ZipRecruiter

Log In

1

Utilization Case Manager Jobs in Oklahoma (NOW HIRING)

ScionHealth

Case Manager II - PRN Days

Broken Arrow, OK · On-site

$19 - $25/hr

Follows patients throughout the continuum of care and ensures optimum utilization of resources ... Experience in case management, utilization review, or discharge planning a plus.

Corvel

Medical Case Manager I

Oklahoma City, OK

$63K - $95K/yr

As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...

Corvel

Medical Case Manager I

Oklahoma City, OK · On-site

$63K - $95K/yr

As a Medical Case Manager you will make a meaningful difference in the lives of injured workers and ... A cost containment background, such as utilization review or managed care is helpful * Strong ...

Corvel

Telephonic Case Manager I

Oklahoma City, OK · Remote

$63K - $95K/yr

The Case Manager communicates directly with treating physicians to evaluate and recommend ... Strong cost containment background, such as utilization review or managed care helpful

Corvel

Telephonic Case Manager I

Oklahoma City, OK · On-site

$63K - $95K/yr

The Case Manager communicates directly with treating physicians to evaluate and recommend ... Strong cost containment background, such as utilization review or managed care helpful

previous pagenext page

Showing results 21-40

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

Case Manager / RN Acute Care

Hillcrest Healthcare System

Tulsa, OK • On-site

Full-time

Medical, PTO

Re-posted 21 days ago

Job description

Join our team as a day shift, full-time, Acute Care Registered Nurse (RN) Case Manager in Tulsa, OK. 

 

Why Join Us?

Thrive in a People-First Environment and Make Healthcare Better

  • Thrive: We empower our team with career growth opportunities, tuition assistance, and resources that support your wellness, education, and financial well-being.
  • People-First: We prioritize your well-being with paid time off, comprehensive health benefits, and a supportive, inclusive culture where you are valued and cared for.
  • Make Healthcare Better: We use advanced technology to support our team and enhance patient care.

Get to Know Your Team:

  • Hillcrest Medical Center is a 656-bed hospital that includes The Alexander Burn Center, The Peggy V. Helmerich Women’s Health Center, Kaiser Rehabilitation Center, the latest technology for the treatment of cancer, and the Oklahoma Heart Institute.
  • The RN case manager is responsible for assessing and coordinating patient care across the continuum, utilizing accepted criteria and guidelines to manage benefits and determine the medical necessity of the services provided.
  • This position functions to achieve optimal clinical and quality outcomes by effectively managing care and resources to reduce unnecessary utilization.
  • The RN Case Manager reports to the Director of Case Management or designee.  

Job Requirements:

  • RN, Associates degree in nursing or higher

Preferred Job Requirements:

  • Two (2) years acute hospital-based nursing experience
  • Certification in case management (ACM or CCM)
  • Experience in acute care hospital case management
Qualifications:

Job Requirements:

  • RN, Associates degree in nursing or higher

Preferred Job Requirements:

  • Two (2) years acute hospital-based nursing experience
  • Certification in case management (ACM or CCM)
  • Experience in acute care hospital case management
Education:UNAVAILABLEEmployment Type: FULL_TIME

Apply