RN Care Manager - Adult Services - PRN

RN Care Manager

INTEGRIS Health Decisions, Oklahoma's largest not-for-profit health system, has a great opportunity for a RN Care Manager in Oklahoma City, OK. In this position, you'll be a part of our Decisions team providing exceptional work supporting the INTEGRIS Health caregivers and the community at large. 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.

Job Description

• Responsible for the clinical and financial outcomes for an assigned caseload of patients.
• Facilitate patient care during hospitalization by managing, coordinating, and monitoring resource utilization to achieve optimal clinical outcomes and financial goals.
• Proactively plan, coordinate, and negotiate efficient patient movement throughout the continuum of care.
• Function in the role of clinician, educator, researcher, manager, and advocate to serve the best interests of the system and patient.
• Assess patients from clinical, social, and financial perspectives and coordinate post-discharge needs with the care team.
• Function as a clinical and financial resource for patients and interdisciplinary team members.
• Assist in clinical data collection utilizing established criteria and the InterQual system.
• Proactively perform utilization review; communicate coverage information with third-party payers, medical staff, and clinical providers.
• Lead age and developmentally appropriate patient education groups to address the emotional, physical, and environmental needs of Behavioral Health and/or Addiction Recovery patients.
• Participate in the writing of treatment plans with other program staff and physicians.
• Assist in the utilization review process by contacting patients' insurance companies to provide clinical information to authorize patient treatment.
• Serve as a patient advocate in addressing patients' needs and those of individuals involved with the patient.
• Complete or facilitate the completion of Emergency detention paperwork and ensure its distribution and receipt by legally designated individuals.
• Process orders/refills or laboratory requests for ordering physicians.
• Monitor patients' medications and provide education related to use and side effects.
• Monitor vital signs as indicated by physician orders or if deemed medically necessary.
• Provide referral options for patients who are assessed but do not enter the program.
• Complete a comprehensive Initial Mental Health Assessment of patients' clinical, psychological, and financial needs utilizing all available resources.
• Attend and participate in treatment team meetings.

Requirements

• 5 years of experience in a variety of clinical settings (i.e., 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.

Working Conditions

Potential exposure to infectious diseases, potential physical danger from disturbed/irate patients and families. Emotional stress due to inability to control volume or timing of referrals and necessity to respond to a wide variety of demands and expectations from patients, families, physicians, and other health care professionals. Occupational exposure to bloodborne pathogens and other infectious materials as defined by OSHA. This position may have additional or varied physical demand and/or respiratory fit test requirements. Please consult the Physical Demands Project SharePoint site or contact Risk Management/Employee Health for additional information.