About this role
Position Title:
Care Management RN (Levels 1-3) - Full time - Sooner Pediatric Clinic (M-F Days)Department:
OUHP Population Health (inactive)Job Description:
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This position may be filled as a Level 1, 2, or 3 depending on specific education, experience, and license requirements.
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 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 certification 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.
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 certification from the American Heart Association required.
Minimum Qualifications (Level 3):
Education Requirements: Bachelor’s degree in nursing required.
Experience Requirements: At least 5 years of Care Management experience.
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 certification from the American Heart Association required.
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.
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Other facts
About OU Health
At OU Health, we take pride in serving Oklahoma as a destination of choice for treating severe and life-threatening conditions. We are uniquely positioned as Oklahoma's flagship academic health system in partnership with the University of Oklahoma.
Join us in inspiring hope and making a meaningful impact. You can be part of something greater than yourself, whether you’re a nurse, physician, student, or in another support role.
Why OU Health?
- Inclusive Culture: A workplace where everyone belongs.
- Career Development: Opportunities for growth and advancement.
- Innovation and Excellence: Encouraging innovative thinking and continuous improvement.
We are proud to serve Oklahoma with advanced technology and expert care, leading with compassion, civility, and inclusion. Our values push us forward in our journey to become Oklahoma’s Employer of Choice.
Be part of a community that values your unique skills and perspectives. Together, we can make OU Health the destination of choice for the healthcare needs of all Oklahoman’s.
What you'll do
- Care Management RNs are responsible for coordinating care and services for selected patient populations, ensuring efficient healthcare resource utilization. They conduct assessments, develop care plans, provide education, and advocate for patients' needs.
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