Oklahoma Licensed Case Manager

Job Summary

A company is looking for a Case Manager - Utilization Review.

Key Responsibilities

• Conduct timely medical necessity reviews using medical coverage guideline criteria
• Present cases that do not meet clinical criteria to the Medical Director
• Communicate with payers to ensure timely clinical review submissions

Required Qualifications, Training, and Education

• Graduate from an accredited school of nursing required; Bachelor of Science in Nursing preferred
• Three years of clinical nursing experience in an acute care facility
• Current RN License issued by the Oklahoma State Board of Nursing or a multistate Compact RN License
• Experience with utilization review or case management preferred
• Case management certification preferred