Top 17 Utilization review nurse Jobs in Tinker Afb Ok

RN Case Manager - Utilization Review
INTEGRIS Health —Oklahoma City, OK
- Full-time
- Nursing
- RN License
- Hospital
- Health insurance
- Paid time off
Quick Apply
10d
RN-Community Care Coordinator, Nursing Operations
US Veterans Health Administration —Oklahoma City, OK
- $75,016 - $139,502 a year
- Online Application
- Background check
- Nursing
- Doctoral degree
- Paid holidays
- Dental insurance
RN Case Manager - Utilization Review Part Time
INTEGRIS Health —Oklahoma City, OK
- Part-time
- Nursing
- RN License
- Hospital
- Health insurance
- Paid time off
Quick Apply
6d
RN Case Manager - Baptist Case Management
INTEGRIS Health —Oklahoma
- Full-time
- Nursing
- RN License
- Hospital
- Health insurance
- Paid time off
Quick Apply
1d
Senior Review Coordinator (Oncology) - Utilization Management (RN)
Telligen —Oklahoma City, OK
- Email
- Hybrid work
- Nursing
- RN License
- Research
Quick Apply
Part-time RN Nurse Navigator - Meinders Center for Movement Disorders
Mercy —Oklahoma City, OK
- Part-time
- Nursing
- RN License
- Hospital
- Health insurance
- Dental insurance
Complex Care Manager - Readmissions
OU Health —Oklahoma City, OK
- Full-time
- Nursing
- RN License
- Hospital
- Relocation assistance
- Health insurance
LPN Medical Records Specialist
A Path of Care Home Health —Oklahoma City, OK
- Full-time
- Nursing
- Mid-level
- Office
- Paid holidays
- Disability insurance
Quick Apply
3d
Case Manager (SW / RN) PRN
SSM Health Rehabilitation Hospital – Oklahoma City —Oklahoma City, OK
- $40 an hour
- Weekends as needed
- Hospital
- Inpatient
- Mid-level
- Opportunities for advancement
Quick Apply
Registered Nurse (Weekend Supervisor
Midwest City Post Acute & Rehab —Oklahoma City, OK
- $38 - $42 an hour
- Part-time
- Nursing
- Patient monitoring
- RN License
Quick Apply
8d
RN Case Manager - South Case Management
INTEGRIS Health —Oklahoma City, OK
- Full-time
- Nursing
- RN License
- Hospital
- Health insurance
- Paid time off
Quick Apply
10d
RN Case Manager - Integris Edmond
INTEGRIS Health —Edmond, OK
- Full-time
- Nursing
- RN License
- Hospital
- Health insurance
- Paid time off
Quick Apply
Utilization Management Coordinator
Saint Francis Hospital, Inc. —Oklahoma City, OK
- Part-time
- Microsoft Word
- LMFT
- Nursing
Quick Apply
2d
Medicaid Medical Review RN (Medical Reviewer III)
CoventBridge Group —United States
- $78,000 - $85,000 a year
- Full-time
- Remote
- Nursing
- Microsoft Excel
- RN License
- Paid holidays
- Disability insurance
2d
Utilization Management Reviewer
Amerihealth Caritas —United States
- Full-time
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Paid holidays
- Health insurance

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RN Case Manager - Utilization Review

INTEGRIS Health -
Oklahoma City, OK

Quick Apply

Job Details

Full-time
10 days ago

Benefits

Health insurance
Paid time off

Qualifications

Computer operation
RN License
Managed care organization experience
Computer literacy
Health insurance knowledge
Bachelor of Science in Nursing
Bachelor's degree in nursing
Computer skills

Full Job Description

Join our team as a day shift/variable, full time, RN Case Manager - Utilization Review, at INTEGRIS Baptist Medical Center, 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.

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

Completes a comprehensive assessment of patients clinical, psychological and financial needs utilizing all available resources.
Recommends and coordinates timely transfers to appropriate levels of care as indicated by clinical needs and utilization criteria.
Develops, implements, evaluates and revises, as necessary, a plan for discharge, including referrals to other health care and community organizations based on needs assessment.
Communicates discharge care plan, and any changes in the plan to patient, family and all appropriate healthcare professionals.
Assists physicians and hospital staff in appropriate utilization of resources through application of utilization criteria and facilitating timely discharge planning for patients.
Coordinates services between hospital departments to facilitate timely patient discharge.
Conducts concurrent review of patient records on admission to the hospital and as determined by the patient's clinical condition.
Applies utilization criteria accurately in order to determine appropriate utilization of resources.
Notifies designated internal and external contacts of utilization issues that may affect patient care and/or reimbursement.
Facilitates patient transfers to other health care organizations in accordance with hospital policies and all-applicable state and federal guidelines and regulations.
Acts as a resource/advisor to physicians regarding discharge planning, medical record documentation, and all issues that may affect resource utilization and reimbursement.
Integrates and manages established pathways, where available, to enhance clinical effectiveness and clinical resource management.
Maintains knowledge and understanding of CMS regulations, Medicare/Medicaid, managed care and other payer regulations and benefit limits.
Acts as a resource and provides education for patients, their family members and all health care professionals regarding HCFA regulations, Medicare, Medicaid, managed care and other payers.
Develops and maintains knowledge and understanding of hospital and community resources, and facilitates use of most appropriate level of care to conserve patient, hospital, and payer resources.
Identifies opportunities to reduce cost of managing patient care without impacting quality or outcomes.
Participates in collecting and recording data for utilization and Quality Improvement reporting. * Works collaboratively and professionally with patients, family members, and physicians, hospital staff and other individuals and agencies involved in providing patient care.

REQUIRED QUALIFICATIONS

EXPERIENCE:

2 years experience in a clinical settings (e,g. home health, inpatient, physician office, clinic)

LICENSE/CERTIFICATIONS:

BLS (Basic Life Support) Issued by American Red Cross or American Heart Association within 30 days of hire
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

SKILLS:

Excellent interpersonal communication and collaboration skills
Computer experience

EXPERIENCE:

Experience with managed care and payer/provider requirements

EDUCATION:

Bachelor's of Science in Nursing

LICENSE/CERTIFICATIONS:

Case Management Certification

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.

INTEGRIS Health mission: Partnering with people to live healthier lives.

To our patients, that means we will partner to provide unprecedented access to quality and compassionate health care. To you, it means some of the state's best career and development opportunities. With INTEGRIS Health, you will have a genuine chance to make a difference in your life and your career.

INTEGRIS Health is the state's largest Oklahoma-owned health system with hospitals, rehabilitation centers, physician clinics, mental health facilities and home health agencies throughout much of the state.

Quick Apply

Refine Your Search

utilization review nurse jobs in tinker afb ok

RN Case Manager - Utilization Review

RN-Community Care Coordinator, Nursing Operations

RN Case Manager - Utilization Review Part Time

RN Case Manager - Baptist Case Management

Senior Review Coordinator (Oncology) - Utilization Management (RN)

Part-time RN Nurse Navigator - Meinders Center for Movement Disorders

Complex Care Manager - Readmissions

LPN Medical Records Specialist

Case Manager (SW / RN) PRN

Registered Nurse (Weekend Supervisor

RN Case Manager - South Case Management

RN Case Manager - Integris Edmond

Utilization Management Coordinator

Medicaid Medical Review RN (Medical Reviewer III)

Utilization Management Reviewer

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