RN Case Manager - Oklahoma City, OK Job at Truhealth, Oklahoma City, OK

cFhpdmZPazc4Wksvb0RwVitYR29uTkZRQ1E9PQ==
  • Truhealth
  • Oklahoma City, OK

Job Description

This job is located in Oklahoma City, OK.

The RN Case Manager is primarily responsible for the daily management and support of the Case Management strategies for care coordination for a group of members who are associated with a Medicare Advantage plan. Visit (in person and/or telephonic) patients to ensure proper nursing care. Interview or correspond with physicians to correct errors or omissions and to investigate questionable claims. Consult and coordinate with health care team members to assess, plan, implement and evaluate patient care plans.

This position requires an individual who is a self-starter and team player, has the ability to manage multiple priorities, work with minimal supervision on assigned projects and activities, and demonstrates excellent communication and presentation skills. This individual must be able to adapt quickly to change and be able to collaborate with multiple teams

Here are a few of our benefits:

  • Annual performance wage increases
  • 401k retirement plan with a company match
  • Medical, dental and vision insurance
  • $50,000 basic life insurance – paid by the company
  • Paid time off
  • UKG Wallet – access your pay faster!
  • Holiday pay
  • Telehealth through 98point6 – free to all employees
  • Continuing Education opportunities
  • Career Advancement Opportunities

Qualifications/Requirements:

  • Minimum of 2 years of experience in clinical nursing or rehabilitation for the geriatric population.
  • 2-years managed care experience required.
  • Minimum of 3-5 years’ experience doing case management in a managed care environment preferably with a managed care organization or like facility, Preferred.

Essential Functions:

  • Complete Health Risk Assessments for members as assigned.
  • Initiate, update and/or revise care plans as needed.
  • Maintain a case load of patient as assigned.
  • Evaluates, coordinates, and plans patient care in collaboration with an interdisciplinary health team; reassesses and revises plans of care in collaboration with other members of the health care team.
  • Provides patient/family education based on identified learning needs utilizing available teaching resources
  • Provides education based on identified learning needs utilizing available teaching resources to members of the Home/Facility staff as needed.
  • Coordinates outpatient discharge planning based on patient needs, clinical circumstances and benefit coverage.
  • Participates in all Managed Care related audits; generates, maintains and tracks periodic and annual reports/documents via MS Office program, e-mails to support Care Coordination program.
  • Performs improvement projects involving development of monitoring/collection tools, review of medical records, data entry, analysis, and preparation of audit findings and reports.
  • Participates in patient care conferences, committee meetings, staff development and educational programs to increase or maintain professional competency.
  • Correctly applies medical management criteria.
  • Researches clinical questions from employers, members and payers as required.
  • Educate members on health access options.
  • Responds, manages, and resolves day-to-day problems presented in care coordination and communicates effectively with the Facility/Home.
  • Other duties as assigned.

Education:

  • Graduate of an accredited RN program.
  • Bachelor’s Degree preferred.

Licensure/Certifications:

  • Current license to practice as a register nurse in assigned state.
  • Current CCM license, Preferred
  • CPR for Healthcare Professionals certification.
  • Current valid driver’s license.
  • Current motor vehicle insurance.

 

Experience

Required
  • 2 year(s): Geriatric Care
Preferred
  • 2 year(s): Skilled Nursing

Licenses & Certifications

Required
  • Registered Nurse

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Job Tags

Full time,

Similar Jobs

Just Construction Recruitment

Security Project Manager Job at Just Construction Recruitment

 ...Job Description Were working with a leading Security Systems Integrator who is seeking an experienced Security Project Manager to oversee CCTV and Access Control installation projects across commercial and mission-critical environments. This is a great opportunity... 

Voodesk

Virtual Assistant Job at Voodesk

At Voodesk , we help businesses grow by powering their operations with world-class virtual supportdriven by talented people and smart technology. As a Virtual Assistant , youll play a key role in helping entrepreneurs, startups, and growing teams stay organized, productive... 

Actalent

Certified Compounding Pharmacy Technician Job at Actalent

 ...Job Description Job Description We are hiring for a Compounding Pharmacy Technician here in Columbus! This is a long-term career opportunity and we are looking for someone who is both Certified and has Compounding experience already. Please note: We are also hiring... 

Nurse First

Travel Cardiac Echo Sonographer Job at Nurse First

 ...Job Description Nurse First is seeking a travel Echo Technologist for a travel job in Mooresville, North Carolina. Job Description & Requirements ~ Specialty: Echo Technologist ~ Discipline: Allied Health Professional ~ Start Date: 12/15/2025~ Duration... 

Maxim Healthcare

LPN - Pediatric Vent - Private Duty Nursing Job at Maxim Healthcare

 ...Maxim Healthcare in Miami is hiring for a Licensed Practical Nurse (LPN) to work with Pediatric patients in their own homes. Why...  ...caregivers, employees and communities for more than 30 years. We offer private duty nursing, skilled nursing, physical rehabilitation, companion...