Nurse Care Manager
Nurse Care Manager
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Job Posting Title
Nurse Care ManagerAgency
807 HEALTH CARE AUTHORITYSupervisory Organization
Population Care ManagementJob Posting End Date (Continuous if Blank)
May 19 2025Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.
Estimated Appointment End Date (Continuous if Blank)
Full/PartTime
Full timeJob Type
RegularCompensation
$65607.00 / annualJob Description
Agency/Division Information
The Oklahoma Health Care Authority (OHCA) works to ensure Oklahomans have access to better health and better care. The agencys core values include passion for purpose trust and transparency empowerment and accountability best in class and outcomedriven and servant leadership. As part of the interview process candidates may be required to attend an inperson interview at our Oklahoma City office.
Position Purpose
The Nurse Care Manager ensures that medically complex and special healthcare needs of SoonerCare members are effectively managed by coordinating access to medical care community resources and social services. This role involves conducting clinical reviews facilitating care management activities and collaborating with intra and interagency personnel to ensure program adherence to state and federal guidelines. Additionally the Nurse Care Manager supports the agencys mission by providing leadership in resolving member issues contributing to case management decisions and advocating for the needs of vulnerable populations while ensuring compliance with OHCA policies and program requirements.
Principle Activities May Include
Coordinate and facilitate access to medical care for medically complex/special health care needs members identified through various referral sources including selfreferrals provider referrals and other state agency referrals. Facilitate access to community resources and social service agencies within the parameters of the SoonerCare program.
Conduct clinical reviews and document Care Management activities utilizing the clinical case management system and other available tools. Complete level of care determinations and assessments for identified populations using standardized tools and processes. Prepare costeffectiveness statements reports and other necessary documentation.
Collaborate with intraagency and interagency personnel regarding policy and program issues related to Care Management. Participate in case staffing meetings and collaborate with other agency staff to ensure coordination of efforts. Provide testimony as requested for adjudication of administrative appeals.
Interface verbally and in writing with members families and providers to resolve issues. Act as a SoonerCare Care Management resource answering questions for OHCA personnel related to the complex special needs of identified members.
Work with internal and external QA processes to monitor program adherence to state and federal guidelines and contracts. Represent OHCA SoonerCare in public forums involving various stakeholder groups informational seminars and training sessions as assigned.
Evaluate appropriateness for healthcare services for identified clients and make recommendations for care plans based on established guidelines for the clients diagnosed condition.
Other duties as assigned.
Knowledge Skills Abilities and Competencies
The Nurse Care Manager requires indepth knowledge of healthcare policies clinical case management and community resource coordination along with the ability to communicate effectively with members providers and agencies. Strong problemsolving skills and strategic thinking are necessary for navigating complex healthcare systems ensuring compliance and advocating for members with special healthcare needs. The Korn Ferry competencies that best align with this role include Ensures Accountability (demonstrating ownership for program adherence and compliance) and Collaborates (working effectively with diverse internal and external stakeholders to provide comprehensive care management).
**To be considered for this position your application must include a resume/CV with complete work and education history.**
Education and/or Experience:
Possession of a valid permanent Oklahoma license as a registered nurse as approved by the Oklahoma Board of Nursing or Registered Nurse License recognized by the Enhanced Nurse Licensure Compact (eNLC)
AND
2 years of professional nursing experience.
Preference may be given to candidates with
Experience as an Exceptional Needs Coordinator Nurse Case Manager or Quality Assurance/Utilization Review Nurse
Advanced Healthrelated Education (e.g. MSN)
Experience with the Uniform Comprehensive Assessment Tool (UCAT)
Experience with aged blind or disabled population
Experience with Medicaid/SoonerCare
Related Professional Certifications (other than BLS/ALS/PALS)
Experience with MS Excel Access PowerPoint
Bilingual
Physical Demands:
Must be able to remain sitting for prolonged periods at a desk and working on a computer.
Must be able to move or lift up to 15 pounds at various times.
Work Environment:
The office work environment includes regular exposure to general office equipment such as computer equipment phones and copy machines.
Why Youll Love Working Here
At the Oklahoma Health Care Authority (OHCA) were proud to create a workplace where employees thrive. Named a Top Workplace in Oklahoma for five consecutive years this achievement reflects the dedication and collaborative spirit of our incredible team. Heres what we offer to support employees and their family:
Generous statepaid benefit allowance to offset insurance premiums.
A wide selection of toptier health insurance plans.
Optional flexible spending accounts for health care or dependent care expenses.
Employee Assistance Program (EAP) offering confidential support.
Wellness benefits including an onsite gym and fitness center discounts.
11 paid holidays annually.
15 vacation days and 15 sick days in your first year.
Retirement Savings Plan with substantial employer contributions.
Longevity Bonus to reward years of service.
Public Service Loan Forgiveness eligibility and reimbursement for educational expenses.
Professional development training opportunities including CEU support.
Accommodation Statement:
The Oklahoma Health Care Authority complies with applicable State and Federal civil rights laws and does not discriminate. All qualified applicants will receive consideration for employment without regard to race color sex religion disability age national origin or genetic information. If a reasonable accommodation is needed to participate in the job application or interview process to perform essential job functions and/or to receive other benefits and privileges of employment please contact the Civil Rights Coordinator at.
Notice to applicants:
Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.
Current State of Oklahoma employees must apply for open positions internally through WorkdayJobs Hub.
Equal Opportunity Employment
The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information race religion color sex age national origin or disability.
Current active State of Oklahoma employees must apply for open positions internally through the Workday Jobs Hub.
Required Experience:
Manager
Employment Type
Full-Time
