OU Health

Academic health system delivering specialized care

Adult Case Manager, Registered Nurse - Emergency Dept

Medical, Clinical & VeterinaryUpdated on Nov 12

Full-timeOklahoma City, OK, USAIn-person

About the Job

Requirements

Level 1 requires an associate’s degree or higher in nursing and 0–3 years of nursing experience; care management experience is preferred.
Level 2 requires a bachelor’s degree in nursing and at least 3 years of care management experience.
Level 3 requires a bachelor’s degree in nursing and at least 5 years of care management experience.
A current Registered Nurse license issued by the Oklahoma State Board of Nursing or a current multistate compact Registered Nurse license (eNLC) is required.
Basic Life Support certification from the American Heart Association is required; it is required for the inpatient setting at Level 3.
The role requires expertise in regulatory requirements related to care management, knowledge of healthcare regulations including CMS guidelines, and understanding of utilization management principles.
The role requires proficiency with electronic health records and care management software.
The role requires strong communication, interpersonal, and leadership skills; organizational skills; assessment, critical-thinking, and problem-solving skills; and a commitment to continuous learning, quality improvement, and patient-centered care.
The role is safety-sensitive and subject to a zero-tolerance drug and alcohol standard under Oklahoma law.

Responsibilities

Conduct comprehensive assessments of patients’ health status, medical history, and ongoing care needs.
Develop individualized care plans with the interdisciplinary healthcare team, patients, and families to ensure continuity of care.
Educate patients and families about health conditions, treatment plans, medications, financial expectations, and self-care strategies.
Coordinate communication among patients, families, healthcare providers, and community resources to optimize patient-care outcomes.
Evaluate care-plan effectiveness and adjust plans as necessary.
Evaluate healthcare utilization patterns and identify opportunities to improve efficiency and cost-effectiveness.
Advocate for appropriate allocation of resources and services to meet patient needs while following regulatory guidelines and reimbursement criteria.
Collaborate with insurance providers, social workers, and other stakeholders to secure timely service authorizations and patient coverage.
Monitor and evaluate patient outcomes, healthcare processes, and care-delivery systems to identify areas for improvement.
Participate in quality-improvement initiatives and interdisciplinary care conferences to promote evidence-based practices and improve patient safety and satisfaction.
Ensure compliance with federal, state, and local regulations and accreditation requirements related to care management and patient care.
Implement strategies to minimize readmissions, prevent complications, and optimize care-planning processes.
Perform other duties as assigned.

Desired Qualifications

Care management experience is preferred for Level 1.

Position Title:

Adult Case Manager, RN - Emergency Dept

Department:

OUMC ED Care Management

Job Description:

New to OU Health? Ask your recruiter about our competitive wages and total rewards package, including a sign-on bonus and possible relocation assistance if you are located outside of 100 miles!

**This position may be filled as a Level 1, 2, or 3 depending on specific education, experience, and license requirements.**

AREA/SCHEDULE: Adult Emergency Dept / FULL TIME: 3x 12-hour shifts (36 hours) one week, then 3x 12-hour shifts & 1x 8-hour shift (44 hours) the next week. Every other weekend included.

Care Management RNs are accountable and responsible for coordinating the care and services of selected patient populations and ensuring the efficient utilization of healthcare resources. The primary responsibility of the role will be to assess, plan, implement, coordinate, monitor, and evaluate the options and services required to meet the healthcare needs of patients, while promoting quality outcomes and patient satisfaction.

Essential Responsibilities

Responsibilities listed in this section are core to the position. Inability to perform these responsibilities with or without an accommodation may result in disqualification from the position.

Conduct comprehensive assessments of patients' health status, medical history, and ongoing care needs. 
Develop individualized care plans in collaboration with the interdisciplinary healthcare team, patients, and their families to ensure continuity of care. 
Provide education to patients and their families regarding their health conditions, treatment plans, medications, financial expectations, and self-care strategies.
Coordinate and facilitate communication between patients, families, healthcare providers, and community resources to optimize patient care outcomes. 
Evaluate effectiveness of care plans and adjust as necessary. 
Evaluate healthcare utilization patterns and identify opportunities for improving efficiency and cost-effectiveness.
Advocate for appropriate allocation of resources and services to meet patients' needs while adhering to regulatory guidelines and reimbursement criteria. 
Collaborate with insurance providers, social workers, and other stakeholders to ensure timely authorization of services and coverage for patients. 
Monitor and evaluate patient outcomes, healthcare processes, and care delivery systems to identify areas for improvement. 
Participate in quality improvement initiatives and interdisciplinary care conferences to promote evidence-based practices and enhance patient safety and satisfaction. 
Ensure compliance with federal, state, and local regulations, as well as accreditation requirements related to care management and patient care.  
Implement strategies to minimize readmissions, prevent complications, and optimize care planning processes.

General Responsibilities

Performs other duties as assigned.

Minimum Qualifications (Level 1):

Education Requirements: Associate’s degree, or higher, in nursing required.

Experience Requirements : Minimum of 0 - 3 years Nursing experience required, with Care Management experience preferred.

License/Certification/Registration Requirements: Current Registered Nurse License (RN License issued by the Oklahoma State Board of Nursing, or a current multistate compact Registered Nurse (eNLC)). Basic Life Support from the American Heart Association required.

Minimum Qualifications (Level 2):

Education Requirements: Bachelor’s degree in nursing required.

Experience Requirements: At least 3 years of Care Management experience.

Minimum Qualifications (Level 3):

Education Requirements: Bachelor’s degree in nursing required.

Experience Requirements: At least 5 years of Care Management experience.

Knowledge/Skills/Abilities Required

Demonstrates expertise in regulatory requirements regarding the care management discipline. 
Strong communication, interpersonal, and leadership skills.
Detailed oriented with excellent organizational skills.
Commitment to fostering a culture of continuous learning, quality improvement, and patient-centered care.
Strong assessment, critical thinking, and problem-solving skills 
Strong knowledge of healthcare regulations, including CMS guideline 
Show clear understanding of utilization management principles and integrate these with care management responsibilities.
Serve as liaison between patients, families, and healthcare providers. 
Proficiency in utilizing electronic health records (EHR) and care management software.
Strong assessment, critical thinking, and problem-solving skills.

This is a Safety Sensitive position under 63 0.S. 427.8 and is subject to a zero-tolerance drug and alcohol standard in compliance with Oklahoma law.

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OU Health is an equal opportunity employer. We offer a comprehensive benefits package, including PTO, 401(k), medical and dental plans, and many more. We know that a total benefits and compensation package, designed to meet your specific needs both inside and outside of the work environment, create peace of mind for you and your family.

About the Company

OU Health

Academic health system delivering specialized care

OU Health is the flagship academic health system for Oklahoma, partnered with the University of Oklahoma, delivering advanced medical care for severe and life-threatening conditions. Its offerings come from a network of hospitals and specialists that use cutting-edge technology, clinical expertise, and research-driven practices to diagnose and treat patients, educate students, and train clinicians. OU Health differentiates itself through its status as Oklahoma’s academic health center, its collaboration with a major university, and a strong focus on inclusive culture, career development, and continuous improvement to provide compassionate, civil, and patient-centered care. The company aims to become Oklahoma’s destination of choice for healthcare, and to be Oklahoma’s Employer of Choice by attracting and retaining diverse talent who can contribute to innovative patient care and improved outcomes.

Company size: 1,001-5,000
Company stage: Grant
Total funding: $1.7M
Headquarters: Oklahoma City, OK
Founded: Not listed

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