager jobs in Oklahoma look for?

The top searched job categories for Utilization Case Manager jobs in Oklahoma are:

What cities in Oklahoma are hiring for Utilization Case Manager jobs?

Cities in Oklahoma with the most Utilization Case Manager job openings:

Utilization Case Manager jobs near you

Registered Nurse Case Manager PRN

USPI, INC.

Oklahoma City, OK • On-site

Other

This job post has expired today. Applications are no longer accepted.

United Surgical Partners International rating

5.3

Company rating: 5.3 out of 10

Based on 16 frontline employees who took The Breakroom Quiz

Job description

Registered Nurse Case Manager PRN

Community Hospital is hiring a PRN Registered Nurse Case Manager!

We're offering an exciting opportunity to work alongside a dedicated, compassionate team – where you are valued just as much as the patients we serve. At Community Hospital, we are guided by our CARES values where Compassion is required, Attitude is valued, Respect is demanded, Excellence is expected and Service is commended. Come be a part of a place where your hard work is recognized, your goals are supported, and your impact matters.

The RN Case Manager is 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 in the multidisciplinary team to achieve patient and physician satisfaction and optimal outcomes. Must be able to work with all disciplines to meet patient needs from admission through discharge.

Essential Functions:

  • Provides case management services to patients according to policy and procedure.
  • Ability to take direction from others and follow through in a concise manner, which also promotes efficiency.
  • Ability to communicate well with patients, families, co-workers, etc.
  • Ability to set priorities.
  • Acts to protect and advance patient's best interest.
  • Maintains knowledge of billing, payor contracts, agreements and reimbursement issues.
  • Satisfactorily demonstrates the knowledge, skills and abilities to perform the duties outlined in this job description as well as continually demonstrates competency in performing the job duties.

Qualifications:

  • Current Licensure with the Oklahoma State Board of Nursing
  • B.S. in Nursing or related health field preferred but not required.
  • Minimum of three years hospital based nursing practice prefer experience in utilization/case management.
  • BLS for Healthcare Providers required within 30 days of hire.

What United Surgical Partners International employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply