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Nurse Care Manager – RN

Job Description

  • Location: Oklahoma City, Oklahoma
  • Type: Contract
  • Job #19214

Job Title: Nurse Care Manager – RN
Location: Oklahoma City, Oklahoma
Schedule: Full-Time
Pay: $31.54 per hour
 
Job Overview
Act as a clinical nurse specialist to plan, develop and coordinate Care Management for identified members to ensure necessary access to providers and medical services in accordance with the SoonerCare programs. Interface with SoonerCare members, providers, advocacy groups, legislative representatives, other state agencies and OHCA staff to facilitate Care Management for those members. This may include high-risk obstetrics, at-risk newborns, children with special healthcare needs, women in need of treatment for breast/cervical cancer, members with long-term care needs, members with multiple chronic co-morbidities, and complex members requiring highly specialized medical care both in and out of state.
 
Qualifications

  • Current / Valid License as a Registered Nurse in Oklahoma AND
  • Minimum of 2 years full-time professional clinical experience with one year in an acute care setting
  • Previous experience as a Nurse Case manager or Quality Assurance / Utilization Review Nurse
  • High level of experience with the Microsoft Office Suite
  • Advanced Health-related Education is preferred
  • Experience with obstetrics, pediatrics, and / or disabled populations is preferred
  • Experience with Medicaid / SoonerCare is preferred

Responsibilities and Duties

  • Coordinate and facilitate access to medical care for medically complex/special health care needs members identified for Care Management through data mining, incident reports, intra-agency referrals, provider referrals, member self-referrals, legislative referrals, and other state agency referrals.
  • Identify, review, research, and facilitate removal of barriers to medically necessary care for persons with diverse and complex needs. Facilitate access to community resources/social service agencies within the parameters of the SoonerCare program.
  • Document Care Management activities utilizing the clinical case management system and/or other available tools. Interface verbally and in writing with members/families/providers to resolve issues.
  • Work with intra-agency and inter-agency personnel regarding policy and program issues/concerns related to Care Management of SoonerCare members.
  • Participate in case staffing meetings as requested by leadership.  Collaborate with other agency staff regarding members’ care to ensure coordination of efforts.
  • Provide testimony as requested for adjudication of administrative appeals.
  • Act as SoonerCare Care Management resource in answering questions for OHCA personnel related to the complex, special needs of identified members.
  • Work with internal and external QA processes/ personnel to monitor program adherence to state and federal guidelines and contracts.
  • Represent OHCA SoonerCare as needed in multiple public forums involving various stakeholder groups, as well as informational seminars and training forums, as assigned.
  • Other duties may be assigned.

Why Work for Galt Foundation
Galt Foundation is a non-profit staffing agency with the mission to provide, promote, and expand employment opportunities for individuals with disabilities. We give priority in hiring individuals with disabilities including medical, physical, and psychological conditions.

Galt has and will continue to create a better workplace – one in which employers have access to skilled and motivated workers, and people of all abilities can find meaningful, sustaining work.
A devoted and friendly team that is there to help you every step of the way in advancing your career.
 
Job Application Process
Galt Foundation utilizes online forms and electronic signatures throughout the hiring process. As an employer of people with disabilities, we understand assistance or accommodation may be required. Should you need to complete an application in-person at a Galt Foundation office, please email recruiting@galtfoundation.org. In-person assistance is available in Salem, Oregon and Oklahoma City, Oklahoma.

Note: Please allow five (5) business days to process your application.

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