Nurse Care Manager

Recruitment #220628-UNCY-116

Introduction

This position is open ONLY to OHCA Staff and/or Contractors.

Nurse Care Manager

POSITION REQUIREMENTS:
To provide telephonic health coaching and support for at risk members with chronic health conditions via motivational interviewing, behavior modification techniques, disease self-management education and goal setting to improve health related outcomes.

PRINCIPLE ACTIVITIES:
- Coordinate and facilitate access to medical care to address the medically complex/special health care needs members appropriate for Care Management identified through member self-referrals, provider referrals, targeted high risk groups and other state agency referrals.
- Review, research, identify and effectuate removal of barriers to medically necessary care for persons with diverse and complex needs. Facilitate care with community resources/social service agencies within the parameters of the SoonerCare program.
- Document Care Management needs of identified members and activities performed to meet those needs. Utilize clinical case management system to ensure documentation and facilitate communication regarding member’s needs within the OHCA organization. Interface verbally and in writing with members/families/providers to resolve issues.
- Coordinate with other care management programs to resolve issues/concerns related to Care Management of SoonerCare members.
- Advise and participate in Health Care Systems Innovation and unit staff meetings.
- 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.

WORK HOURS: Adherence to work hours established for this position will allow for flexibility at the discretion of the supervisor or unit director.  It is expected that an inability to attend on any given day due to illness etc., will prompt a telephone call to the supervisor in a timely manner.  Request for annual leave will be submitted in writing with adequate advance notice to enable appropriate unit staffing (excluding emergency situations).

ACCOMMODATION STATEMENT:
The Oklahoma Health Care Authority complies with applicable 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 405-522-7335.

MINIMUM QUALIFICATIONS

KNOWLEDGE AND BACKGROUND REQUIREMENTS
QUALIFICATIONS:
To perform this job successfully, the individual must be able to perform each essential duty satisfactorily. 

The requirements listed below are representative of the knowledge, skills, and/ or ability required
A current R.N. Nursing License is required.

EDUCATION AND EXPERIENCE:
- Current/valid license as a Registered Nurse in Oklahoma AND
- Minimum of two (2) years full time professional clinical experience with one year in an acute care setting
- No substitution for the RN license

PREFERENCE MAY BE GIVEN TO CANDIDATES WITH:
- Experience as an Exceptional Needs Coordinator, Nurse Case Manager or Quality Assurance/Utilization Review Nurse

- Advanced Health-related Education (e.g. MSN)

- 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

NOTES

Please read instructions carefully and include all required documents when you submit your application.

No additional information will be accepted after the application has been submitted.