RN Case Manager - Inpatient Rehab - PRN Days

About the position

INTEGRIS Health Southwest Medical Center, named the top hospital in the Oklahoma City metro by Newsweek, has a great opportunity for a RN Case Manager in Oklahoma City, OK. In this position, you'll work the day shift with our Jim Thorpe Rehabilitation team, providing exceptional care to those who have entrusted INTEGRIS Health with their healthcare needs. If our mission of partnering with people to live healthier lives speaks to you, apply today and learn more about our recently enhanced benefits package for all eligible caregivers, such as front-loaded PTO, 100% INTEGRIS Health paid short-term disability, increased retirement match, and paid family leave. We invite you to join us as we strive to be The Most Trusted Partner for Health.

Responsibilities

• 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.

Requirements

• 5 years experience in a variety of clinical settings (e.g. home health, inpatient, physician office, clinic) required.
• Experience with managed care and payer/provider requirements preferred.
• Current licensure as a Registered Nurse (RN) in the State of Oklahoma or current multistate license from a Nurse Licensure Compact (eNLC) member state.
• BSN preferred.
• Excellent interpersonal communication and collaboration skills.
• Computer experience required. Windows preferred.
• Current Case Management Certification preferred, at minimum attained within one year of hire (INTEGRIS Certified Case Management only).
• Current Driver's License issued by the state of Oklahoma.

Benefits

• Front-loaded PTO
• 100% INTEGRIS Health paid short-term disability
• Increased retirement match
• Paid family leave