Complex Care Manager - Emergency Dept (M-F)
On-siteOklahoma City, Oklahoma, United States
Oklahoma City, Oklahoma, United StatesOn-siteFull TimeEnterprise
Full TimeEnterprise
Job Summary
Conduct EMR reviews and patient interviews to assess and close clinical and non-clinical care gaps. Perform readmission reviews to reduce avoidable hospitalizations and manage denial cases by collaborating with physicians and payers. Facilitate complex discharge planning and analyze utilization metrics to identify trends and improve care strategies. Serve as a liaison between patients, families, and the interdisciplinary team to coordinate services and advocate for appropriate coverage. Work M-F in Downtown Oklahoma City, with a competitive wage package and relocation assistance for eligible candidates.
Required Qualifications
- Bachelor of Science in Nursing (BSN)
- Graduate of an accredited school of social work
- Master Social Worker (LMSW) under supervision or Licensed Clinical Social Worker (LCSW)
- Current Registered Nurse License (RN License issued by the Oklahoma State Board of Nursing, or a current multistate compact Registered Nurse (eNLC))
- Current Licensed Master Social Worker (LMSW) or under supervision for Licensed Clinical Social Work (LCSW) or LCSW from the Oklahoma State Board of Licensed Social Workers
- Basic Life Support from the American Heart Association
- At least 5 years Care Management experience
- 1 year in an acute or ambulatory care setting
- Professional demeanor
- Self-directed
- Ability to work as a member of a team
- Excellent verbal and written communication (including documentation) 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
- Clear understanding of utilization management principles
- Serve as liaison between patients, families, and healthcare providers
- Excellent organizational and project management abilities
- Knowledge and skill in chronic disease management
- Strong organizational and time-management
- Ability to assess, adapt, and calmly respond to changing and crisis environment
- Ability to facilitate patient access to community resources
- Proficiency in utilizing electronic health records (EHR) and care management software
- M-F, Downtown Oklahoma City
Desired Qualifications
- Master's degree, English major preferred
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